A couple months ago, while staring down the barrel of Trumpcare and contemplating the dismal economic prospect of a life spent freelancing, I was surprised and delighted to learn that I’m actually just one state legislator’s vote away from universal health care. The New York Health Act is a bill currently in the state legislature that would create a single-payer system of health insurance for every resident of the state. It was first introduced in 1992 by Assemblymember Richard Gottfried of Manhattan. The Assembly passed the bill that year, as it did last year and in 2015. In the State Senate, the bill currently sits just one vote short of a majority. Governor Cuomo has not yet stated a position on the bill, but he wants to become President very badly, and it’s hard to imagine a piece of legislation that could do more to lend him progressive credibility going into a primary. So on Tuesday I joined 600 other activists, nurses, doctors, and union members in Albany for a day spent lobbying state legislators. Health care providers who participated were asked to wear white coats and stethoscopes—it makes a strong impression when a bunch of uniformed doctors crowd into your office and ask for things.
I can’t claim long or sustained involvement with the Campaign for New York Health, and I don’t want to speak out of turn, but the mood at the rally struck me as more than cautiously optimistic: we really could win, and soon. Obamacare was not a solution to the problems of the American health care system—I pay more than $350 a month for a policy with a $7,500 deductible—but it does strike me as the one major policy achievement of an administration that otherwise oversaw business as usual. For all its flaws, it established the principle that people deserve health care because they exist, not because they got a full-time job or “earned” it in some other way. Trumpcare’s failure demonstrated this simply and powerfully—taking health insurance away from people is no longer a politically viable course. Those opposed to single payer can no longer state the real reasons for their opposition in public, and will instead have to fall back on unconvincing sob stories about how private insurance companies create jobs (the bill contains language about transitioning the state’s 25,000 health insurance workers into the new state-run system).
With the inadequacies and cruelty of a privately run health insurance system now obvious to nearly everyone, what’s left in New York is the work of organizing. If no senator can be persuaded to change his vote to yes, then somebody will have to be voted out. On the bus home from Albany, one of the day’s organizers described the lay of the land. Senators from upstate are being scrutinized for vulnerabilities, chief among which might be the fact that political categories are currently quite unstable with respect to health care. Republican legislators should not expect their constituents to vote against a challenger who can realistically promise cheap health care for everyone. Organizers are also canvassing for potential candidates to challenge Republicans in the Long Island suburbs. One woman, a resident of Sunset Park, suggested organizing a campaign of community leaders to “essentially shame” her state senator. Though Simcha Felder was elected as a Democrat in the so-called “Super Jewish” 17th District—so called because it encompasses the Orthodox neighborhoods of South Brooklyn—he caucuses with the Republicans, robbing the Democratic Party of a Senate majority they earned at the polls.
Some, all, or none of these tactics might work, but I’m betting against “none.” Everything I saw and heard in Albany suggests that single payer’s moment has arrived in New York. It’s true that the state’s private insurers have yet to begin mounting their opposition to the bill, and when they do it will certainly make things difficult. But low turnout and a general lack of interest means that organizers and activists can have an outsize impact on state-level politics. Having never participated in state-level politics before, this seemed to me like a good time to start.
Our group of first-time lobbyists sat in the conference room next to Assemblyman Nick Perry’s office, talking to his legislative aide, who had a shiny suit and a dramatically swooping hairdo. This group was dedicated enough to spend the day riding a bus and attending meetings in Albany, but we were all new to the game, and we did not know the ins and outs of the state legislative process. Assemblyman Perry, who represents a swath of central Brooklyn, was already in favor of the bill, so we didn’t have to convince his aide of anything—just reiterate the importance of the issue and thank him for his support. We told some personal stories, as our brief lobbying prep email had advised. As our conversation with the aide went on, the conversation turned; instead of saying what we wanted and why we wanted it, our group began asking the staffer questions about strategy. Who should we be talking to, what chairperson, what committee? Where could our efforts be best deployed? I believe someone used the term pressure point.
Lingo aside, it had become clear just how little we knew about the legislature’s process. One person didn’t realize that the assemblyman we were lobbying was different from a state senator. As we unmasked our ignorance, the ambient anxiety in the room rose. There was a nervous scramble to regain some of that extremely-informed high ground, parroting back some of the information about committee procedure and vote-counting that we’d been given on the bus. The specter of those ridiculed Tea Partiers holding Govt Hands Off My Medicare signs materialized in our collective imagination and stood hovering in jean shorts above the conference room table. We could not be like them.
There are many good reasons for citizens to understand the finer points of policymaking. But in this room, we were at our most powerful and effective when we put aside the urges to be experts (we are not) and to show off our sophisticated political analysis (we didn’t have one). The organization that had put together the lobbying meetings, Physicians for a National Health Plan, did not need us to be West Wing cast members, storming the state capitol armed with mental dossiers of each legislator’s secrets and motivations. They needed us to be warm bodies who live in the right districts, people willing to simply show up and say what we want.
