By Shefali Luthra
MARCH 12, 2019
COLUMBIA,
S.C. — It was a sleepy Saturday in mid-February. But Virginia Sanders was
speaking, and the audience was rapt.
“One
might not have the power. But a thousand has the power,” she said. “Don’t let
anybody fool you that you don’t.”
Sanders,
76, has been an organizer and activist all her life. She marched in the civil
rights movement. She protested against the Vietnam War. During the 2016
primary, friends recall, this petite black woman marched up to men in Ku Klux
Klan robes to distribute flyers about then-candidate Bernie Sanders — no
relation. (They took the papers, she said.)
Now,
she is focused on a different battle, one that has captured liberals’
imagination across the country: “Medicare-for-all.”
Outside
Washington, Sanders is among the ranks of activists readying for a fight, even
in states where, backers acknowledge, this approach often isn’t considered
mainstream.
Organizers
working with National Nurses United, the largest union and professional
association for registered nurses in the U.S., have launched a grassroots campaign, championing a sweeping
Medicare-for-all bill introduced in Congress late last
month by Rep. Pramila Jayapal (D-Wash.) and Rep. Debbie Dingell (D-Mich.).
In
states including Texas, Arizona, Louisiana, Idaho and Missouri, a series of
events have been held to harness energy on the ground and to showcase
enthusiasm — even in unlikely places — for the Medicare-for-all idea.
And
that enthusiasm is sizable.
Sanders
was speaking at what activists call a “barnstorm.” The event was meant to turn
the roughly three dozen people in this gray hotel conference room into foot
soldiers in what’s at best a sharply uphill health care fight.
Winning
Medicare-for-all wouldn’t be easy, Sanders told her audience of would-be
activists, but she is still a believer.
“When I
say South Carolina is a red state, it’s a blood-red state,” Sanders said after
the event. “[But] if we can just educate people who live at or below the
poverty level to vote with their best interest, we can change South Carolina.”
The
battle over health care reform is playing out in heated rhetoric on the
national stage. Polling shows the concept has general support. But that backing wanes if
respondents are told about potential consequences, such as eliminating private
insurance or raising taxes.
Democrats
seeking the party’s 2020 presidential nomination are for the most part adopting
the Medicare-for-all slogan head-on, though often hedging on specifics. Health
industry interests are lining up in opposition. And Republicans decry it as
“socialized medicine.”
At this
barnstorm in South Carolina’s capital, about 36 people showed up to munch
sandwiches and potato chips at what was effectively a two-hour organizing
lesson in an off-election year — and on the same day as a visit here from Sen.
Kirsten Gillibrand, a New York Democrat running for president.
The
following afternoon, in Fayetteville, W.Va., about 30 came to a similar event,
this one hosted above a local sandwich shop and bar. Activists sipped beers,
swapped health care stories and planned phone banks and canvassing events to
spread the word.
It’s an
unusual kind of energy around a policy that, before 2016, had been relegated to
a progressive pipe dream.
“There
is an incredible amount of activism among liberal communities, which also exist
in conservative states,” said Robert Blendon, a professor of health policy and
political analysis at Harvard University. That activism, he added, could shape
the Democratic primary and, by proxy, the 2020 presidential contest.
The
Vibe On The Ground
The
coalition pushing Medicare-for-all is widening — with what started as a
signature proposal for Sen. Sanders’ presidential campaign taking on broader
appeal.
In
Fayetteville, local Democrats who had fiercely supported Sanders or Hillary
Clinton in the 2016 primary came together to learn about Medicare-for-all, said
Chris Pennington, a 36-year-old substitute teacher and Bernie Sanders delegate
in 2016.
Columbia’s
event certainly drew a familiar crew, said Lucero Mesa, 61, who organized it
and co-chairs the local chapter of Our Revolution, a political action group with
ties to Sanders’ 2016 presidential campaign. But then her eyes widened as more
attendees filed in: “I’m starting to see faces I don’t recognize!”
On a
national level, Medicare-for-all earns ire from Republican lawmakers. But “it’s
not a partisan issue” in a place like West Virginia, Pennington said. Indeed,
polling from the Kaiser Family Foundation suggests
that as many as a third of Republicans support the idea. (Kaiser Health News is
an editorially independent program of the foundation.)
Following
that Sunday’s event, Pennington announced plans to set up a canvassing booth at
the Fayetteville High School basketball game two days later.
Meanwhile,
the thorny issue of whether to keep private insurance, a question that has
already ensnared candidates, has less impact among these activists.
In the
same breath as embracing legislation introduced by Sen. Sanders, which would
effectively eliminate the insurance industry, organizers expressed openness to
other policy approaches, as long as they kept certain broad principles intact.
When
asked if the system in Sanders’ bill — which is inspired by the Canadian health
care model — would best serve American interests, Lawrence Nathaniel, a
25-year-old Columbia activist, didn’t hesitate.
“I
don’t think we should be fighting to be like other countries. We should be
fighting to be like our own,” said Nathaniel, who campaigned for Sanders and
then Clinton in the 2016 election and is planning his own campaign for
Congress.
Virginia
Sanders went a step further. Calling to get rid of private insurance might
actually be “a mistake,” she said.
“We can
let the American people have input,” she added.
To be
sure, even though the Medicare-for-all message faces skepticism in many other
red-state locations, it still tilts the health care debate. In Texas, for
instance, activists acknowledge that this kind of sweeping reform is improbable
but say it has opened the discussion up to incremental ideas, such as pursuing
the Affordable Care Act’s Medicaid expansion — also still considered a long
shot.
It also
could have far-reaching political ramifications. The activists organizing now,
Blendon noted, are likely to vote in the upcoming Democratic primaries.
“A lot
of these groups will … turn out in states you don’t expect,” he said. “There is
a general principle running through part of the Democratic Party. And the
principle is they want universal coverage, and a very strong role for
government.”
For
someone like Virginia Sanders, it’s not so much a political issue as a moral
one.
“We
have to fight. Freedom isn’t free,” she said. “Power concedes nothing. It has
to be taken.”
Shefali Luthra: ShefaliL@kff.org,
@Shefalil
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