First of all, knowledgeable activists believe that the ACA will benefit millions and its success will clear the road to single payer, the final destination. If Obamacare fails, many of us understand that it will set back all healthcare reform. Then again, the insurance companies are so greedy, the current system so dysfunctional and so expensive (increasingly) and unjust that it may self destruct if the Affordable Care Act fails. Obviously, the success of Vermont’s single payer plan is huge and we really look forward to its quick implementation.
The ACA implementation is not trivial. Here in California, one of the leading ACA states, $1 billion has been budgeted – between federal and foundation contributions – to enroll about 5.5 million people. Covered California is enlisting all sorts of organizations to become certified enrollers. And the plan is to pay $58 per enrollee. This alone comes out to be about $300 million. Covered California is running a pretty tight organization and I wish them the best.
Once the exchanges are rolling by October 1st and once enrollees become enrolled by January 1st, the ACA will gain momentum in California. I will look forward to all the anecdotes of the positive impact of Obamacare on people everywhere.
So, paradoxically, one way you can help single payer is to get involved in the implementation of the ACA.
Once the ACA becomes a reality, the road to single payer goes through the state “innovation waiver:”
To qualify for an innovation waiver, the state must establish that its reform plan would provide coverage that:
. Is at least as comprehensive as ACA coverage,
. Is at least as affordable as ACA coverage,
. Covers at least as many residents as the ACA would have covered, and
. Will not increase the federal deficit.
Again, here in California, we have certain advantages when it comes to the innovation waiver.
First of all, California has tried to pass single payer for almost 30 years. Four times, a single payer bill got to or through the legislature in Sacramento, and twice SB 810 was vetoed by Gov. Arnold Schwarzenegger. But the worst case scenario happened last year when SB 810 failed by two votes in the state Senate when six Democrats voted against the bill or abstained. So SB 810 was stopped but the single payer movement has not and we are putting together a strategy that will urge Sacramento to apply for an “innovation waiver.” I will cover it in more detail in future diaries. I expect the launch of this strategy to be on Sept. 15. More on this below. But bottom line is, we have a plan that clearly covers (with minor modifications) the first three requirements for the “innovation waiver”.
There is one issue with the ACA that is more relevant in California than elsewhere. I understand that Obamacare is a victory for President Obama given the polarization in Washington D.C. and the destructiveness of the GOP since he was elected in 2008. I was very disappointed when Obama took single payer off the negotiating table, and also when we ended up without a public option. But the reality of Washington and most red states is that the Tea Party/GOP is bent on sabotaging the ACA by defunding it. So the fight at that level goes on and I understand how important it is that Obamacare succeeds enough for the 2014 midterms. The issue is the over 3 million (that’s a lot of people) undocumented workers. Single payer would cover them; the ACA does not.
So yes, single payer would cover more people than the ACA.
As far as the 10 year budget proving that the new plan does not increase federal monies coming to California for the ACA’s implementation, it will require an economic study similar to the famous Lewin report of 2005. We need a new report given that the Lewin group was purchased by the insurance companies, and given that the study is a bit old. It will cost about $200,000-$300,000, and again we have a plan to get this new study funded.
The organization behind the formulation of the strategy to go through this process and its implementation is the AllCare Alliance, formed by a growing number of single payer organizations, unions and other non-profits in California. Here is one of the possible logos for the alliance.
This is the beginning of the new single payer battle in the pivotal state of California. The plan and the people are coming together. Another thing you can do to make single payer a reality is to donate a bit of money. Whatever you donate now, before our Sept. 15th launch, I will match up to $1000. This will help us finish our web site and upgrade our software (I’m involved in this.) The California OneCare donation page works (I am on the Board of Directors).
Let’s do it. For California, for the whole country, to save money and to save lives.
Sen. Harry Reid agrees with us as LFT NSF noted:
“What we’ve done with Obamacare is have a step in the right direction, but we’re far from having something that’s going to work forever,” Reid said.
When then asked by panelist Steve Sebelius whether he meant ultimately the country would have to have a health care system that abandoned insurance as the means of accessing it, Reid said: “Yes, yes. Absolutely, yes.”
The idea of introducing a single-payer national health care system to the United States, or even just a public option, sent lawmakers into a tizzy back in 2009, when Reid was negotiating the health care bill.
“We had a real good run at the public option … don’t think we didn’t have a tremendous number of people who wanted a single-payer system,” Reid said on the PBS program, recalling how then-Sen. Joe Lieberman’s opposition to the idea of a public option made them abandon the notion and start from scratch.