THIS TIME ON CODE WACK!
As millions of Americans face losing their health coverage, what can single-payer advocates do right now to protect our care and push for something better? What’s truly at stake for our country—and especially for its most vulnerable residents?
To find out, we spoke to Michael Lighty, president of the Healthy California Now coalition and former healthcare constituency director for the Bernie 2020 campaign.
SHOW NOTES
WE DISCUSS
What can we do to support single payer despite the hostile political climate under Trump?
“The most important thing we can do now is fight against these federal Medicaid cuts … “
“I mean, people say, ‘oh, well, the work requirement, you know, well, I understand that.’ Well, actually, the work requirement is cruel and horrific in its own way because it’s a job loss penalty. The reason that Medicaid exists is when you lose your job, you can qualify for Medicaid. If you can’t qualify for Medicaid unless you’re working, what happens when you’re unemployed through no fault of your own, right? So it’s a job loss penalty. Some folks call it the MAGA murder budget because that’s what’s going to happen…
“Millions of people in this country are gonna lose health care because of this budget. And in California, people who currently have coverage are going to lose it, period. And we’re gonna have less money for healthcare services. So that’s the fight.
“And we got to hold Republican legislators responsible for that. We’ve got to put pressure on Republicans in swing districts, and we’ve got to make sure that Democrats hold the line and are saying things. You don’t hear a lot of Democrats criticizing the work requirement, but they should. So that fight is really the immediate task. ” – Michael Lighty
Why do you think Democrats haven’t been more vocal in speaking out against the Medicaid work requirement?
“When you’ve got the second highest leader in the Senate, Dick Durbin from Illinois, saying he’s fine with it, that’s chilling….
“I think [some Democrats] believe it’s somehow popular because it’s like, ‘Well, yeah, people should work.’ Well, if you believe that Medicaid is a welfare program, I guess you can make that argument ’cause that’s what the Clinton welfare reform did, was establish work requirements for welfare.
“But Medicaid isn’t a welfare program. It’s a healthcare program and a healthcare program that is designed for people… like only about 7% of people who are eligible for Medicaid who could work don’t. So this is a very small problem.
“When they imposed [work requirements] in Arkansas and Georgia, it cost more than it saved. And it threw hundreds of thousands of people in those states off of Medicaid and people who were eligible. The biggest effect of work requirements is that people can’t fill out the paperwork. So you don’t fill out the paperwork, you lose your health care and [the government] saves money. Oh, well that’s, that’s like the perfect, you know, MAGA program.… “ – Michael Lighty
So it sounds like they’re trying to save money but actually by imposing work requirements, Medicaid will cost more?
“They’re just calling it waste, fraud and abuse … the waste fraud and abuse, by the way, are the profits that the managed care organizations so-called “earn” through administering Medicaid benefits. Like 90% or 95% of benefits nationally through Medicaid are administered by these for-profit, private managed care organizations. That’s where the waste, and that’s where the fraud is actually.
“California clawed back $5 [billion] to $7 billion from these organizations who had overcharged and been over reimbursed. So that’s where the fraud and waste is. So if you wanna eliminate something, eliminate that.
“These Republicans think that Medicaid is a public program and it is publicly financed, but it is privately administered for the benefit in part or in large part for for-profit health insurance companies. And then they’re like, like the Wall Street Journal [says] ‘… oh, people are just pushing back on Medicaid because the left sees this as a precursor to Medicare for All.’
It’s like, ‘no, we don’t <laugh>. We don’t see universal health care as simply a program for private insurance companies to make more money.’
And as good as the Affordable Care Act was, that’s what it did, right? It increased the profits of the health insurance companies. So no, the privatization of Medicaid, like the privatization of Medicare is the opposite of what we want. ” – Michael Lighty
Helpful Links
5 Key Facts About Medicaid Work Requirements, KFF
How National Medicaid Work Requirements Would Lead to Large-Scale Job Losses, Harm State Economies, and Strain Budgets, The Commonwealth Fund
Work Requirements Might Cut Medicaid Spending. But at What Cost?, KFF
Increasingly Privatized Public Health Insurance Programs in the US, JAMA Network
Medicaid Privatization: Has the Invisible Hand Led Us Astray?, The American Journal of Clinical Oncology
Episode Transcript
Read the full episode transcript.
Biography: Michael Lighty
Michael Lighty, President, Healthy California Now, has organized, advocated and developed policy for single-payer, Medicare for All nationally and in California for over 30 years.
He is a founding Fellow of the Sanders Institute, and most recently, he was the Healthcare Constituency Director for Bernie 2020.
Formerly he was director of public policy for the California Nurses Association/ National Nurses United. He was lead policy analyst, a leader of Campaign for a Healthy California and testified on behalf of the single-payer bill, SB 562.
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