Aleksander Hemon recently said in an interview that the job of the people in any democracy “is to drive their leaders crazy with demands.” How nice it was to lean into that role, to be a pure constituent, to show up and say, I want this kind of health care plan, I want it for these reasons, and I don’t really care how you do it. The squeaky wheel doesn’t have to deliver savvy and compelling instructions on grease application.
The bus to Albany dropped us off at a Baptist church without pews. Inside, we found our group in one of the loose rows of plastic chairs facing the altar. It had rained that morning, so we were late getting out of Manhattan and now the coffee and bagels were gone, but there were still plenty of signs. On the lobby table, stacks of them read HEALTHCARE IS A HUMAN RIGHT and GUARANTEED HEALTHCARE FOR ALL NEW YORKERS. A bit later, I did spot pews on the second floor. Stained glass, too, but we weren’t allowed up there.
It was in a church that I was first taught to forget my body. Most Protestant churches, and this one in Albany was no exception, are plain things, intended to remind you that the real spiritual world is elsewhere. Once, at the Christian school I attended, we were told to break our secular CDs and tape the pieces to the classroom walls. Everywhere we looked were polycarbonate constellations of No Doubt, Radiohead, Blink-182. “Our focus is not on this world,” our teachers would say by way of explanation. They were paraphrasing the Apostle Paul who wrote in his Second Letter to the Corinthians, “Though outwardly we are wasting away . . . we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal.”
Faith leaders have rigorous arguments for universal healthcare, but it was still disorienting for me to be in a church full of people demanding care in this world. One woman held a sign with a checklist of policies the New York Health Act would include: Medical care. Dental care. Vision. Coverage for mental and reproductive health. Over time, I had abandoned much of the religious doctrine of my childhood, but ethical systems outside the church can be lonelier, less organized ones. Marching out of the church with the other lobbyists, I felt what, until I became in involved in protests and rallies, I had only known as a religious feeling. The joy of being in a group with common cause; the pleasure of shared conviction. I thought about Paul, who, as the story goes, was literally blinded by the light of Jesus for disbelieving. I wanted universal healthcare for him, too.
At the rally, a few senators thanked NYSNA—the New York State Nurses Association—and made jokes about how they would need their services after standing out in the cold for so long. One woman spoke of her brother, who committed suicide after a case manager turned him back to the VA Hospital he hated. Shortly after that her father died. Her mother followed. In a loud voice that somehow also conveyed her shyness, she described the snow on her farm the day she learned of her brother’s death and the childhood photo that showed his feet in tiny cowboy boots. A single mother with diabetes counted the ten prescriptions she couldn’t afford. Marisol Alcantara, a state senator from the Bronx, said we were going to get shit done.
While they spoke, I kept seeing a simple cardboard sign across the crowd that read HEALTHCARE IS A MORAL IMPERATIVE. I haven’t been religious for almost fifteen years, but there’s another line of Paul’s I still believe in. 1 Corinthians 6:19 reads, “Your body is a temple.” This one was used to scare us off sex and artificial sweeteners. I don’t count sex or sugar among my fears anymore, but I do still believe in the body as a site of the highest moral obligation. We stood in the cold and listened to the stories of the speakers, and then we all shouted, “Fight back!”
We had some time before heading back to the city, so we visited the New York Capitol building, where there was a bell that wouldn’t stop ringing. It was calling the senators back to the Assembly Chamber, where earlier, they had failed to pass the budget and were now slow in returning. Like the church, there was stained glass here, too, and this time, we were allowed to sit on the second-floor benches. But that’s where the comparisons end, because in the chamber, there was also polished granite, red leather, chandeliers, a grandfather clock, and paint that shimmered like gold lamé. When the room was first built in 1899, it had the largest spanned arch in the world and two forty-five-foot murals painted on the sandstone walls by William Morris Hunt. Within a decade, the ceiling began to crack and stones fell from the heavens. Repairs required dropping the ceiling four feet below the murals, swallowing the scenes of justice, so now the only people in the room were us, a handful of senators, and their aides. We sat and watched what the bodies below us would do. Not much of anything, as it turned out. Aides showed each other the funny things on their phones. Senators exited the room and returned with paperwork. The New York Health Act wouldn’t be up for a vote until it had another co-sponsor, but there was reason to believe that could happen soon. When we left after forty minutes, the bell was still ringing.
On the bus ride home, I reread 1 Corinthians 6, because I had forgotten how it ended. “Remember,” Paul writes, “you are not your own; you were bought at a price.” I felt an old anger rise in the back of my throat, but I didn’t suffer it long. Instead, I looked around at all the people on the bus.
—Kelley Deane McKinney