The national focus of Medicare for All activists has centered, up till now, almost exclusively on Congressional bill HR 676, there is a compelling argument that we adopt a balanced, complementary, two-track approach with Congress: continued strong, grassroots lobbying for national Medicare at the same time we advocate with equal vigor for state-level Medicare, through the state-enabling Universal Health Care legislation,

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U.S. Rep. Jayapal's "Other" Universal Healthcare Bill, HR 6097

One of the least covered developments in the new, Democratic-majority, 116th Congress -- as related to our work -- is the rapid power rise of second-term U.S. Representative Pramila Jayapal (WA, 7th CD), the first Indian-American woman ever elected to Congress. Right now, Ms. Jayapal is the most important politician for the Medicare for All movement, at both the national and state levels. Why? Because Jayapal is not only 1. the co-chair of the new Medicare for All Caucus , and 2. co-chair of the established Progressive Caucus , but she will also soon be, 3. the primary sponsor of the newly re-written national Medicare for All Act (previously HR 676, soon-to-be re-numbered, perhaps renamed, and likely to be reintroduced in early February), and 4. the primary author of the newly reintroduced State-Based Universal Health Care (SBUHC) Act (HR 6097 from last Congress, likely to be dropped a month or so after the national Medicare bill) that provides the necessary legal and financial waivers for seamless and smooth, state-level implementations of universal health care systems.

While the national focus of Medicare for All activists has centered, up till now, almost exclusively on Congressional bill HR 676, there is a compelling argument that we adopt a balanced, complementary, two-track approach with Congress: continued strong, grassroots lobbying for national Medicare at the same time we advocate with equal vigor for state-level Medicare, through the state-enabling Universal Health Care legislation, HR 6097. Why? 1. History; 2. Constitution; 3. Citizens United; 4. Opportunity; 5. Solidarity.

History. Almost all modern American social, political, economic, civil rights, and welfare reforms have taken shape, and first been adopted, at the local and state levels. Starting with the Progressive Era(1880-1920), to the Depression Era/New Deal(1933-1941), and through the New Frontier/Great Society(1961-1968), federal-level programs benefited from local- and state-level innovation, demonstrating the kind of "laboratory" experimentation as envisioned by our founders, regarding housing, food, education, healthcare, and more. Much as our national government has swung to the right, further right, and still further right since the election of Nixon in 1968, the most notable reforms in recent times, that of same-sex marriage and marijuana legalization, have taken root at the state level, with high hopes of going national very soon. On the question of recent healthcare reform efforts, I think we can agree here that, while Obamacare was a national political feat, as a policy prescription, built on the Heritage Foundation's insurance-purchase mandate, it has fallen woefully short of the "universal healthcare" promises heaped on it at the time of its passage in 2010.

Constitution. Like Canada's constitution, ours is a federalist design, where powers are divided between the national and state government, per the 10th Amendment's deference to state initiative in matters not explicitly the preserve of the national government. Canadian single payer healthcare adoption started in the Province of Saskatchewan before going national. In the U.S., over the last forty years or so, national power both public and non-profit has become heavily corporatized through the unregulated and outsized role of Big Money (a kind of legalized and fused Plutocracy-Kleptocracy), through the Supreme Court's Citizen's Uniteddecision of January 2010. The dramatic return to a late-19th century-, Gilded Age-style corporate high-jacking of nearly all institutions, including medicine, has made our political work much more difficult at the national level, and increasingly challenging in most states. At the same time, the Supreme is now dominated by five Federalist Society-trained judges who, while bringing a corporatist legal training reminiscent of the pre-1940s SCOTUS, they are also far more inclined to favor state power over national power where domestic policy is concerned.

Solidarity. The fact that U.S. Rep. Pramila Jayapal now carries both the national single-payer bill (HR 676) and the state-enabling universal healthcare bill (HR 6097), speaks both to the complementarity of the legislation, and the two-track political approach that underscores the need for solidarity among and between activists working at each level. Jayapal is a community organizer who personifies and models the kind of collaborative efforts we should engage: inside-outside strategies, broad-based coalition-building, intersectionality (connect the dots across all related issues), solidarity, and State-Based Universal Health Care (SBUHC) Act opportunity.

Opportunity, therefore, is the final key to our success based on 2018 election results -- as California, New York, Wash State, Maine, and Minnesota, by virtue of stronger-than-ever Democratic power convergence, offer real chances of success, potentially very soon but, I will argue, if, and only if, Jayapal's ERISA-waivering and federal healthcare dollar-financing HR 6097 passes out of Congress and is signed by the next president.

Our work is cut out for us. We have five clear reasons why our movement needs to become the leading instrument for winning Medicare for All in 1, 3, or 5 states in the next few years, based on a common understanding of our History, our Constitution, the Citizens United decision, activist Solidarity, and recognized Opportunity.

Onward to Expanded and Improved Medicare for All,

Authors Website: https://www.onepayerstates.org

Authors Bio:

Chuck Pennacchio, Ph.D., is a five-decade issue, electoral, and union organizer; president of the One Payer States network (onepayerstates.org); senior advisor to Healthcare for All Pennsylvania; co-founder of Our Revolution PA; founder of the Justice for All Network (justiceforall.global); lead-producer of the single-payer documentary "Fix It: Healthcare at the Tipping Point" (fixithealthcare.org); 2016 Bernie Sanders delegate; 2006 Democratic primary candidate for the United States Senate (PA); aide to four U.S. Senators and one U.S. House Member, 1979-1988; 32-year history and politics professor at University of the Arts in Philadelphia, Delaware Valley University (PA), Texas A&M-Corpus Christi, and University of Colorado-Boulder; and author/co-author of several books, book chapters, and articles on U.S. and European history, U.S. healthcare, and U.S. politics. More importantly, Chuck is the father of two children, Sophia (28) and Ben (25), who are politically and intellectually engaged citizens. He is registered to vote in Sharpsburg, Pennsylvania, but "lives virtually" in 25 states, and "mentally occupies" the transcendent cities of Berlin, Berkeley, and Philadelphia.