Health Reform Markup Action: Support State Single-Payer Waiver Amendments

I participated in a Progressive Democrats of America (PDA) single-payer conference call last night, facilitated by PDA’s National Director, Tim Carpenter, and featuring reports by Donna Smith of the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC) and Katie Robbins of Healthcare Now!.

I’ll cut straight to the action point: Bernie Sanders, who sits on the Senate HELP (Health, Education, Labor, & Pensions) Committee, and Dennis Kucinich, who sits on the House HELP subcommittee, are offering amendments to their committees’ respective health reform bills to allow waivers permitting states to enact and apply federal funds toward their own single payer programs. Whatever form the federal legislation finally takes, such state programs cannot move forward without specific language in the federal bill permitting it.

Whether or not you’re simultaneously fighting for a robust public option, I urge you to contact Senators and Representatives on these respective committees, especially if they represent your state or district, to insist that state single-payer waiver language be included in the bills.

The major single payer organizations have not given up on straight-up advocacy for national single payer; in my view, this activism continues to push the debate in a salutary direction. Realistically, however, if single payer can’t happen on a national basis, states that want it should at least be allowed to enact it for themselves. As Donna Smith noted on the call, single payer is a civil-rights movement that remains, right now, in the "lunch counter stage." And Katie Robbins noted that public option advocacy — for all its deficiencies — really "stands on the shoulders" of the many years of single payer activism that preceded it.

The California legislature has already passed a single-payer bill twice, twice terminated by you-know-who. Imagine California leading the way on single payer the way it’s pushed the envelope beyond federal requirements on auto emissions and greenhouse gases.

The push to ensure that state single payer waiver language be included in federal reform legislation has been active for a while. I’ll close with the text of a Dear Colleague letter on this matter sent in April by Reps John Conyers, Dennis Kucinich, and Eric Massa:

April 9, 2009

Dear Colleague:

As the effort to reform health care gathers momentum, states have taken it upon themselves to enact their own reforms out of desperation to increase qualiiy, provide care for the uninsured and underinsured, and reign in uncontrolled cost increases. Many have turned to the model proven to meet those goals inside and outside the U.S.: the single payer model.

In last three years, the California State legislature has twice passed a single payer bill. Pennsylvania, Colorado, Illinois, Montana, New York, Washington, and Minnesota are also home to single payer bills with strong grassroots movements behind them. Unfortunately, if the bills were to pass, federal barriers would need to be overcome. ERISA could preempt the states from enacting their own health care reform. Waivers would need to be granted that would allow the states to redirect the federal funds they currently receive for health care. Federal financial assistance, if necessary, could also be imperative.

Enabling the states to meet their own needs would be a strong compliment to a national health care reform plan. Please join us in calling for language that allows the states to impliment a single payer plan if they so choose.

Dennis J. Kucinich
John Conyers, Jr.
Eric Massa

[sic X 2 for "reign" and "compliment"]

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