Health Care For All Texas

03/03/2026

From Labor Campaign for Single-Payer

This newsletter is going out to union officials, staffers, and activists around the country. We know that, every day, you have to wrestle with the effects of the world’s most expensive and complex healthcare system on your members. We hope that this newsletter will give you some information and tools to make that job a bit easier.
Since our early December update about new co-sponsors of Medicare for All in Congress — Reps. Adelita Grijalva (AZ) and April McClain Delaney (MD), in addition to Senators Chris Van Hollen (MD) and Tina Smith (MN) — it has gained three more: Reps. Julie Johnson (TX), Jared Moskowitz (FL), and Sarah Elfreth (MD). With 2026 primary campaigns underway, there are new candidates supporting Medicare for All and labor rights, perhaps in your district...

Congratulations to our allies at the New York State Nurses Association on carrying out a strike during an historically cold winter and coming out with significant wins, as the New York Times reports: "Strike Ends After 6 Weeks as Last Holdouts Approve Deal." See more below on this and other nurses strikes.

Rest in peace to Reverend Jesse Jackson, who passed away at the age of 84. The Chicago Sun-Times writes: "For the late Rev. Jesse Jackson, social justice was also entwined with economic justice and labor organizing, including organizing boycotts, pushing for job opportunities and supporting unions to pressure businesses." Unions released statements, including the AFL-CIO, UAW, and AFGE. The New Yorker published on his "Timeless Economic Platform," and we're also sharing this Jacobin piece from 2020, "The Birth and Death of Single-Payer in the Democratic Party," about Rev. Jackson's 1988 presidential campaign.

Although the Labor Campaign for Single Payer is an organization focused on engaging the labor movement in the campaign to take health care off the bargaining table and guarantee it as a human right, in these turbulent times we would be remiss if we did not recognize the reality of this moment and how labor is joining together with their communities to protect our immigrant union siblings, family members, friends and neighbors. On January 7th, an ICE agent in Minneapolis shot and killed Renée Nicole Good, and the city erupted in increased protest. In These Times reported that on January 23rd, "'Everybody Showed Up': Stunning Crowds at Minnesota Day of Strike and Shutdown Against ICE." The day after, two Border Patrol agents killed Alex Pretti as he tried to protect a woman they assaulted. Pretti was an intensive care nurse and AFGE Local 3669 member of the Minneapolis VA.

Alex Press wrote an excellent holistic article, "Why Labor Unions Can't Ignore ICE." Many increasingly aren't... salute to our allies in National Nurses United: "'We Will Not Stop Until ICE is Abolished': Nurses Hold Week of Action Following Murder of Alex Pretti" as seen in Workday Magazine. Statements about Pretti's killing came from several other unions, including Minnesota AFL-CIO, his national union AFGE (which called for Secretary of Homeland Security Kristi Noem's resignation), UE ("Militarized Immigration Enforcement Incompatible with Democracy"), and the UAW.

We have a section on our site featuring each issue in print-friendly files to share with your coworkers, and you can subscribe there — PDFs are posted after the email goes out:

03/02/2026

Today’s comes from a leader in Southeast Pennsylvania. It shows us the limits of “good insurance” in a healthcare system that fundamentally puts profit over people:

Today I traveled 2.5 hours to see a specialist that I scheduled an intake appointment with 4 months ago. Some would say that I have nothing to worry about - I have comprehensive health insurance through a union job, and (at least for now) a steady income to pay for the remaining medical bills. Still, I went home in tears after the doctor told me that “there’s no test to definitively say that you have this condition, and no course of treatment even if we did.” I was given long list of food restrictions to manage a related condition and sent home with orders for tests that the doctor doesn’t expect will help. Having “good health insurance” doesn’t guarantee getting the healthcare you need if you’re getting healthcare in a system that cares more about payment than people. The best health insurance couldn’t compare to having the right to healthcare.

