Single Payer Rises Again

As the ACA takes effect, an alternative gains ground at the state level

When Sergio Espana first began talking to people, just over a year ago, about the need for fundamental changes in the U.S. healthcare system, confusion often ensued. Some people didn’t understand why, if the Affordable Care Act (ACA) had passed, people still wanted to reform the system; others thought organizers were trying to sign them up for “Obamacare.”

Healthcare is a Human Right Maryland, the group to which Espana belongs, is in pursuit of something else: a truly universal healthcare system that would cover everyone and eliminate insurance companies once and for all. Espana and many others in the growing movement see opportunity in the renewed discussion around healthcare reform as the ACA’s insurance exchanges go into effect.

They believe that the ACA’s continued reliance on (and subsidies of) private insurance simply aren’t good enough. People are still falling through the cracks, employers are trying to dodge the requirement that they provide insurance for their workers, and many states refused federal subsidies to expand their Medicaid programs. What these activists want is a program that would replace existing insurance programs, cover everyone regardless of their employment status, and be funded by the government, with tax dollars. Such a plan had strong support when the national healthcare overhaul was being crafted in 2009—including initial backing by President Obama—but the president and Congress decided it wasn’t politically possible and passed the ACA as a compromise.

More here.