A Win for Healthcare Protection State by State

Affordability Health Care Ideas and Issues

            Bradford         There’s a sure but steady victory being engineered by progressives on a state-by-state basis that is worthy of deep analysis and solid celebration.  What’s especially sweet is the fact that’s is a case of the people exercising their will over the opposition of their elected officials in a pure and simple demonstration of the difference between how democracy works as opposed to gerrymandered representation systems.

I’m talking about healthcare and more particularly the decade old US Affordable Care Act, which extended coverage to millions during the Obama administration.  Ten years ago, the Supreme Court ruled that the ACA was legal, but that states had the authority to decide whether to allow their people to get coverage, once again facilitating their program of assisting in the creation of two Americas, one bluish and the other reddish and privileging representation over the peoples’ will.  Some states, like Arkansas, very red on the color chart, signed up on a hybrid basis.  Others like Louisiana, also rosy, came in with a Democratic governor muscling past a Republican legislature.  All these states, like the famous expression about families, are unhappy in different ways.

As recently as 2019, there were nineteen state holdouts, but now the number is down to a dozen.  As the New York Times points out, it has taken the power of the people through the initiative referendum process to whittle the number down.

In 2017, Maine voters rebuked their Republican governor, Paul LePage, by passing an expansion initiative, though it took the election of a Democrat, Gov. Janet Mills, to put it in place. In 2018, Idaho, Nebraska and Utah — all states that Mr. Trump had won handily two years earlier — passed ballot measures as well. So did Missouri and Oklahoma in 2020.

Coming up in days may be the seven state to overcome gubernatorial and legislative opposition, another red state of the West, South Dakota, where polls indicate, the measure is favored to pass.  You would think with this kind of track record that Republicans would be getting the message that they are way out of step with what their people want, especially given the experience of the pandemic and now the troubling economic forecasts.  Maybe they are? The Republican governor in South Dakota, who is desperate to be seen as a national star and seemed at one point almost ready to agree with Trump’s narcistic request for a place on Mount Rushmore, says despite her opposition, if the voters approve the expansion, she’ll implement it.  You’d think implementing the will of the people would be automatic, but, sadly, there’s too much evidence to the contrary.

The driving force behind these efforts and these victories has been the Fairness Project, created in 2015 as a c4 nonprofit, largely with resources from SEIU’s Healthcare Union West and the advocacy by its president, Dave Regan, of initiative strategies in California and elsewhere to impact change.  The Project has been active on minimum wage increase efforts as well as ACA expansion votes and claims a record of eighteen wins on nineteen efforts.

Sure, this road now gets even harder.  Of the remaining twelve, only three states, South Dakota, Wyoming, and Florida, allow referendum votes and Mississippi just lost the ability to go this route. The Fairness Project is targeting North Carolina next.  ACORN has won minimum wage increases in Florida, but it’s expensive and the legislature has made these efforts much harder to get on the ballot, but I hope it stays on the list.  It’s worth doing whatever we can for Beto O’Rourke in Texas, but the horror of Greg Abbott as governor in Texas seems likely to continue.

Nonetheless, the benefits to working and lower-income families of these progressive efforts has been incalculable.  The lesson continues to be that when we do the work and take these issues to the people, we win.