Featuring Michael Lighty, a founding Fellow of the Sanders Institute, who has organized, advocated and developed policy for single-payer Medicare for All nationally and in California for nearly three decades. Most recently, he was the healthcare constituency director for Bernie 2020.
Listen to the podcast!
Click the arrow in the circle (below left).
What are the prospects for Medicare for All under President-elect Joe Biden’s tenure given his stated opposition to it? What steps can we expect the federal government to take to address healthcare inequities? What about reform efforts within the states? Michael Lighty, founding fellow of the Sanders Institute and former healthcare constituency director for Bernie 2020, and host Brenda Gazzar discuss how Biden’s presidency might affect federal and state efforts to win Medicare for All.
Does a Biden White House spell the end of Medicare for All?
—– TRANSCRIPT —–
(10-second Talk back music)
Welcome to Code WACK!, your podcast on America’s broken healthcare system and how Medicare for All could help. I’m your host, Brenda Gazzar.
What are the prospects for Medicare for All for the country and for state-based efforts under a Biden presidency?
Who better to ask than Michael Lighty, whose organized, advocated and developed policy for single-payer Medicare for All nationally and in California for nearly three decades. He’s a founding Fellow of the Sanders Institute. Most recently, he was the healthcare constituency director for Bernie 2020.
Welcome to Code WACK!, Michael.
Lighty: Oh, thank you, Brenda, it’s great to be back.
Q: I wanted to ask you about Joe Biden. What does Joe Biden’s presidential election mean for the national Medicare for All movement?
Lighty: I guess I would be a little bit on the optimistic side, I mean he did kind of make a point, particularly in the last month of the election, saying he didn’t support Medicare for All. So we can’t be naive about where his stance lies. But, on the other hand, if you look at the pandemic, they want to do something immediately to give people health care, the Health Care Emergency Guarantee Act embodies key principles of Medicare for All covering everybody, no out-of-pocket expenses, filling the gaps you know where where people are uninsured like in Medicaid expansion. So I think in the context of that discussion, the Guarantee Act looks very attractive.
Secondly, this is an administration that will feel compelled to allow states to set up single-payer systems, through the provision of 1332 of the Affordable Care Act, which grants the federal government the ability to provide waivers for states to do universal health care. So robust applications like from California, New York for those waivers would very likely succeed. So a lot of the efforts go to the state level.
And then finally, under the Unity Task Force that was established between the Sanders and Biden campaigns, they came up with a very robust version of a public option. It is to put everyone who earns under $54,000 into Medicare. It’s focused on the states that didn’t expand Medicaid, and you would do that again on a basis of no out-of-pocket expenses for those families of four. So you look at that terrain and you say, okay, we’re not going to make a leap forward. I guess he’s not prepared to sign you know H.R. 1384, but you do have openings that are consistent with a publicly administered, publicly financed system. And of course you have the agitational value of saying, what you’re going to do is leave 10 million people uncovered? You’re going to spend all this money subsidizing the profits of a rapacious and denial-based healthcare industry, and you’re still not solving the problem. We have a solution.
Q: What does Biden’s election mean for state-based efforts like in California, in the state of Washington and in New York?
Lighty: I’ve been in touch, you know, with those folks in the different states and I think there is a sense of real momentum, because the Trump administration has essentially allowed the states to do whatever the hell they want. They instituted Medicaid work requirements, which were ultimately ruled illegal. They’ve expanded short term association health plans. They’ve done a bunch of other stuff. And so the precedent is established for great flexibility at the federal level, to enable state, what’s called state innovation.
And I’ve kind of looked at the regs and so forth that govern it and a waiver can be initiated by the governor or the legislature, provided they have, you know, the means to actually carry it out, and that changes the equation from whether single payer to how. And that’s what we need. We need leadership from Governor Newsom. In New York it’s going to come from the legislature — I don’t think it’s going to come from Governor Cuomo. Inslee, maybe harder to read, but clearly there’s real support in the legislature in the state of Washington. So you look at who is going to initiate it, who sets it up as a question of how we’re going to implement it, and then the debate changes at the state level.
There is no excuse for California, where three quarters or more of the state legislature are Democrats, when Democrats in California support this reform by three quarters percent, like 75%. So the politics are right, the policy is clearly right because you’re not going to get to universal coverage anyway, and you’re not going to control costs. We estimate, just looking at recent work that was done by William Hsiao, and also brought up by Cindy Young, the president of Health Care Now, we think the savings, $80 billion — 80 billion — retiree health liabilities between the private and public sector are $174 billion. Those will be taken care of by the present system. You’re looking at potentially $250 billion.
Part of it goes back to the state budget for education and other services say, housing, and part of it goes back to private sector employers who can turn that — and we can require that they turn that over — to wages. We need to focus on a profound fiscal quality of life, and bottom line budget for business, and peace of mind for workers, security for workers, all that can be achieved at the state level through a publicly administered and finance system if we get the waivers from the federal government to really start the process and put the legislators on the spot. So first we need the governor to move, and we need the legislators to step up and solve this problem and save that kind of money. They’re talking about, you know, deficits of $25 billion by 2025 in the state budget. This reform solves that problem.
Q: Thanks so much, Michael.
Find more Code WACK! episodes at ProgressiveVoices.com and on the PV app. You can also subscribe to Code WACK! wherever you find your podcasts. This podcast is powered by HEAL California, uplifting the voices of those fighting for healthcare reform around the country. I’m Brenda Gazzar.
_________________________________________________________________________________
HEAL California is an independent news and information hub focused on the Medicare for All movement.
With non-partisan news, views, podcasts and videos, we highlight the on-going injustices of our broken healthcare system and amplify the voices of those who are most impacted by it.
Our Podcasts shine a light on the failures of America’s healthcare system, while explaining how Medicare for All could help.
Our Media page offers connections to experts and additional resources including links to legislation and studies.
Keep up with the Medicare for All movement!
Follow us on Facebook and Twitter, and subscribe for email updates.
