Podcast / Start Making Sense / Jan 31, 2024

Heroes of the Left, Plus Healthcare for the Undocumented

On this episode of Start Making Sense, John Nichols presents The Nation’s Progressive Honor Roll and Sasha Abramsky reports on California’s big step toward healthcare for all.

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Heroes of the Left, Plus Healthcare for the Undocumented | Start Making Sense
byThe Nation Magazine

The Nation’s annual Progressive Honor Roll features movement leaders who provide hope for 2024. John Nichols tells their stories.

Also: California moved one step closer to universal healthcare on January 1, when it expanded coverage to all low-income residents, regardless of immigration status. Sasha Abramsky reports.

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The Nation’s annual Progressive Honor Roll this year features movement leaders who provide hope for 2024. John Nichols is on this episode of the Start Making Sense podcast to discuss.

Also on this episode: California moved one step closer to universal healthcare on January 1, when it expanded coverage to all low-income residents, regardless of immigration status. Nation columnist, Sasha Abramsky reports.

The Nation Podcasts
The Nation Podcasts

Here's where to find podcasts from The Nation. Political talk without the boring parts, featuring the writers, activists and artists who shape the news, from a progressive perspective.

How the Sixties Ended, plus the Endless War in Gaza | Start Making Sense
byThe Nation Magazine

“1974,” the new memoir by Francine Prose, recalls the year when “the sixties” came to a definitive end, when it became clear that the changes we’d wanted, the changes we’d fought for, were not going to happen. She spent that year in San Francisco, where she got to know Tony Russo of the Pentagon Papers case.

Also: On May 31, Joe Biden declared, “It is time for this war to end.” But the leaders of both Israel and Hamas seem content for the war in Gaza to grind on into the indefinite future. Hussein Ibish explains why.

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Jon Wiener: From The Nation magazine, this is Start Making Sense. I’m Jon Wiener.  Later in the show: California has just moved one step closer to universal healthcare, when it became the first state to expand coverage to all low-income residents, regardless of immigration status. Sasha Abramsky will report.
But first: heroes of the left: John Nichols has our Progressive Honor roll for 2023–in a minute.
[BREAK]
Last year was a rough one. The rise of Trump, and Israel’s war in Gaza, left a lot of us feeling dread, outrage, and despair. But we also have leaders and activists who show us how to keep fighting and give us reasons for hope. Some of the best are featured in The Nation’s annual Progressive Honor Roll, and for that we turn to John Nichols. Of course, he’s national affairs correspondent for The Nation, the author of many books most recently, It’s Okay to Be Angry About Capitalism co-authored by Bernie Sanders. He puts together the magazine’s annual Progressive Honor Roll. John, welcome back.

John Nichols: It’s an honor to be with you.

JW: One of the exciting parts of 2023 was the unprecedented summer of strikes, led by the United Auto Workers, which had a brilliant and creative strategy that forced General Motors, Ford, and Stellantis to agree to a historic pay increases for almost 150,000 auto workers, and put the union at the center of the fight to define the future of electric vehicles. At the top of this year’s Progressive Honor Roll, you have Shawn Fain, president of the UAW, our class warrior. Most of us had never heard of Shawn Fain until the last year or so.

JN: Well, that’s right. He wasn’t the head of the UAW until the last year or so. He ran as a dissident, an outsider against the old leadership of the UAW, and his argument was that it needed to become what it once was, a militant union. Unlike some politicians who win elections and don’t keep their promises, he kept his promise. Fain came into the leadership of the UAW in the spring, and by the summer, they were in the thick of these negotiations with the big three automakers. And you can imagine the pressure on the guy. It’s kind of amazing when you think about this is the stuff with cinema almost.
You’re newly elected, you’re a dissident. you’re an outsider, you’re changing up everything, and then suddenly you’ve got the biggest fight of your life on your hands. It would’ve been understandable, I think, to many people if Fain had gone a cautious route, but that wasn’t what he was elected to do. He went an aggressive route asking for really high pay increases, for a restructuring of how the industry did a lot of things and all sorts of visionary proposals, even proposals borrowed from European industrial unions for a four-day week and things of that nature. He didn’t get, and the union, his activists, didn’t get everything they asked for, but they got a lot. They got an epic deal.

