Following the debate this week where Washington-based progressive activists attacked progressive efforts to expand health care at the state level (see here, here and here), Nathan Newman offers us this post that asks a few simple questions: Why do D.C. folks feel so threatened by states taking action on the agenda they say they care so much about, to the point they are now calling all efforts by states to lead on expanding health care "disastrous?" And how has it somehow become controversial in progressive political circles to say that we need to push for universal health care at BOTH the state and federal level? Since when did that become such a taboo position? Did I not get the memo or the listserve email that the D.C.-based progressive sphere has decided to go to Defcon 1 in an all out assault on the very concept of passing progressive legislation at the state level? And aren't all of these attacks on state progressives a little strangely timed, considering a fairly sizable state legislative body just passed one of the most progressive universal health care initiatives in contemporary history?
Clearly, there are political and structural advantages on health care at both the federal and state level - as Nathan shows, states can more easily pass structural reforms, and the feds can most easily cut checks. There are also disadvantages to both arenas - again, as Nathan shows, states cannot deficit spend and thus need financial support, and the federal government faces a filibuster on structural reforms that it does not face on simply cutting checks. Since when did trying to maximize the advantages of both in pursuit of getting more folks health care coverage become such a horrific idea?
My guess is since D.C. folks started having delusions that state-based action somehow makes them feel less Relevant and Important. But nothing could be further from the truth. Sure, the Washington political class can often be disconnected from the day-to-day reality that ordinary folks face. That's not a cliche - it's reality, to the point where some D.C. progressives now attack with straight faces state-based programs that are responsible for providing health care to 20 million more Americans. But D.C. clearly is critical in the health care fight simply because the federal government controls the biggest pot of public money. No one working on state policy has ever argued differently - not me, not Nathan, not the Progressive States Network, not anyone. It is the D.C. chattering class that is trying to make this an either/or choice.
As Nathan says, like the conservative movement's most effective campaigns, we progressives need to be fighting at every level. Again, this is not an either/or choice, and to try to make it one is not only an insult to the thousands of state legislators, organizations and activists who have actually expanded coverage where Washington elites have to date failed, but is counterproductive to the progressive movement's larger goals of providing universal health care to all Americans. We need action at all levels - and saying that shouldn't be considered controversial.