The battle to win union support for single-payer healthcare didn't start yesterday, or even with Bernie Sanders' 2016 run. It has come a long way, motivated at first by coalitions of progressive unionists like Labor Campaign for Single Payer, and eventually boosted by the leadership of National Nurses United. Due to their work (and Bernie's championing of Medicare For All), hundreds of resolutions in support of Medicare For All have been passed by union locals, central labor councils, state federations, and even the national AFL-CIO in 2017.
The Texas State AFL-CIO joined them just a few weeks ago. While it was a late adopter of Medicare For All, the resolution they passed was stronger than many others, including one passed by the national AFL-CIO in 2017. That resolution seemed to take an “all of the above approach” on healthcare, lumping in Medicare For All as a goal alongside others like “supporting individual [insurance] marketplace stabilization.” The Texas resolution, in its own words, “enthusiastically supports Medicare for All and calls on the Texas federal legislative delegation to work toward assuring appropriate and efficient health care for all residents of the United States.”
I was present at the Texas AFL-CIO convention and participated in some of the healthcare discussions. Delegates who were hesitant about going “all in” on Medicare For All voiced many of the same questions I hear in my breakroom discussions at work. If we don’t have great health plans, doesn’t that make unions less attractive? Wouldn’t a socialist system be less efficient? Why fight for non-union members when we are struggling to make gains for ourselves?
Just a few years ago, this conversation was always an uphill battle in Texas. But this experience was dramatically different, as airline mechanics, teachers, refinery workers, and electricians clambered to be the first to address each hesitation voiced at the convention. It was apparent that the Democratic primary debates -- and Bernie’s consistent support for Medicare For All -- have sharpened the contrast between corporate-friendly half-measures and a true single-payer system that would eliminate private insurance. The attacks on Medicare for All from forgettable primary contestants like Reps. Tim Ryan and John Delaney, even when invoking union members as opponents to the demand, have also seemed to backfire, offering Bernie the opportunity to explain:
“...many of our union brothers and sisters [...] are now paying high deductibles and co-payments and when we do Medicare for All, instead of having the company putting money into health care, they can get decent wage increases which they are not getting today.”
The Democratic primary contest isn't the only one affecting debates happening within labor regarding Medicare for All. Current AFL-CIO President Rich Trumka is expected to retire soon, and likely candidates for the top position include his hand-picked successor Liz Shuler from the IBEW, and insurgent leader of the flight attendants union Sara Nelson. Both women spoke at the Texas AFL-CIO state convention and championed a progressive political vision (purely coincidental, as scheduling had happened before candidacy rumors began circulating) -- but only Nelson mentioned Medicare for All specifically. The flight attendants union president has also repeatedly rebuffed the insurance industry talking points voiced by Delaney, Ryan, and Biden.
While the continued spread of Medicare for All resolutions across the US and its increasing presence in top union leadership debates are certainly signs of progress, we will need to see real, ongoing commitments from all labor leaders to make Medicare for All a reality. As Mark Dudzic noted in Democratic Left, “What is needed now is for unions to move beyond ‘resolutionary politics’ to commit substantial resources and organizing capacity.” This means dedicating money and staff time to efforts educating and activating union members, making firm demands on recipients of union political contributions to support the Sanders bill, and truly incorporating the healthcare fight into their vision of building union power. It means taking the same enthusiasm and dedication of National Nurses United for Medicare for All into unions like the Teamsters, the Mine Workers, and the Building Trades.
DSA members can play an important role in helping labor live up to its resolutions and its most progressive commitments. Where there is an active Medicare for All canvassing and educational program, DSA can act as a natural ally to local unions and labor councils looking to get members involved. It will also take DSA members in the ranks of the unions educating their co-workers on the shop floor and holding their own leadership accountable to these resolutions -- and where they don’t yet exist, organizing to get them passed.
There is still a lot of work to be done in our unions to drive support for Medicare for All, but one thing is certain: as health care bargaining eats up more of our contract fights, and as workers continue to see diminishing returns, support taking health care off the table through Medicare for All is growing even despite the corporate media’s fear mongering. Now we need to turn that support into action.
Ryan Haney is a member of the Teamsters union and lives in Dallas, Texas.