THIS TIME ON CODE WACK!
Today, we’re talking about rising healthcare costs and the renewed momentum behind Medicare for All. Recent polling shows majority support for the idea across Democrats, independents, and even a notable share of Republicans, even when voters are told it would replace most private insurance and require higher taxes.
As premiums, deductibles, and out-of-pocket costs continue to climb, healthcare affordability is once again at the forefront of the political debate. To help us unpack what’s driving this support and whether it represents a real political opportunity, we’re joined by longtime healthcare advocate and policy strategist Michael Lighty, president of Healthy California Now and former healthcare constituency director for the Bernie 2020 campaign. This is the first of two episodes with Michael Lighty.
Check out the Transcript and Show Notes for more!
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SHOW NOTES
WE DISCUSS
Recent polling shows about 65% of likely voters support Medicare for all. Even when people are told it would replace most private insurance and involve higher taxes, about 63% still supported it. What is driving that support?
Lighty: “Primarily the cost of health care, because … if they have an individual plan through the Affordable Care Act exchanges, or if they have employer coverage, which is still the majority of people, or if they’re on Medicare … all of those programs are experiencing significant price increases…”
“… the broad general experience is people having to pay more for what, at times, is patchy or inadequate coverage, and that’s the best case scenario.
“ Then there are folks who can’t afford any insurance … [or] … who are substantially underinsured with high out-of-pocket costs like deductibles, where you have to … pay out of your pocket before you get any coverage at all.
“So you just look at that whole … broad experience and no matter what kind of coverage you have, unless you’re in a very elite position it’s gonna cost you more.”
So how can Medicare for All supporters take advantage of this broad support? Does it suggest a political strategy, or is it just temporarily tied to the current health insurance affordability crisis?
Lighty: “It definitely suggests a political strategy … And you can tell <laugh> that that’s the case because there’s an article in Politico – always a reliable source of establishment political analysis and reporting – which says, ‘oh, the Democrats have an advantage on health care because it’s all about extending the ACA subsidies or not.’ And so therefore, ‘Let’s not muck it up with a demand for Medicare for All.’
“So that tells you that the establishment, the corporate Democrats, the centrist Democrats, the geniuses at the Democratic Party who brought us Trump 2.0 are now saying we can’t advocate for Medicare for All. … that is an indication that a political strategy is what is necessary…
“… potentially … we could set the table for the 2028 presidential primary on the Democratic side with significant victories by pro-Medicare for all candidates for the Senate.”
Turning to California — you worked hard to pass Senate Bill 770, which Governor Newsom signed in 2023. Can you explain why it was such an important step and how it relates to the California Nurses Association’s CalCare bill? And what about next steps?
Lighty: “… we have had experience trying to pass an omnibus single-payer bill [like CalCare] through the state legislature and getting a governor signature, you know, for a couple decades. Certainly I have been personally involved in efforts over the last 20 years…. let’s see if we can take an alternative approach.
“… the system that, for example, CalCare describes is the system we want in general. There are policy particulars that we can debate over, and there’s political viability of certain approaches. But fundamentally, a publicly financed, publicly administered system as CalCare sets up, is our objective – that guarantees healthcare to everybody, eliminates financial barriers to care and takes the insurers … out of the system.
“Now, SB770 sets out a set of policy parameters and priorities and institutes essentially a process where stakeholders can work with the governor’s office and the Department of Health Care Services to come up with approaches to achieve that objective.
“It’s called unified financing. It’s another term for single-payer.
“And you can evaluate these different policy approaches in terms of equity, quality and cost. And so the idea was, ‘okay, let’s, let’s go through this process, have extensive community and stakeholder engagement where advocates for a full blown single-payer program can play a prominent role, put that before the legislature, get a waiver authorization from them, and then go to the federal government and talk about what they’re willing to support.’ Obviously, [right now] we don’t have a federal government who’s willing to have that conversation.
“ … [Meanwhile] everything we can do to put forward the demand for a guaranteed healthcare system that’s publicly financed and that eliminates the insurance companies is effective politically. Right. It’s effective to inoculate voters on the lies that the commercial insurance and healthcare industry will tell about single-payer. It’s important to educate the legislators about the advantages of that approach. And it’s a way to organize our supporters and reach out because the point of SB770 was ‘let’s engage people … and organizations particularly … who support single payer, but have not been engaged fully in the fight to pass single-payer bills.’”
Helpful Links
Michael Lighty, The Sanders Institute
Dem’s unity hits a Medicare-For-All wall, Politico
Why Your Health Insurance Costs Will Soar in 2026, Money
Looming affordability crisis set to hit Americans with health insurance through work, Politico
Medicare for All Household Savings Calculator
California law signals ongoing push for single-payer system, Roll Call
California Seeks Federal Waivers for Unified Health Care Financing, Physicians for a National Health Program
Episode Transcript
Read the full episode transcript.
Guest Biographies: 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 he was the Healthcare Constituency Director for Bernie 2020. He is a consultant for the National Union of Healthcare Workers.
Most recently, he co-wrote and was a leader in the successful campaign to enact CA SB 770. He worked for 25 years for the California Nurses Association/ National Nurses United, including as the director of public policy.
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