Dan Hodges, Chair of Health Care for All-California gave the following presentation on July 17, 2010, at the Summer Conference at UCLA. The conference was sponsored by Physicians for a National Health Program-California (PNHP-CA) and co-sponsored by the State Strategy Group.

We do public education and mobilizing not just to spread the word about single payer but to build a grassroots movement whose political power will be used to enact single payer.

In this presentation I want to discuss the paramount strategy to winning single payer, which is through the legislature, and to critique the frequently voiced alternative, the ballot initiative.

The name the State Strategy Group uses for our legislative strategy, the Healthy Majority Campaign, paints the proverbial lipstick on a pig. That is because both the Assembly and the Senate require a Sick majority — a two-thirds super-majority — to spend revenues, going back to 1935, as well as to raise revenues, thanks to Prop. 13 in 1978.

To achieve a real Healthy Majority, we will have to elect at least two thirds of the legislators in each house who are pro-single payer in three key ways:

1. They will pass a single payer policy bill, like Sen. Leno’s SB 810.

2. They will pass a single payer financing bill.

3. They will over-ride a veto of the policy bill or the financing bill.

When we started the Healthy Majority Campaign, with the June primary in 2008, the Democrats were six seats short of two-thirds in the Assembly and two seats short in the Senate. Today, the Democrats are short three seats in the Assembly and one seat in the Senate.

But note that it is the Democrats who are short those few seats. Our campaign is farther from a real two-thirds Healthy Majority because some of the Democrats are, at best, moderates. This means that a critical part of the Healthy Majority Campaign is to replace weak Democrats with strong pro-single payer Democrats. The Healthy Majority Campaign is not just about improving the head count of Democrats in the legislature. It is also about improving the Democrats who are in the legislature.

Meanwhile, we confront well-heeled opponents of a Healthy Majority. Our antagonists not only want to halt the Democratic tilt to the left, which is seen, for example, in passage of single payer legislation, but also the Republican tilt to the right, as shown by opposition to taxes as well as abortions, gay rights and environmental protections. They have been using ballot initiatives to facilitate electing moderates from both parties. These initiatives are intended to weaken the parties and, therefore, to re-orient the parties’ growing political leanings away from the so-called extremes and back toward the middle.

For example, in 2008, the voters barely approved Prop. 11. It creates the Citizens Redistricting Commission to draw new Assembly and Senate districts after each federal census, starting in 2011. The avowed goal is to make the new districts more competitive. What these districts are really supposed to do is make it more difficult for incumbents to be re-elected and also, especially, to make it easier to elect more moderate legislators from both parties.

Will Prop. 11 succeed? It is doubtful. California’s current political demographics correspond to an increasingly hardening political geography. Until a generation ago California’s geographical-political fault line divided the north from the south. Today the fault line divides the eastern, inland Republicans from the western, coastal Democrats. Since minority residents are protected by the Voting Rights Act from being diluted through re-districting, and since Prop. 11 requires minimizing the splitting of cities, counties and communities of interest, it is very likely that much less than 20% of the current legislative districts could become more competitive.

What is especially important about the Healthy Majority Campaign is that it is a strategy that is based on strengthening party politics instead of running ballot initiatives.

It should be our goal to elect legislators who will not only enact a single payer plan but will also be responsible for financing it.

Furthermore, we should not want to spell out the details for financing single payer through the ironclad text of a ballot initiative.

Although 24 states in the country allow the initiative, in California the initiative process is uniquely restrictive. Here are four reasons why:

  • In California, the legislature has no power to stop an initiative from going on the ballot.
  • In all other 23 states, but not California, the legislature may pass a law that modifies and/or repeals an initiative.
  • In California, only another initiative can change or overturn a previous initiative.
  • In California, it takes only a simple majority of the voters to pass a constitutional amendment (or an initiative), but the legislature can only amend the constitution with a 2/3 vote, which then must be approved by a majority of the voters.

In addition to the inflexibility of the initiative process, successfully running a ballot initiative is less favorable to supporters of single payer than electing a Healthy Majority. To elect legislators, we have to win over a majority of voters in their districts. Districts are drawn to contain an equal number of residents. However, across districts, significantly different numbers of residents register to vote and turn out to vote, both for primaries and general elections. Also, different numbers of residents are eligible to vote.

The most important predictors of who is eligible to vote, who registers to vote and who actually votes are immigration status, race and class. The districts that elect moderate to conservative legislators have higher voter turnouts than the districts that elect liberal to progressive legislators.

The differences in voter eligibility, registration and turnout among districts are not critical obstacles to the success of the Healthy Majority Campaign. However, these differences are enormously consequential for ballot initiatives. This is because the votes for a proposition are cast, in effect, in a single district: the state of California. Voting at the state level continues to favor the election of Republican governors. It does not favor supporters of single payer.

Next year the ballot initiative in California will be 100 years old. It will be the centennial of a milestone of the Progressive era’s legacy of weakening party politics in this state.

For example, for almost 50 years the Progressive legacy also included cross-filing in primaries. This allowed candidates to become the nominees of more than one party for the same office. Incumbents were listed first. Candidates’ party affiliations could not be named. Cross-filing was a boon to the Republicans, helping them keep the governor’s office for decades. Cross-filing was eliminated in 1959, after Pat Brown and the Democrats finally won control of the statehouse.

Cross-filing was the forerunner of the Prop. 198’s blanket primary in 1996. It allowed voters to cast their ballots for any candidate in any party for any office. In 2000, the Supreme Court struck down Prop. 198 because it subverted party politics.

To get around the unconstitutionality of the blanket primary, the jungle primary was presented in 2004 as Prop. 62. It was defeated. With the jungle primary, candidates do not have to state their party affiliations. The top two vote-getters overall advance, even if they are from the same party. The jungle primary effectively ends the party nominating process.

To achieve the Sick majority to pass a budget last year, Abel Maldonado was promised a second try to get the jungle primary enacted. It was placed on the ballot this past June as Prop. 14, and it was approved.

In contrast to redistricting, if the jungle primary survives legal challenges (a big if), it might be a more effective way of increasing the election of moderates from both parties.

For example, the top two vote-getters in a primary may be from the same party. In the general election, each of these candidates can appeal to voters from all parties. It is in the interest of voters registered to the party that placed neither candidate in the top two in June to vote for the more moderate candidate in November.

Also, for example, the outcome of a jungle primary might pit a liberal to progressive against a moderate to conservative in the general election. Since party affiliation no longer matters, anyone to the right of liberal to progressive (including registered Democrats) could vote for the for the moderate to conservative, even if he or she is actually a Republican.

Both the blanket primary and the jungle primary were championed by Republicans. And this is no historical accident.

The Progressives were closely allied with or actual members of the Republican Party, not only here, where the most politically important Progressive was Republican Governor Hiram Johnson, but also in the country, where the most famous Progressive was Teddy Roosevelt. In fact, in 1912, Hiram Johnson was TR’s running mate for the Progressive Party. In 1916, however, the Bull Moose was a stuffed animal, and Roosevelt and Johnson actively campaigned on behalf of the GOP ticket.

Today, the tools and the goals of the Progressives continue to serve Republican interests and opponents of strong party politics.

The term Healthy Majority may be putting lipstick on a pig. But the results of a successful Healthy Majority Campaign, in mobilizing grassroots political power that strengthens party politics, might help turn a sow’s ear into a silk purse.

Dan Hodges