WASHINGTON—With wide backing from unions and citizens groups, and majority public support, the House Progressive Caucus formally unveiled its comprehensive Medicare For All legislation. Solons also promptly targeted the villains in the fight for single-payer government-run health care: U.S. health insurers and the big drug companies.
Those interests, Medicare For All backers declared, “put profits before people” and that must stop.
Surrounded by more than 100 backers at a Feb. 27 outdoor Capitol Hill press conference, from National Nurses United (NNU), the Center for Popular Democracy and Our Revolution, a parade of lawmakers, led by caucus co-chair Pramila Jayapal, D-Wash., pitched the fight over the new legislation, HR1384, in human, justice and financial terms.
They said it would save people money they now pay on health insurers’ co-pays, deductibles, and out-of-pocket costs, save businesses money they fork over to the insurers for declining coverage for their workers, and save U.S. health care spending by letting doctors and nurses treat patients before their conditions worsen.
“Thirty people die every day in America because they lack health care coverage,” said one backer, Robert Weissman, president of Public Citizen. After 150 hearings and events NNU held nationwide, the union concluded “people across this country want real reform, now,” said union Executive Director Bonnie Castillo.
“For all the people suffering from illness in the U.S., this (legislation) is for you,” Jayapal said.
The measure has more than 100 House co-sponsors already. Besides NNU, initial union backers include the Coalition of Labor Union Women, the Teachers (AFT), the Labor Campaign for Single Payer, the Amalgamated Transit Union, the Postal Workers, and the Flight Attendants-CWA.
Other union backers include the Brotherhood of Maintenance of Way Employees-Teamsters, the Theatrical and State Employees, the Professional and Technical Engineers, the National Union of Healthcare Workers, the New York State Nurses Association, the Service Employees, the United Electrical Workers and, for the first time ever, the Machinists.
“We know we must take this on now,” AFT President Randi Weingarten declared at the press conference. “Health care costs have become an issue in every collective bargaining agreement for two decades – and an issue in the recent teachers’ strikes.”
And unions can’t solve it on their own because the insurers have too much power, she added. Even when Weingarten headed a New York City union coalition bargaining with city officials over contracts, they couldn’t cap costs because of the insurers’ clout.
“This is a failure of the health care system,” she said.
“It is past time to shift the health care burden off hard-working families by streamlining our health care system, instead of padding the pockets of the insurance companies,” said IAM President Robert Martinez in a statement.
Jayapal called the union support “unprecedented,” even though a prominent past backer, the Steelworkers, isn’t on the list yet. Nor is the AFL-CIO, which included single-payer in its health care initiatives endorsements at its last convention, in St. Louis.
HR1384 would replace the private insurance industry and its 33 percent overhead share of the nation’s health care spending – along with its high co-pays, deductibles and cost-shifting to workers — with a government-run system that covers far more people and far more procedures than Medicare does. There would be a 2-year phase-in period involving Medicare growth.
Reproductive rights coverage would be guaranteed and dental, vision, mental health, primary care and guaranteed total payment for hospital care would be added to the coverage mix.
And HR1384 would eliminate the high deductibles, rising co-pays and high health insurance cost-shifting by employers that now plague both the present health care payment system and the country. Firms now unload health care costs on their workers, if they cover the workers at all. Weingarten noted the Auto Workers were forced to take over health care costs when GM and Fiat-Chrysler went broke during the Great Recession.
The U.S. spends 19 percent of its gross domestic product on health care, far more than any other developed nation, “and has some of the worst outcomes” for all that money, Jayapal said. They include finishing dead last among developed nations in maternal health and infant mortality and declining longevity.
Meanwhile, the health insurers walked away with $43 billion in profits last year and insurance company CEOs raked in millions of dollars each in salary and bonuses, she said. All because they and Big Pharma “put profits before people.”
“First of all, we cover everyone,” Jayapal declared. That’s in contrast to 30 million uninsured – including a ban, in the Affordable Care Act, on covering undocumented people – and 40 million underinsured.
And while the ACA added millions of people to coverage – 330,000 in Cook County, Ill. alone, said Rep. Chuy Garcia, D-Ill. — too many people, several speakers said, are one serious illness, or one illness of a family member, away from health-care-cost-caused bankruptcy.
Even people supposedly covered by the present system are still stuck with thousands of dollars in out-of-pocket costs. Jennifer Epps-Addison, executive director of the Center for Popular Democracy, told the crowd she usually doesn’t use her own story to illustrate problems, but she would here: Her husband, who has had multiple sclerosis for three years, is covered by CPD’s health insurance.
It costs $850 a month for their family. But it still leaves them paying out of pocket $500 monthly for his medicines, and leaves him battling their insurer over the phone to get it to cover new treatments for MS his physicians want to use. The insurer consistently refuses, she said. That sticks the family with the bill. “We are one job change away from risking my husband’s life,” the mother of three added.
For many other families nationwide, Epps-Addison and other speakers said, the situation is worse: They must choose between rent and medicine, between food and co-pays for doctors’ appointments. And they find themselves skipping appointments or cutting pills in half to save money.
Castillo told the group that nurses take an oath both to care for and to advocate for their patients, but the health insurance industry gets in the way. The Affordable Care Act, which Democratic President Barack Obama pushed through Congress nine years ago – over vitriolic hatred from the GOP – only partially solved the problem.
And when congressional Republicans failed in 62 attempts to repeal the ACA, the GOP turned to Republican President Donald Trump to dismantle it administratively. So “half-measures won’t do,” Castillo said.
But while single-payer has wide public support, it also faces determined opposition from the health insurers, who have already launched a multi-million-dollar scare campaign against it, from the GOP, which calls it “socialism” and from the radical right. The health insurers don’t even like a “compromise” to set up a government-run system alongside their firms – and let consumers and companies choose their coverage option.
Business is split, with some firms, including three at the press conference, backing it as a way to help their employees, save themselves money and increase their competitiveness against firms, foreign and domestic, who don’t have to shoulder health care costs. The domestic competitors don’t offer health insurance; the foreign firms, in nations with single-payer, don’t have to.
Some congressional Democrats are on board, either. Some support a more-limited option, such as extending Medicare’s coverage down to people aged 50 or older, or the alternative plan that sets up the government-run system side by side with the private insurers.
And one person in the audience held up a hand-made sign imploring four of Connecticut’s five representatives, all Democrats, to support the single-payer bill. The one not on the sign: Rep. Jahana Hayes, D-Conn., a first-year lawmaker, union member and former National Teacher of the Year. Hayes made single-payer a key campaign plank in her win in the Danbury-Waterbury 5th District last year.
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