JW: What makes Shawn Fain unique among labor leaders of the last several decades is that he talks about organizing not just the non-union auto plants. He has declared the UWA’s goal is to activate the entire working class economically and politically, and he talks about a lot more than higher wages. He’s really a social justice militant. In a speech last week, he talked about the right to love who one chooses, and afterwards, when reporters asked him about immigrants at the border, he said they were like most immigrants of earlier generations, desperate people just seeking a safe and decent life. You talked about restoring the UAW to what it once was, and it once was in the forties and fifties and into the sixties, the anchor of liberalism. And let’s add right now, unions provide probably the best way to win the white working class away from Trump.

JN: There’s one other thing too, just to emphasize. Trump came in and said that if the union got its goals, they would destroy the companies. The jobs would go overseas, the plants would close. Well, just to let you know that they just today were announcing some very big profit sharing that’s going to go to the workers. So in addition to this new contract, they’re going to get profit sharing. The companies aren’t closing down, they aren’t leaving. Once again, Donald Trump was wrong.

JW: Next on The Nation’s Progressive Honor Roll are Rebecca Solnit and Thelma Young Lutunatabua. They’ve led the way in providing hope for the planet. Their project is called, “It’s Not Too Late.” We actually featured them on the podcast last year. But remind us about Rebecca Solnit and Thelma Young Lutunatabua, and “It’s Not Too Late.”

JN: Well, between you and I, we’re probably the Rebecca Solnit fan club, because Solnit as a philosopher has staked out this argument that hope is different than optimism. Optimism, you just think things are going to turn out fine. Hope says you got to work at it, but it does say that if you work at it, there’s a possibility that you can make the big change. And she and Thelma have been very, very committed to kind of a reframing of the climate discussion and to say that, yes, we have a crisis. It is a severe crisis, but there are so many things happening now that make it possible to address that crisis. So rather than simply thinking, oh, it’s overwhelming, we’ve run out of time, we have the technology, we have a growing consciousness. If we put this to work, we can actually address the climate crisis and create a circumstance where we do have good jobs, safe and protected environment and a real future for all of us, particularly for working class and low-income folks.

JW: They have a great website, nottoolateclimate.com. “There are still important choices to make about climate. We know individual actions matter, but in order to have effective change, it will take mass action. We know the difference between the best- and worst-case scenarios matters. We know that the future is being decided in the present. We know that a lot of people are overwhelmed by doom and gloom, but it is not too late.” It’s from the website nottoolateclimate.com.
Next, we turn to Israel’s war against the Palestinians in Gaza. The October 7th Hamas attack on  Israel killed 1200 people, mostly civilians.  Tthen Israel invaded Gaza. As of this week, there are more than 27,000 Palestinians reported killed. Among Progressives, the initial response to the war was clumsy and confusing, but three leaders emerged to steer the ship, and those are the ones honored by The Nation’s Progressive Honor Roll. Beth Miller, the political director of Jewish Voices for Peace, Abbas Alawieh, I think I’m pronouncing that right, former chief of staff to Cori Bush, and Eva Borgwardt, the political director of IfNotNow. Tell us about them.

JN: These folks scaled up immediately. They did so in a very collaborative and very well-coordinated way. At a point when there needed to be an alternative answer to simply supporting Israel’s assault on Gaza, they offered that alternative.

JW: And that alternative was the Ceasefire Now resolution in the House that called on the Biden administration to exhaust every diplomatic tool to end the assault on Gaza.

JN: And they offered it working with members of Congress, working with people in communities across the United States, recognizing the need for a multiracial, multi-ethnic and multi-religious coalition. The successes are seen in the extent of the movement that we see in the United States right now. The movement for a Ceasefire Right Now in the United States is one of the biggest foreign policy related movements in the history of the country. It’s huge, and it’s, maybe it stumbles at times, but it’s often very focused, very coordinated and one of the reasons for that is these three people.

JW: And let me just add that IfNotNow, has a particularly good website, IfNotNow movement.org. Most Americans know less than they think they do about Palestine. And as you point out, that includes most members of Congress to bring historical perspectives on this war. The Nation’s Progressive Honor Roll has named Rashid Khalidi, the Edward Said Professor of Modern Arab Studies at Columbia. Please explain his contribution.

