LEAGUE POSITION ON HEALTHCARE REFORM
“Impact on Issues,” LWV Official Policy Document
The League’s statement of support for Single Payer — 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 League favors a national health insurance plan financed through general taxes in place of individual insurance premiums (p. 129, last line).
- The League is opposed to a strictly private market-based model of financing the health care system (p. 130, line 6).
- The League supports increased taxes to finance a basic level of health care for all U.S. residents, provided health care reforms contain effective cost control strategies (p. 130, line 9)
- The League believes that the ability of a patient to pay for services should not be a consideration in the allocation of health care resources (p. 130, par. 6).
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:
- Testifying before Congress,
- Joining coalitions to support bills (like HR 1976) that propose single-payer programs,
- Supporting grassroots reform efforts within the League and with League allies.
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 LEAGUE
RESOLUTIONS, STUDIES, AND
OTHER DOCUMENTS ON
HEALTHCARE REFORM
- 2010 LWVUS Resolution passed by delegates at the National Convention calling upon the LWVUS leadership to advocate strongly for Improved Medicare for All legislation
- 2015-2016 LWVUS Position broadened to include full access to behavioral healthcare.
- In 2015, LWV of Colorado finished an official study on Mental Health Care in Colorado, and petitioned the state League to include access to Quality Behavioral Health Care in their Health Care position statement. Their 45-page study includes: need for services, Colorado’s current service delivery system, stigma and barriers to effective service delivery, and new and promising practices.
- To access the LWV-CO study materials and the Behavioral Health Position, download from the LWV-CO website or the LWV-US “clearing house” (Go to Social Policy, Mental Health Care, Studies, 2015 Colorado Behav. Health Study) https://sites.google.com/a/leagueofwomenvoters.org/clearinghouse/home
- In 2016, LWV-CO presented the state’s new position to the national League, which adopted it “by concurrence” at the national convention.
- 2019 Medicare for All Resolutions at State Conventions
- 2020: LWV-WA Position Statement on Healthcare
- 2020 Health Care Caucus (to be added)
- 2021 Developments
- New NY State Healthcare Positions, on healthcare and the financing of healthcare. In 2020, the New York State League Healthcare Positions Update Committee (2019-2021) proposed two new positions to replace the two NYS positions adopted in 1991. The committee submitted the new positions to all Leagues in the State and facilitated the Consensus Process. In March 2021, Both new positions were formally adopted.
Highlights of NYS new Healthcare Positions (2021) — changes from the 1991 positions- Changes to guidelines for safe staffing, public health disparities, and comprehensive care (including vision, dental, hearing, and long-term care) without any financial barrier to access.
- Separating insurance from jobs: “funding supported in part by broad-based and progressive state income taxes with health insurance access independent of employment status.”
- Supporting state-based universal single-payer healthcare (in the absence of a healthcare financing system that includes all residents of the United States).
- Creating a healthcare trust fund managed by the NY Health Trust, that operates in a similarly efficient fashion as Social Security or Medicare trust funds.
- New NY State Healthcare Positions, on healthcare and the financing of healthcare. In 2020, the New York State League Healthcare Positions Update Committee (2019-2021) proposed two new positions to replace the two NYS positions adopted in 1991. The committee submitted the new positions to all Leagues in the State and facilitated the Consensus Process. In March 2021, Both new positions were formally adopted.
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)
- Formation of a National Rural Affairs Caucus, with an initial focus on Healthcare.
Based on the Rural Caucus of LWV-NY, HCR4US invited League members from around the country to enable resource sharing, consultation, and collaboration among Leagues and League members in rural areas. It aims to encourage the formation of MAL Units and League Chapters in rural areas to increase the League’s advocacy and education outreach, and also focus the attention of state Leagues on the needs of residents of rural areas.
The form to express interest can be accessed here: Rural Affairs Caucus Interest form For more information, or to receive the summary of the first 60 responses, contact the RAC leader, Kathleen Stein at this email: lwv.rac@gmail.com
ROLE in UNITED NATIONS GLOBAL UNIVERSAL HEALTH CARE INITIATIVES
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. Annually on December 12, Observers encourage local Leagues to celebrate Universal Health Coverage Day and advocate in concert with the UN on behalf of millions of people around the world without access to adequate health care. A central member of the HCR4US Network, Michelle Dorsey M.D., of Metro-Phoenix has been an observer since 2018. Read more…
Health Care Reform for the U.S. (HCR4US) Google Group/Network:
- History of HCR4US 2005 to the present
Directory of States in our network: Contact HCR4US to find fellow advocates in your state or add your state to our network:
Alabama, Alaska, Arizona, California, Colorado, District of Columbia, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming - Link for Minutes of monthly calls from Dec 2018
- How to JOIN. Use the HCR4US Contact form to join the network.
Check out our page to help you
GET INVOLVED – Suggestions for individuals and local Leagues
