The 2022 midterm elections are MOSTLY in the books – thank again Georgia, for the endless run-offs that keep on giving, every two years it seems like. You’ve heard the national narrative: Democrats did surprisingly well, given how parties in power usually take big losses during the mid-terms, and particularly when Biden has such low approval numbers.
Today we’ll talk about how healthcare did on Election Day, and how the fight over Medicare for All within the Democratic Party affected those results.
First the good news, some wins on single payer healthcare ballot measures:
- Oregon: voters approve Measure 111, a constitutional amendment enshrining access to affordable healthcare as a fundamental right. Oregon is now the first state with a constitutional obligation to provide healthcare to constituents. The amendment states that Oregon is obligated to “ensure every resident has access to cost-effective, clinically appropriate and affordable health care as a fundamental right,” but not does define what health care access looks like or how the state will fund it.
- South Dakota: voters approve Constitutional Amendment D, expanding Medicaid eligibility under the ACA, covering 45,000 more South Dakotans. Anybody in making less than 133 percent of the federal poverty level (about $18,000 for an individual or $36,900 for a family of four) would now qualify for Medicaid coverage. There were 12 states left that had not expanded Medicaid – and now there are 11! South Dakota is the seventh state to approve Medicaid expansion via the popular vote. (Medicaid Expansion has passed all seven times.) Some experts predict a slow rollout/implementation similar to that seen in Missouri.
- Arizona: voters approve Proposition 209, or the Predatory Debt Collection Act, which cuts down on interest rates on medical debt and increases the amount of assets protected from creditors. The average Arizonan with medical debt has $1,903 in collections and while 20% of white Arizonans have medical debt in collections, that number for communities of color is much higher at 39%. In Arizona, interest rates for medical debt increase by as much as 10% each year – this legislation caps the interest rate at 3%. It also protects homes, household furnishings, vehicles and bank accounts from collections or forced sale.
- Run by Healthcare Rising Arizona, a grassroots, labor-backed organization, this law is the first of its kind. Of course the interest groups backed by collection agencies launched a legal challenge against the ballot initiative. Sadly for them, it failed. The proposition passed by with 75% support.
- While it doesn’t address the main issue of high medical costs, the new law will provide real relief to people struggling with medical bills.
- Massachusetts: a non-binding ballot policy question in favor of M4A passes in 20 state house districts. Our friends at MassCare put single-payer on the ballot, instructing state representatives to support Medicare for All. The question passed in all 20 districts. Most states don’t have this tool; it doesn’t require the legislator to sponsor a bill, but it can be an effective pressure tool for legislators who aren’t supporters of M4A yet. Great work by our comrades at MassCare, especially former Healthcare-NOW Communications Director/current Executive Director Stephanie Nakajima.
- Our own Ben Day organized around this question in his own neighborhood. He found talking to voters about this ballot measure was a great way to bring new people into the movement and hear new stories about the healthcare system. The question passed by over 77% in his district, so good job, Ben!
- The Pros of Ballot Questions: when you put something popular like Medicare for All to a vote, you win! However, passing and implementing ballot initiatives require deep, heavy duty organizing, and a lot of follow up. This kind of direct democracy is great for involving more people and building our movement, but the higher the stakes, the more pushback you’ll get from your opponents.
- The Cons of Ballot Questions: ballot questions can be hugely expensive to pass, especially if your opposition has deep pockets, like the healthcare industry. Colorado is a cautionary tale. In 2016, the day the state of Colorado voted for Hillary Clinton over Donald Trump by about 5 points, voters there also rejected a ballot measure to enact a state-based single-payer system by an astounding margin of 79 percent to 21 percent. Ballot initiatives are not easier than passing legislation, and probably require just as much work and resources as passing a law.
There was also good electoral news in the reproductive health column! Turns out that people with uteruses vote, and they get pissed off when you try to take away their rights. Victories on abortion in five states:
- Michigan: voters approve amendment to state constitution guaranteeing the right to an abortion.
- Vermont: voters passed Article 22, the Reproductive Liberty Amendment, protecting the right to reproductive autonomy.
- California: voters approve an amendment to their state constitutions guaranteeing the right to an abortion and contraception.
- Kentucky: voters reject a ballot measure aimed at denying constitutional protections for abortion.
- Montana: voters reject the “Born Alive” ballot measure, which would have required medical workers to provide care to infants born prematurely or in rare instances of surviving an attempted abortion, or face penalties.
Medicare for All candidates’ results were a mixed bag. We have some really exciting new Medicare for All leaders entering Congress next year. But it wasn’t all good news, because we saw vividly how the Democratic Party establishment keeps shooting itself in the foot by, essentially, trying to undermine progressive candidates – even in the general elections – and trying to prop up losing corporate Democrats.
The good news first! New M4A champions joining Congress:
- Texas: Greg Casar, longtime city councilor and now Congressional District 35 representing East Austin
- Pennsylvania: Summer Lee, state’s first Black congresswoman, won against long-time health insurance industry executive.
- Florida: Maxwell Frost, first “Gen Z” member of Congress – he’s bussin! (For The Olds, please consult this definition and delight the youngsters in your life with your knowledge of their slang.)
Now the bad news, and also troubling news. Democrats lost the House, which means a split Congress for the next two years, and in all likelihood no major healthcare legislation. Democrats had a chance of holding the House, which would have given room to advance Medicare for All. Unfortuntely the Democratic Party can’t get out of its own way, and we’ll focus on two districts that perfectly illustrate that problem.
- Oregon: M4A supporter Jamie McLeod-Skinner beat out incumbent Representative Kurt Schrader, one of the worst Dems in the House, in the primaries for Oregon’s 5th district. Schrader is a long-time NON supporter of M4A, and opponent of the Build Back Better bil – specifically the pieces around negotiating prescription drug prices. So it was a rare case where a sitting representative was ousted from his seat in the primaries. Biden actually backed McLeod-Skinner, as did the local Democratic establishment, and it was a rout, despite being outspent 5-to-1.
- The bad news: this is a swing district, and McLeod-Skinner NARROWLY lost to her Republican opponent in the general elections by 1% (49% to 51%). Centrists will claim that progressives can’t win in a swing district, but this hides the real story: the Democratic Congressional Campaign Committee (DCCC or the D-trip) and House Majority PAC both pulled out of this race, stopped supporting McLeod-Skinner, in the final weeks of the race, claiming it was unwinnable. Even though she lost by only 1%.
- New York: This one state basically cost Democrats a majority in the House. The New York Democrats suffered huge electoral losses. Take the case of Sean Patrick Maloney, the incumbent representative for New York’s 18th district. Not a M4A supporter, and actually Chair of the DCCC – the very organization that pulled its support from Jamie Mcleod-Skinner’s race. Like everywhere, New York was significantly redistricted this year. Instead of running in his own district, Maloney chose to run in a safer neighboring district, pushing M4A supporter Representative Mondaire Jones out of his district. (Jones went on to lose the primary in his new, more conservative district.) Maloney runs a really right-wing campaign and LOSES in the general election. But not before the DCCC spent $6 million on his race! That’s money that could have put McLeod-Skinner over the top in Oregon. To cap it all off, Pat Ryan, the Democrat who runs in Maloney’s old district WINS his election – becoming one of the few success stories in New York this election cycle.
- Moral of the story: don’t ever, ever, ever give money to the DCCC or to the House Majority PAC. Give directly to the candidates who support the issues you care about.
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