JN: Well, he was there right at the start immediately because he’s such a respected academic and because he’s been a spokesman and a writer, a researcher on these issues for such a long time, there’s a lot of media that turn to him, not just left media or Progressive media, but also a lot of so-called mainstream media, and he was there with a smart, nuanced, detailed discussion, which, had great regard for the circumstance of the Palestinian people, understood the dynamics between Palestine and Israel, recognized the horror of what happened on October 7th, but also said, ‘look, we don’t need more horror.’ The United States was very lucky to have this individual at the ready to step up and speak about these issues in deep and fundamental, and again, very nuanced ways.

JW: Rashid Khalidi wrote one of the first opinion pieces about the war for the New York Times op-ed page. He concluded, “The only possible solution is one that ends the oppression of one people by another and guarantees absolutely equal rights and security for both peoples.” And The Nation in this context also honors one newspaper, the Israeli daily Haaretz, which a lot of us find to be indispensable for daily news about Gaza and about Israeli politics.

JN: There are actually quite a few sources that are very good, and I think Al Jazeera deserves recognition for some of the very good work that they’ve done. And then if I could just give one shout out to Jewish Currents here in the US, which I think has been doing really important work.  But Katrina vanden Heuvel, our editor, wanted to particularly focus on Haaretz for a reason.  This newspaper is – it’s a mainstream daily newspaper in Israel. It’s on the left, there’s no question of that, but it is widely circulated, widely read, and it has said from day one, this crisis is Netanyahu’s crisis. His policies, his approaches have made things worse. They’ve had nuance and complex coverage of all the stuff that’s going on both within Israel and in Palestine. For a tremendous number of Americans, this particular newspaper became an essential source of information, and that’s one of the reasons why we included it in this list.

JW: Yeah, I want to recommend the daily brief, which comes via email from Haaretz.com, H-A-A-R-E-T-Z.com.
One more I’d like to highlight from The Nation Honor Roll, somebody I’d never heard of, Allison Spillman. I’d learned from you that she challenged the right-wing effort to take over her local school board by running as a candidate and winning in Charlottesville, Virginia. This is part of a wave of hyper-local organizing that turned out to be the key to the Democrats holding Virginia in 2023. Tell us about Allison Spillman.

JN: Well, our great national correspondent, Joan Walsh, really wanted to focus on this one and for good reason. As you know, over the last couple of years, there’s been a lot of talk about the right-wing efforts to take over school boards. And they don’t just want to take over school boards. They want to ban books. They want to shut down programs that aid LGBTQ youth. There’s all sorts of aspects of this culture war assault via the school boards. And if you read the media, a lot of the major media, you’d think the right was winning all over the place. The reality is Randi Weingarten and other folks will tell you, is that Progressives are actually doing very, very well in school board races across the country as they step up and say, hey, we want, well-funded schools. We want teachers to be respected, and we frankly want to teach children the whole of what’s going on, not some narrow right-wing agenda.
And it came to a head in Virginia, there in this particular school board race where you had Antonin Scalia’s daughter running as the conservative candidate, right? I mean somebody, and newsflash, if you got those kinds of contacts, you can raise a lot of money. So you had a conservative candidate who was raising a substantial amount of money, not running far right-wing, kind of trying to position as a little more thoughtful, but of real concern.
And then you see a more progressive candidate step up, and Allison Spillman, who basically said, look, we got to be careful here. If we lose our school board to the right, even in this relatively liberal town, we’re going to end up in a place where we don’t want to be. We’re going to be talking about what books can be read, what programs can be organized, how we teach and stuff like that in ways that frankly disrespect teachers and disrespect the basic premises of education. She was very thoughtful in her race. She ran as a candidate who had kids in the schools, which is always a good thing. And she didn’t just win, she won big. And it was – focusing on this race is important because it was an important race in and of itself, but it also serves as a marker for races in communities across this country. And what it tells us is that Progressives A, should run for the school board, and B, that if they do, they can run as Progressives with a bold, thoughtful, smart vision and they can win.

