Chuck Pennacchio, founder of OnePayerStates, visited our Politics Done Right set at Netroots Nation 2024 to discuss universal healthcare starting at the state level and his work towards national universal healthcare.
Chuck Pennacchio discusses universal healthcare at the state level.
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In a conversation with Politics Done Right, Chuck Pennacchio, founder of OnePayerStates, laid out the foundational strategy for achieving universal healthcare in the United States by focusing on state-level implementation. His approach, steeped in pragmatic historical and economic rationale, highlights the necessity of working state by state to build a momentum that could eventually shift the national healthcare landscape toward a single-payer system.
State-Level Change as a Gateway to National Reform
Pennacchio emphasized a pragmatic approach to healthcare reform, noting that real, transformative social change in the U.S. has historically begun at the state level. This strategy mirrors how Canada built its national healthcare system, starting with one province, Saskatchewan, in the 1960s. He discussed the success of state-based reforms and their potential to act as laboratories for innovation, a concept ingrained in American governance known as the “laboratories of democracy.”
The current states leading the charge, including California, Oregon, Washington, Minnesota, New York, Massachusetts, and Maine, represent diverse regions and political landscapes. Pennacchio believes that other states will be motivated to follow suit by proving that universal healthcare can be effective in these states. Oregon, for example, has recently instituted a governing board to oversee its push toward a state-based healthcare system, a move that Pennacchio sees as a potential tipping point for broader adoption.
Economic Arguments for Universal Healthcare
A key part of Pennacchio’s message was the economic viability of state-based universal healthcare. He explained that most Americans are already paying hidden taxes through inflated healthcare costs, a burden they may not fully realize. By shifting to a single-payer system, states could provide better coverage for their residents and reduce the overall financial strain on individuals and businesses.
Pennacchio stressed the importance of framing healthcare reform in terms of economic justice. “We need to make the economic argument,” he said, urging advocates to explain how a single-payer system would save money for most people while improving access to care. He also addressed the political resistance from powerful players in the “medical-industrial complex”—including big pharmaceutical companies, insurance giants, and medical equipment manufacturers—that profit from the current for-profit healthcare system. These entities, he noted, have a stranglehold on national healthcare policy through their substantial financial influence in Washington, making state-level efforts a more feasible immediate goal.
Addressing Progressive Pushback
Pennacchio acknowledged some pushback within the progressive movement, particularly from those who advocate for an all-or-nothing approach to healthcare reform at the federal level. He argued, however, that this perspective overlooks the lessons of history. The Progressive Era reforms, the New Deal, and the Great Society all began with state and local initiatives that served as models for national policy.
Moreover, he pointed out the dangers of political purity, where factions within the progressive movement hinder each other by insisting on ideological perfection. As he termed it, this “circular firing squad” approach ignores American politics’ practical realities and the obstacles entrenched corporate power poses. Instead, he urged progressives to unite around achievable goals, such as state-level universal healthcare, to build momentum toward national change.
Building Political Power and Coalition
One of Pennacchio’s central messages was building political power by connecting healthcare to broader social justice movements. He argued that healthcare justice intersects with pressing issues such as housing, food security, policing, and climate change. The fight for universal healthcare, he said, must be part of a larger push for “transformational justice,” a term he used to describe a holistic approach to societal equity.
His organization, OnePayerStates, is working to bring together diverse coalitions—including younger activists, people of color, LGBTQ+ communities, and immigrants—under the banner of healthcare reform. By framing healthcare as a fundamental human right and connecting it to other justice issues, Pennacchio hopes to build a broad-based movement capable of overcoming the significant opposition from corporate interests.
The State-Based Universal Healthcare Act
Pennacchio also discussed legislative efforts to facilitate state-based healthcare reforms, specifically the State-Based Universal Healthcare Act (HR 6270), introduced in the House of Representatives. This bill, which he describes as a critical stepping stone, would allow states to use federal funds to create their single-payer systems. Senator Ed Markey is expected to introduce a companion bill in the Senate.
The passage of this legislation would be a game-changer, enabling states that are ready and willing to implement universal healthcare to do so while setting the stage for eventual nationwide reform. Pennacchio encouraged listeners to contact their U.S. representatives and senators to support the bill, emphasizing the need for grassroots pressure to push these reforms forward.
Conclusion
In the end, Chuck Pennacchio’s message is clear: state-based universal healthcare is the most viable path toward comprehensive reform in the U.S. While national Medicare for All remains the ultimate goal, the road to that destination runs through states willing to act as models of what is possible. By working at the state level, advocates can bypass the gridlock in Washington, challenge the entrenched power of the medical-industrial complex, and, most importantly, provide real relief to millions of Americans in need of affordable, high-quality healthcare.
Pennacchio’s call to action is one of unity and pragmatism, urging progressives to embrace state-level reforms to achieve lasting, transformative change.
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