“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. (Note: Impact on Issues is being updated to reflect the Update Concurrence that was adopted at the 2022 National Convention, which strengthened several aspects of the position reported here. For information on the CONCURRENCE, click here. The new statement is anticipated Feb 2023.)

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.

Watch a two-minute clip with statement by LWVUS Director of Government Affairs, Jessica Jones Capparell, in response to a question during an LWV-MA program April 2022: Q: “Does the League support a Medicare for All system of health care?” A: Yes!

Unprecedented growth of PRIVATE EQUITY INVESTMENT in Health Care makes the LWV position on PRIVATIZATION relevant to Health Care Advocacy.

In addition to failing to achieve goals of the League’s Health Care Position, the current “financialization” of health care violates the guidelines of the LWV position on Privatization. Full wording of the 2012 position from pages 63-64 of the 2020-22 Impact on Issues can be found here. The position does not categorically oppose “the transfer of governmental services, assets, and/or functions to the private sector,” as long as “transparency, accountability, and preservation of the common good” can be ensured. The need to safeguard public health is highlighted with this warning:

Privatization is not appropriate when the provision of services by the government is necessary to preserve the common good, to protect national or local security or to meet the needs of the most vulnerable members of society.

Private Equity (PE) investment in health care has made the sector 2nd only to Apple and Amazon in profitability, but NOT health care excellence. More and more studies describe the rapid decline in quality of care and outcomes.

The fallout from PE, sometimes called “vulture capitalism on steroids,” is gaining more media attention. The statistics on health outcomes are grim. The HCR4US YouTube channel has two videos (so far) of programs detailing the troubling trend.

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


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… (Official UN Universal Health Coverage Day here)

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

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Health Care Reform for the US