If our healthcare system were designed to prioritize people over profits, would this doctor have the flexibility to spend time thinking creatively with me about how to my alleviate my life-altering symptoms? Would there be more research into conditions that aren’t profitable to treat? Would patients and healthcare providers feel more human along the way? I am ready to fight for healthcare as a human right, because we all deserve quality healthcare regardless of our ability to work and regardless of our ability to pay. No person is disposable - it’s time to get rid of this system that treats us that way!

- S. in SEPA

03/02/2026

I made up my mind officially on Friday when I voted with my daughter. I want to let you know the process I went through and my thoughts.

03/02/2026

“With Candid Indifference and Finality of Tone” Exhibit Closing and Artist Talk

Friday, March 13, 2026
6:00 PM 8:00 PM

Creative Action (BLDG 3)1023 Springdale Road Austin, TX, 78721 (map)

“With Candid Indifference and Finality of Tone” intermingles the Texan infrastructure with the body to explore American healthcare brokenness. Larkin draws parallels to collective loss and healthcare disproportionality through personal experiences with grief and chronic illness. The imagery invokes sensations of spatial occlusions, construction sites, industrial catastrophes, and unreliable memories. Our bodies, cut off from access when sick, are like the particularities of our environments, where one works in less than ideal conditions - under invisible powers. Larkin asks: what happens when an insurance entity can, with candid indifference and finality of tone, dictate the path and extent of your life?

Facilitated by the artist Zack Larkin and UpFront Gallery

No limit
Wheelchair accessible

“With Candid Indifference and Finality of Tone” intermingles the Texan infrastructure with the body to explore American healthcare brokenness. Larkin draws parallels to collective loss and healthcare disproportionality through personal experiences with grief and chronic illness. The imagery invo...

03/01/2026

It’s the Prices and More
Summary: A blog post in Health Affairs highlights high US prices as the cause of massive healthcare costs. There is truth in this view. However, the problems plaguing US health care are far beyond prices. And, the price problem itself would be mitigated with single payer. (Read online here.)
The US Health Spending Problem Is Still About Prices
Health Affairs Forefront
February 18, 2026
By Irene Papanicolas, Jonathan Cylus, & Luca Lorenzoni

For more than two decades, debates about why US health care spending is so high have been shaped by the insight articulated by Gerard Anderson, Uwe Reinhardt and Peter Hussey: that the United States does not use more health care than other high-income countries but pays much higher prices for it. The original “It’s the Prices, Stupid” argument was fundamentally about price levels, not price growth. That central insight remains as true today as when it was first articulated: across services, drugs, and inputs, the United States consistently pays substantially higher prices than its peers for comparable services, drugs, and inputs.

Recent estimates of US national health expenditures, produced by the national health expenditures (NHE) team at the Centers for Medicare and Medicaid Services, have reignited debate about what is driving spending growth, which is a related but distinct question. In his recent Health Affairs Forefront piece, “It’s Not the Prices, Stupid,” Michael Chernew argues that utilization and intensity, rather than prices, are the primary explanation for recent expenditure growth.

While we agree that understanding what drives expenditure growth is essential for sound policy, we worry that this framing risks conflating growth dynamics with the underlying reason the United States spends so much on health care in the first place: price levels that are far higher than those paid in other high-income countries.

Health care spending reflects the interaction of prices and volume. In practice, when researchers decompose spending growth, volume typically encompasses both the use and the intensity of care delivered, with intensity referring to changes in the mix or complexity of services per episode.

Although it is lumped together with use, changes attributed to intensity may reflect shifts in service mix, coding practices, payment design, or the adoption of new technologies—many of which operate through higher prices per episode rather than greater quantities of care.

While the NHE estimates do account separately for the administrative spending incurred by payers and insurance, they are not able to do the same for provider-facing administrative costs, such as billing, coding, and prior authorization compliance; instead, these administrative costs are embedded in estimates of provider spending.

There are real consequences of erroneously focusing policy attention on the use and intensity of care as the driver of exorbitant expenditure growth. By suggesting the use and intensity of care as the culprit, decisionmakers may perceive coverage reductions and higher co-payments as the solution to reduce demand. This will result in less access to care and worsen health outcomes, when the real cause of high spending growth is that the prices paid for care exceed the value they provide.

