When kids turn two or three years old, they learn to tell what is called a “primary lie,” which is lying without much sophistication or awareness of how the listener will perceive the lie (hint: you completely failed to fool your parents). But when we turn four, we learn to tell “secondary lies,” which take into account the listener’s likely reaction, and are more plausible. When we turn seven or eight we learn to tell “tertiary lies,” where we also make sure our lie is consistent with surrounding facts. But not until you’ve asked your legislator to support Medicare for All have you experienced the apex of deception: you walk out knowing they didn’t agree with you, but you’re not sure if they disagree with you, or whether you’ve learned anything about their position on the issue! So today we are here to talk about “legislative pushback,” or evasion, or avoidance – basically the whole playbook of tactics that legislators employ to land between “yes” and “no.”
We are joined by Eagan Kemp and Vinay Krishnan today. Eagan is the Health Care Policy Advocate at Public Citizen. He is an expert in health care policy, including single-payer systems, and he previously served as a senior policy analyst at the U.S. Government Accountability Office.
Vinay Krishnan is the National Field Organizer for the Center for Popular Democracy. We know him as an organizer, but he’s also a writer of fiction and non-fiction, and an attorney based in Brooklyn, NY.
Medicare for All bills have not yet been introduced in the 118th Congress, the session that began in January 2023. Healthcare-NOW and our allies are starting our drive to gather co-sponsors BEFORE those bills are introduced. We expect the Medicare for All Act to be reintroduced before June in the House, and hopefully around the same time in the Senate.
We aren’t as dumb as Fox News conservatives like to make us seem, so we know that there isn’t a great chance to pass M4A this session, but it’s important to keep the momentum going by getting new cosponsors on the bill. Our past success in gaining co-sponsors has been due in large part to citizen lobbyists asking, pressuring and demanding their elected officials sign on.
If you’ve never called your Senator or member of Congress, we have a guide! https://www.healthcare-now.org/makethecall. Some calls will be easy if you’re lucky enough to be represented by die-hards like Senator Bernie Sanders (I-VT) and Representative Pramila Jayapal (D-WA-7), the chief sponsors of the bills. But for many of the rest of us, our elected officials are wishy-washy, or even reluctant to sign on to M4A, so our guests give us some strategies for these conversations.
Before we get into the objections, we want you to know you don’t need to be a policy or health economics expert to talk to your elected officials. If you’ve been victimized by the American healthcare industry, you’re an expert.
While we’ve heard some wild reasons for not supporting M4A, most objections fall into a few basic categories:
Downplaying the importance of co-sponsoring the bill
- “Medicare for All is just a slogan that’s not going anywhere so I don’t need to engage”
- “I’m not on a committee of jurisdiction so I can’t co-sponsor”
- “I’m on a committee of jurisdictino so I can’t co-sponsor”
- “I’m in leadership so I don’t co-sponsor bills”
Strategy: these answers tell you that the suffering of people in their district isn’t important enough for them to take action. Help them understand why healthcare for all is so important for their constituents. Bring personal stories; stories can help break down initial barriers and make way for a real conversation. Next time bring even more people and more stories.
“I support M4A but I won’t co-sponsor”
Strategy: consistent follow-up, so they continually feel the pressure. Allow them to ask questions and follow up with information. Emphasize why having a large list of co-sponsors is important in the lead-up to a vote, to show momentum.
Claiming that there isn’t much support or urgency for the issue in the district:
- “I’m not hearing much support for this from my district”
- “This isn’t a problem in my district.”
Strategy: Come with receipts! Personal stories, petitions, local resolutions in support of Medicare for All all show that people in the district need and want guaranteed public healthcare.
M4A isn’t politically feasible
- “It’s not winnable.”
- “It’s too extreme.”
- “You’re asking for too much too soon.”
- “I want to work on bipartisan solutions.”
Strategy: Ask them what their healthcare priorities are, and then highlight how Medicare for All would impact them. There might be pieces of the bill they’re not aware of. This is also another opportunity for personal stories; it’s hard to give these dismissive answers when you have evidence of the damage the healthcare industry causes. If you just go in with policy arguments and generic talking points, you open yourself up even more to dismissive responses. Make it as painful as possible for them to be dismissive assholes.
Nit-picking provisions of the bill, especially the financing
- “You don’t have financing in the bill.”
- “We can’t afford it”
Strategy: highlight the cost savings of moving to a single payer system with far lower administrative costs. These objections often indicate that they just don’t want to invest in certain populations.
The “Ted Cruz:” when elected officials just don’t talk to constituents
Strategy: This is where the fun starts. Bird-dog (go where they are and demand a response) them! Get creative: find out when their plane from Cancun is scheduled to land in DC and post people at all the terminals, ready to greet them and ask them to support M4A. Walk them to their car, ride in elevators with them. Catch them on video refusing to answer or running away.
A powerful example of this tactic was Ana Maria Archila and Maria Gallagher’s confrontation of Senator Jeff Flake in an elevator after he announced his support for alleged abuser Brett Kavanaugh for Supreme Court Justice. Their personal stories of sexual assault and his dismissal of them dominated the news cycle.
Another powerful interaction took place on an airplane when M4A hero and ALS patient Ady Barkan confronted Senator Jeff Flake about a tax bill that would cut Medicaid and funding for disability services.
(Were these uncomfortable moments the reason Flake chose not to run for re-election?)
Other general tips:
- Be comfortable with tension.
- You don’t need to know the answer to every question. It’s always ok to follow up later with answers.
- You are an expert on living in a broken healthcare system! Use your personal knowledge.
- Start with a private, polite conversation. Escalate tactics when they tell you no or won’t respond.
Keep trying, it might take multiple visits, even multiple years, but we’re consistently surprised when elected officials we’ve been lobbying for ages suddenly flip and join the cause.
Medicare for All Conference April 22-23
To learn more about organizing, bird-dogging, municipal resolutions and so much more, attend our virtual Medicare for All conference!
Join hundreds of activists around the country for a 100% online week of inspiration and strategy to win Medicare for All! The “live” conference will take place during the weekend of April 22-23. During the preceding week, each evening we’ll release pre-recorded panel discussions and presentations addressing key issues in the fight for Medicare for All.
This year’s conference, “Everybody In: Racial Equity & Medicare for All,” will be focused on centering race in our conversations about healthcare and building the multi-racial healthcare justice movement we need to win Medicare for All. We’ll be featuring speakers, workshops, interactive discussions, and more! We are still developing the agenda, but we’ll be adding more information to the schedule as we confirm sessions!
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