“Impact on Issues,” LWV Official Policy Document

The League’s statement of support for “a national [program] financed through general taxes in place of individual…premiums” — now also called Improved and Enhanced Medicare for All — is clear.

The following points are found in the League’s Position on Health Care in Impact on Issues 2020-2022. (“Position,” pp. 129-131)

The Healthcare History (Impact on Issues, pp. 131-134) qualifies several elements of the position.

Specifically, the History section describes the position as supporting single-payer health care:

“The League position calls for a national health insurance plan financed through general taxes, commonly known as the “single-payer” approach.” (p. 132, line 5)

The text continues:

As an important step toward a national health insurance plan,…the position also supports an employer-based system [IF] it provides universal access to care.”

The History section also constrains the League’s support for cost controls listed in the Position, explaining

“Copayments and deductibles are acceptable cost containment mechanisms only if they are based on an individual’s ability to pay. In addition, cost containment mechanisms should not interfere with the delivery of quality health care.” 

These constraints apply to other cost-control methods in the position — such as the use of managed care, utilization review of treatment, and mandatory second opinions. Subsequent public policy research and three decades of empirical data now recognize that these methods have formalized barriers to equitable care, reduced universal access, worsened quality by delaying care, and increased administrative costs by increasing complexity.

History of LWVUS Healthcare Advocacy. In the 1990s, the League testified before Congress and joined with other groups in amicus briefs, wide-spread community education programs, and other actions to promote universal coverage. In 2010, the League supported the passage of the Affordable Care Act (ACA) and has fought its repeal.

Events since 2020, however, have exposed tragic shortcomings of the ACA and other reform efforts based on for-profit insurance: the coronavirus pandemic has deepened racial disparities in healthcare and for-profit business models have severely weakened our public health infrastructure.

Under the ACA, for-profit insurers have achieved record profits while medical costs have continued to rise many times faster than wages, and health outcomes for Americans have worsened. In the pandemic, the US, with only 4% of the world’s population, has suffered 16% of its deaths. The ACA has not provided a path to universal and affordable healthcare, nor sufficient investment in public health to fight the coronavirus.

Current Opportunities for LWV Healthcare Advocacy

HCR4US proposes that the League remains true to its stated goals when it advocates strongly for Single Payer/ improved Medicare for All.

Steps LWVUS has taken in the past:

All of these actions remain important contributions toward achieving the League’s goal of universal, comprehensive, high-quality care that is affordable for the individual and sustainable for the country.

State and National LWV Resolutions, Studies, and
Other Documents on Health Care Reform

The full packet of the Study materials from the Update Committee is available here, and the “executive summary” with footnotes is here.  Note that no cost-control measures in the NY position are in opposition to the LWVUS position, but constraints would preclude supporting some LWVUS cost-control methods. (Appendix C covers Cost-Sharing.)

The Study Materials (available here) (Appendix C covers Cost-Sharing)


Since 1945 (under President Truman), LWV has been an official consultant organization to the U.S. United Nations Delegation supporting global UN social and economic initiatives. LWV-UN Observers sit at public meetings of the UN Economic and Social Council, and give input to the Delegation. Read more…

Annually on December 12, local Leagues advocate in concert with the UN on behalf of millions around the world without access to adequate health care. Find out more…

Health Care Reform for the U.S. (HCR4US) Google Group/Network:

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Health Care Reform for the US