Health Affairs Online Comment by Don McCanne

Of course, prices, utilization and intensity all play some role in the cost of health care. But limiting attention to such factors, as we now do to some extent, has resulted in the most expensive health care system in the world with performance of the system ranking near the bottom of industrialized nations. What we really need is structural reform. A single payer financing system can control costs while maintaining high performance through much lower administrative costs, stronger negotiating power, limiting profit from basic coverage while covering costs, universal risk pooling, and emphasis on primary and preventive care. It’s astonishing that we are not supporting reform that would work well for everyone and instead we support reform that enables enrichment of superfluous passive investors and private equity through diversion of our health care dollars. Isn’t it time for Health Affairs to expand its coverage to such patient-friendly models that would greatly improve efficiency and value for our health care spending?

Comment by: Don McCanne (& Jim Kahn)

The renewed emphasis on prices in medical care brings back thoughts of free markets in health care as preached by Milton Friedman. But in a previous HJM post we highlighted that a universal, publicly financed and publicly administered program, as advocated by Kenneth Arrow, will bring us universal coverage, low administrative waste, removal of excess profits, and protected health care access as a social good – features not found in a free-market based system.

The Arrow model relieves us of the need to be concerned about prices because the legitimate costs are already built into the health care delivery system. Thus price shopping is an unnecessary feature that can be omitted from consideration when accessing health care. Rather than being concerned about prices in the marketplace, the patient’s concern is only about access since the payment has already been made through progressive taxes based on the ability to pay. Thus health care is always readily available to everyone without having to face the potential hardship of market prices since they will have been addressed by our public negotiators, as the growth in utilization and intensity will have been similarly addressed on our behalf. After all, negotiators representing all of us should certainly have a greater impact than any of us negotiating on our own. And for those worried about government negotiated expenses, remember that the savings come from reducing waste that is currently going to the investors, private equity and superfluous administration.

P.s. from Jim: The article states “NHE estimates … are not able to [quantify] provider-facing administrative costs, such as billing, coding, and prior authorization compliance …”. Hence costs attributable to administrative bloat imposed by complicated insurance are not highlighted. However, provider billing and insurance-related (BIR) administrative costs have been quantified. I've done much of that work with colleagues. The excess (and hence avoidable) provider BIR burden is ~10% of all spending. E.g., see a 2014 review here. It seems to me that if we need to discuss prices (and we do), we must highlight the wasteful BIR portion, which of course disappears with single payer.

A blog post in Health Affairs highlights high US prices as the cause of massive healthcare costs. There is truth in this view. However, the problems plaguing US health care are far beyond prices. And, the price problem itself would be mitigated with single payer.

02/28/2026

By gatekeeping health data, the AI Action Plan risks hardwiring bias into the future of American medicine.

02/28/2026

What is Single Payer Universal Healthcare //
National Improved Medicare for All?​
​
Learn the bills. ​Get the facts >​​​​​​​​
House Bill 3069
​Senate Bill 1506​​
​​​
The House Bill |. Click for more

The bill to establish National Improved Medicare for All was introduced by Representative Pramila Jayapal and Representative Debbie Dingell as H.R. 3069 and would improve and expand the overwhelmingly successful and popular Medicare program to provide every person living in the United States guara...

02/27/2026

ONE-PAGE PRINTABLE

Preventing Unsafe Rehab Discharge (The “21-Day Rule” Guide)

For caregivers of patients in rehab or skilled nursing facilities

⸻

🚨 If a Facility Says Insurance Is Ending

Remember:

Insurance coverage ending does NOT mean the patient is medically safe to go home.

Facilities must legally ensure a safe discharge.

⸻

✅ STEP 1 — Ask for This Immediately

Request the:

NOTICE OF MEDICARE NON-COVERAGE (NOMNC)

This document activates appeal rights.

⸻

✅ STEP 2 — File a FAST APPEAL

Call the Quality Improvement Organization (QIO) listed on the notice.