JW: We don’t have time to talk about the other people on The Nation’s Progressive Honor Roll for 2023: members of Congress Cori Bush and Jamie Raskin, Senator Jeff Merkley, those legislators in Tennessee who led the fight against guns, Justin Pearson, Justin Jones, and Gloria Johnson, and musician Tom Morello. I’m also leaving out young supporters of abortion rights. Maybe we should put in a plug for the young people of Wisconsin here.

JN: Yeah, that’s sort of almost a vague title to honor. But the fact of the matter is, if you look back at 2023, and even at 2022, and you want to say, well, who came into the process? Who came into the political process and tipped the balance toward Progressive victories? It was very often college students, young voters, often motivated by their concern about reproductive rights. And in the state of Wisconsin, as an example, we had massive youth turnout last April when Janet Protasiewicz was elected to the state Supreme Court, flipping control of the Supreme Court to a liberal majority, and beginning a process that is likely to protect abortion rights as well as likely to restore democracy to Wisconsin by getting rid of gerrymandering. So you give a lot of people credit in 2023, but there’s a line, and we got to get in, and I’m going to get in that line behind the young people who are coming in and casting the votes that are transforming our politics.

JW: Read about all of them at thenation.com. John Nichols, thanks for talking with us today.

JN: Always an honor to be with you, Jon.
[BREAK]

Jon Wiener: Next up, California gets one step closer to universal healthcare by expanding coverage to all low-income residents, regardless of immigration status. For that story, we turn to Sasha Abramsky. Of course, he writes regularly for The Nation. His work has also appeared in The Atlantic, The Village Voice and Rolling Stone. He’s written many books, including The American Way of Poverty and The House of 20,000 Books. Last time we talked here, it was about his cover story for “The Nation, The Small-town Library That Became a Culture War Battleground.” We reached him today at home in Sacramento. Sasha, welcome back.

Sasha Abramsky: It’s so good to be on the show. Thanks for having me on again.

JW: First let’s talk about the problem: the big picture of healthcare for the poor in the United States, maybe starting with Obamacare.

SA: Yeah, if you go to Obamacare in 2010, America had this massive problem, and the problem was multifaceted. On the one hand, there were an awful lot of people, poor people mainly, who just didn’t have health insurance. They either didn’t have a job and they didn’t qualify for Medicaid, Medi-Cal, or they had a job, but the job didn’t come with health insurance. So that was one problem. The second problem is a lot of people who had health insurance had a pre-existing conditions. So they’d get sick, and then it turned out, ‘well, sorry, you’re not actually covered for this particular ailment or this particular medicine.’ And so you had a lot of people with health insurance who were still getting huge bills. And one of the biggest problems, which is a problem of not having a nationalized system, but one of the biggest problems was we’ve got an awful lot of undocumented people in this country, many millions, about 12, 13 million people. And none of those people were covered by any of the state insurance system.
So the Obamacare or Affordable Care Act comes along, and it doesn’t solve the first two problems, but it at least makes a dent in them. It expands the ability to get coverage. That’s number one. And the second thing is it makes companies cover you for pre-existing conditions. So you had this effort to bring in a lot of poor people and a lot of sick people into the health insurance system, and that was good, but one of the compromises that was made to get it passed was that no federal system would cover or touch any undocumented residents. And actually, a lot of the federal systems exclude documented but non-citizen residents. So you have this huge gap in coverage, especially in a state like California, which has got a huge number of immigrants, both legal and undocumented. So that’s the situation post 2010. And what I was writing about is the effort in that 14, 15 years since then to plug those gaps in California.

JW: California’s part of Obamacare includes Medi-Cal, health coverage for poor people. There’s more than 15 million people in California’s Medi-Cal system. Only three states have a total population larger than that. Over the last several years, California expanded coverage to include children in poor families, including the undocumented, as well as young people up to the age of 26 and older people, people older than 50. They already had coverage before this year. The news that you have written about for The Nation is about the new situation since January 1st in California was that everybody else, those adults between 26 and 49, who’d been left out ever since the beginning of time finally got coverage regardless of immigration status. Explain why this coverage of the undocumented is such a big deal and such a politically fraught issue in America today.

