Expect an assault on healthcare in the coming Congress.   According to a Congressional staff member, that assault could come as soon as January 4th through the Budget Reconciliation process.  

Last year, Congress defunded the ACA through the Reconciliation process as well as defunding Planned Parenthood, but President Obama vetoed it.   The veto protection will no longer be in place.

Here is what to watch for:

Affordable Care Act:

Look for Congress to defund the subsidies for insurance purchases on the exchanges as well as reduce the penalty for not having insurance to zero.  The effect will be the collapse of the exchanges, driving premiums, co-pays and deductibles even higher.


Look for Congress to defund the expansion of Medicaid and turn it into block grants.   Block grants allow the states to make their own rules, which will cause many to lose coverage.  Rarely do block grants keep up with inflation, so this could lead to the eventual elimination of the program.


Look for proposals to turn Medicare into a voucher program for those under age 55 to purchase insurance on a special exchange (sound familiar?).   Apparently, Congress does not think people over age 55 have siblings, children or grandchildren that they care about and will be satisfied that they have theirs.

Vouchers will not keep up with inflation and previous analysis of Paul Ryan’s proposal showed that in too many cases, seniors could be spending up to 60% of their income on health care. 

The goal is the eventual elimination of this program.

Employer Provided Health Benefits

Look for Congress to reduce or eliminate the tax credits business gets for providing health care benefits, making it fiscally impossible for businesses to continue offering health benefits and pushing more people into the individual market.  


It is up to us to provide the backlash against these proposals.   The best way to do this is to have a strong offense.   We must:

  • Make Paul Ryan, Mitch McConnell and Donald Trump own this.
  • We must pick up the phones and call them and our own representatives and senators to tell them in no uncertain terms that this is unacceptable to the American people.
  • We must also demand the solution:   Expanded and Improved Medicare for All.  
  • If staff indicates they don’t know the viewpoint of the Representative or Senator, ask them to find out and give you a call back.   Make them take down your name and number.
  • Call back in a few days if you have not heard back from them.
  • Keep calling.  

Phone calls are more effective than emails or postcard campaigns.

Postcards, letters and emails are simply sorted according to broad topics and then a standard response is sent.   Phone calls require staff members to listen to the actual topic at hand.   Calling disrupts normal business and will eventually evoke a response.  

Rob Portman

Washington, DC office:   202-225-3031

Cincinnati office:  513-684-3265

Cleveland office:   216-522-7095

Columbus office:  1-800-205-6446

Toledo office:  419-259-3895

Paul Ryan

Washington, DC office:   202-225-3031

Mitch McConnell

Washington, DC office:  202-224-2541

Bullet Points for Legislators

  • Single Payer saves money.  For the past 20 years, states have commissioned studies on different types of health care systems.   In EVERY case, single payer was shown to be the only way to cover everyone and the only system that saved money and controlled costs.

  • Publicly financed does not mean government run health care.  YOU have publicly finance health coverage, but the government does not make decisions regarding your health care.

  • Cost conscious patients often don't get the care they need.   Most decisions are made by the doctor in concert with the patient, but the patient relies on the doctor's knowledge to make a decision.  Expensive tests and treatments cannot be ordered by the patient, only the doctor.

  • Lifestyle choices are not what is fueling high costs in health care.   The United States ranks low in general health indicators, but high in good health habits.  We smoke less, drink less and consume less animal fat that many other countries with better health indicators and much lower health care costs.

  • Businesses can accurately determine their health care costs and are not subject to unanticipated large premium increases.

  • It will reduce labor costs due to a more efficient way of financing health care, eliminating much wasteful administration.

  • Workers' Compensation costs will be reduced, likely by half, due to the fact that everyone has health coverage and there is no need for the medical portion.

  • It reduces the need for part time employees and provides easier recruiting.  There are no pre-existing conditions or Cobra issues.

  • Eliminates the oversight of health benefits and bargaining health coverage with employees.

  • It creates healthier personnel and more stable employees, reduces absenteeism and eliminates employer health coverage complaints.

  • It reduces employee health related debt and personal bankruptcies.

  • It frees up family income that can be spent on other goods and services, thus stimulating the economy.

Tips for Writing Letters to Editor

Follow guidelines for your local paper (word count, submission instructions, etc.)

Frame your letter in relation to a recent news item Use state specific data whenever possible (let us know if you need help finding some!)

Address counter arguments

Be aware of your audience and emphasize how Medicare for All is good for ALL residents of the state

Criticize other positions, not people Include your credentials (especially if you work in the healthcare field)

Avoid jargon and abbreviations

Don’t overload on statistics and minor details

Cover only one or two points in a single letter

Avoid rambling and vagueness


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