⏰ Deadline:
By noon the day after receiving the notice

Result:
• Discharge usually pauses
• Independent medical review begins
• Facility must justify discharge medically

You do NOT need:
• A lawyer
• Power of attorney
• Doctor approval

⸻

✅ STEP 3 — Shift the Conversation

Say:

❌ “Insurance won’t pay.”
✅ “This discharge is unsafe.”

Unsafe discharge examples:
• Patient needs 2-person assist but only 1 caregiver available
• Home cannot fit wheelchair/equipment
• Caregiver physically unable to lift
• Patient non-weight-bearing or medically unstable

⸻

✅ STEP 4 — Call These Agencies

Every state has equivalents:
• Long-Term Care Ombudsman (patient rights advocate)
• Medicare QIO (appeals)
• State Medicare counseling program (SHIP/SHIBA)
• Adult Protective Services (report unsafe discharge)
• State facility licensing complaint line

⸻

✅ STEP 5 — Request Medical Records

Ask immediately for:
• Therapy notes
• Nursing assistance level
• Physician orders
• Discharge plan
• Insurance communications

Say:

“These are needed for an expedited Medicare appeal.”

⸻

✅ STEP 6 — Questions to Ask at the Meeting
• What transfers can the patient safely perform today?
• Is discharge based on medical readiness or insurance limits?
• Has a home safety assessment been completed?
• What caregiver training has occurred?
• What equipment is confirmed before discharge?

⸻

✅ STEP 7 — Key Statements

Use calmly:
• “I cannot safely accept this patient at home.”
• “We are requesting a Fast Appeal.”
• “This appears to be an unsafe discharge.”

⸻

⭐ CORE IDEA

Facilities must discharge patients based on safety and medical need — not insurance timelines.

Fast action within 24–48 hours often stops unsafe discharges.

⸻

⸻

🧩 FILL-IN-THE-BLANK TEMPLATE

Caregiver Rapid Response (Customize for Any State)

Copy and complete when discharge is threatened.

⸻

PATIENT INFORMATION

Patient Name: __________________________
Facility Name: __________________________
City/State: __________________________
Primary Caregiver: ______________________
Relationship: __________________________

⸻

CURRENT MEDICAL STATUS

Diagnosis/Injury: _________________________

Mobility Status:
☐ Non-weight-bearing
☐ Limited mobility
☐ Requires assist for transfers
☐ Wheelchair dependent

Required Assistance Level:
☐ 1-person assist
☐ 2-person assist
☐ Mechanical lift required

⸻

HOME LIMITATIONS (CHECK ALL THAT APPLY)

☐ Caregiver cannot lift safely
☐ Only one caregiver available
☐ Home too small for wheelchair
☐ No hospital bed space
☐ Bathroom inaccessible
☐ No training provided

Describe concerns:

⸻

⸻

ACTION CHECKLIST

☐ Requested Notice of Medicare Non-Coverage (NOMNC)
Date received: ___________

☐ Called QIO for Fast Appeal
Date/time: ___________

☐ Contacted Ombudsman
Date: ___________

☐ Requested medical records
Date: ___________

⸻

SAFETY STATEMENT (Use in Meeting)

“I am formally stating that discharge to this home environment is unsafe given the patient’s current medical and mobility needs.”

⸻

QUESTIONS ASKED DURING MEETING
1. Is discharge based on medical readiness or insurance limits?
Response: _______________________
2. What transfers can patient perform safely today?
Response: _______________________
3. Has a home safety assessment been completed?
Response: _______________________
4. What caregiver training has occurred?
Response: _______________________
5. What equipment is confirmed before discharge?
Response: _______________________

⸻

ESCALATION CONTACTS (Fill for Your State)

QIO Phone: ______________________
Ombudsman: _____________________
Medicare Counseling Program: ______
Adult Protective Services: _________
State Complaint Line: _____________

⸻

FINAL CAREGIVER STATEMENT

“I cannot safely accept responsibility for care under current conditions. We are requesting formal review and safe discharge planning.”

Signature: __________________ Date: _______