SA: What happened in the years after the Affordable Care Act? When the Affordable Care Act was passed, almost one in five Americans, not quite, but almost one in five Americans were completely outside the healthcare system. They had no private insurance. They didn’t qualify for any of the myriad federal systems, the Veterans Affairs, Medi-Cal, Medicaid, Medicare and so on. So you had this huge pool of people, including vast numbers of kids who when they got sick, either didn’t go to the doctor or they waited and they went to the emergency rooms, which had to see them, but would then bill them. And sometimes those bills were recoverable, sometimes they weren’t.
The Affordable Care Act creates conditions where more and more people can be brought in, and one of the ways it does it is by expanding Medicaid eligibility, which states had to opt into. But an awful lot of states did opt into that, and they got federal subsidies for doing so. And there were various other mechanisms to bring more and more people into health insurance systems. One of the other ways to do it was states were to create these insurance marketplaces with subsidized private insurance.
So California, going into 2010, had about a national average for uninsured. It was about 18%, I believe, of Californians were uninsured. It created what was called Covered California, this very expansive marketplace, which would provide affordable private insurance for people who weren’t being given coverage by their employers. So they were earners, they were too affluent to qualify for Medi-Cal, but they weren’t being given private insurance and they couldn’t afford to buy on the marketplace. So Cover California gave a series of options for subsidized entry into the private marketplace, and it depended on what your income levels were. And the point being that it created a system that made it more possible for an increasing number of people to buy into insurance in affordable price. So that was one way of lowering the numbers of those who were uninsured.
The other way was they expanded Medi-Cal, which most states, especially Democrat-led states, expanded their Medicaid systems so that you would have more people eligible, able-bodied adults being a case in point, people who in various other times and locations didn’t qualify for Medicaid. So those people were also now brought in through the expansion of the Medi-Cal system. So that reduced the gap further there were then all these efforts made to bring children into the insurance system. Now, not every child in California is covered, but the vast majority of children now have access to some kind of health coverage. So that limited it still more.
The huge remaining group was the undocumented. And in California, because there are, I think the estimates are a couple million undocumented people, maybe more, if you have that many undocumented people, you are never going to get down to anywhere approaching zero uncovered. You are always going to have a well of people who lack basic coverage, and that’s a public health issue. On all kinds of levels, that’s bad. So over the last few years, healthcare advocates have really focused their energy onto getting the undocumented covered through state Medi-Cal. Now, the federal government won’t pay a penny. That all comes out of state money, and it’s quite expensive. It’s several billion dollars a year. But California has made that commitment.
And so as you said, at first, they covered children and young adults. Then they covered older, undocumented, and now they’re covering everyone. Now, that still doesn’t get us to universal coverage. There are still holes in it.

JW: A couple of other points about this. One of the best things about what California has done is that the expanded coverage is automatic. People don’t have to do anything to get this. They don’t have to fill out an application. So as of January 1st, in California, all of the poor and the working spoor, regardless of their immigration status, get health insurance. And this covers not just care when they get sick or when they get injured. I understand that the California system includes preventive care services. California, of course, is the bluest of blue states. How does the healthcare for the poor and the undocumented compare to a big red state, for example, Texas?

SA: Well, I’ll answer that in a minute, but let me back into it by saying California is a blue state and it leads the way with a group of other blue states. So where California goes, it’s a fair bet that many other Democratic led states will follow. So you have this situation now where the big blue states, California, New York, Illinois, have been pushing very, very hard for an expanded healthcare system that includes one or another coverage for the undocumented. Smaller blue states are now following.
The Red states have gone in the opposite direction. They’re clamping down on undocumented access to any kind of social safety net. And states like Texas have resolutely refused to expand their Medicaid systems. So Texas is a scandalous situation. It’s got double-digit on insurance rates for children. Imagine that, a society as wealthy as Texas, which has been given the opportunity to expand healthcare to cover low-income children and it says, ‘no, we don’t want to provide routine doctor’s visits. We don’t want to provide routine vaccinations. We don’t want to provide mental health coverage for kids.’ What kind of a state does that? Well, the answer is a state like Texas, which also, at the same time, prosecutes people for getting abortions, threatens to send doctors to prison for performing abortions, where the State Supreme Court said a woman whose life was at risk unless she got an abortion, couldn’t get that abortion. I mean, Texas’s attitudes to health exist somewhere between the Middle Ages and maybe the 17th or 18th century, but it’s hundreds of years behind what most modern democratic societies are.

JW: Getting back to California, we said that went into effect on January 1st is moving towards being close to 100% coverage so that all residents will have health insurance regardless of immigration status. How many people are left out? How many working-age Californians are there without health coverage in California do we think this year?

SA: In California, despite all these expansions, you still have two to two and a half million people who the estimates are don’t have coverage. And there is a problem there that any patchwork system that isn’t a nationalized system or isn’t a universal system, any patchwork system, it plugs a lot of the gaps, but then it always leaves some. And so, one of the problems is you have a lot of independent workers who don’t have a stable job with stable benefits, who may be young and they don’t see why they should buy into insurance, or they may be older and they do see why they should buy in, but they’re too affluent to qualify for subsidized insurance and the insurance rates they’re being quoted 10 or $20,000 a year. And so there are tax penalties for not having insurance, but sometimes people choose to pay the tax penalties rather than pay 10 or 15,000 for the insurance coverage.
So that problem remains. You still have people who, for various reasons, either choose not to or can’t afford to buy into the marketplace. And as long as you have a marketplace-based health insurance system, that’s going to remain a problem. I think no state in the country has got to 100% coverage, but you can approximate. You can get as close as you can. You can expand the subsidies. You can expand the incentives. I guess, at some point, you can extend, expand the sticks, the penalties for not getting health insurance. But there are ways you can encourage more and more people to get the insurance.
But again, as long as you have a patchwork quilt system, it’s not going to be truly 100% coverage. I don’t think the measure of California success or failure here is whether it’s got to 100%. And the measure of California’s success or failure is whether it’s doing way better than other states, given the current parameters of the health system in America. And I know even the California Nurses Association and various others have been pushing for years for single-payer universal health coverage in California. And we may get there one day, but that’s not where the political debate is at the moment. And as long as the political debate at the moment is how do you use public options, but within a private system, you’re still going to have some people who fall outside the scope of coverage.

JW: Now it’s time for your Minnesota moment, that’s news from my hometown of St. Paul that you won’t get from Sean Hannity. Undocumented immigrants in Minnesota will be able to get health insurance coverage through the state’s low-income health insurance marketplace, which there is called Minnesota Care. The Minnesota system starts a year from now, January 2025. They will be able to do what California has done as of January 1st, 2024. Minnesota was able to do this because in 2023, voters gave the Democrats control of both houses of the state legislature as well as the governor’s office. Governor Tim Walz was re-elected. This is what we call a trifecta. Let us note that it took a trifecta in California to achieve this as well.

SA: Yeah, I think the Minnesota lesson is it takes a trifecta anywhere. The way the Republican Party currently thinks about healthcare and about immigration and immigrants – it doesn’t allow any room for a humanization of the undocumented. Now, you can have a legitimate policy argument. What do we do about people who come into the country without status? How generous should the asylum system be, et cetera, et cetera? But it is a reality that there are several million undocumented people in this country, and it is a reality that many of those undocumented are children. And it’s also a reality that if you essentially make it impossible for those millions of people to have access to healthcare, in addition to making it more likely that those individuals will get sick, you make it far more likely to trigger a public health crisis because if you have a lot of children who can’t get vaccinated because they can’t see a doctor, or a lot of people who may have a persistent cough, but they never get a tuberculosis test, or a lot of people who may or may not know that they have an STD or HIV AIDS, if you have diseases like that that are going untreated, undocumented and unmonitored, that’s a public health risk.
So however you look at it, whether you look at it from an empathy angle or whether you look at it from a public health angle, excluding millions of people from any kind of healthcare coverage is as counterproductive as you can get. So if I were advising Republican state politicians on this, I’d say, look, you can have your opinions about undocumented immigration and what to do about it and how to secure the border and so on. That’s one debate. But untangle it from the second debate about what to do about healthcare for the people who are already here. Because at the end of the day, nobody wins. Nobody wins if public health emergencies are allowed to fester. California is actually being extraordinarily pragmatic in expanding healthcare to the undocumented, as is Minnesota.

JW: Momentous achievements in healthcare reform led by California. You can read all about it in Sasha Abramsky’s report, “California Gets One Step Closer to Universal Healthcare.” It’s at thenation.com.  Sasha, thanks for talking with us today.

SA: Always a pleasure. Thanks so much.

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