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Medicare for All Needs a Sunrise Movement

How single-payer advocates can keep their cause from being pushed into the political wilderness

Massachusetts Senator Ed Markey speaks at a Sunrise Movement event.
Alex Wong/Getty Images
Massachusetts Senator Ed Markey speaks at a Sunrise Movement event.

In mid-December, a loose coalition of leftist YouTube pundits hit the gas on an ill-fated gambit to boost Medicare for All under the digital banner #ForcetheVote. Led by pugnacious commentator Jimmy Dore, they argued that Alexandria Ocasio-Cortez and her fellow progressive representatives should withhold their votes in support of Nancy Pelosi’s speakership until she agreed to bring the health care bill to the House floor for an up-or-down vote. To their minds, the smaller House majority Democrats were left with after the election made Pelosi dependent on their votes to retain her gavel, and with that leverage, a forced vote on Medicare for All would expose exactly which Democratic representatives actually supported expanding health care during a pandemic and flush out those that did notthe better to set up primary challenges in the future.

Their strategic argument always seemed to be somewhat lacking. Activists frequently cited a poll indicating that Medicare for All had 88 percent approval among Democrats, but the wording of that survey was vague (another poll with more specific questions shows that Democrats prefer building on the Affordable Care Act over replacing it with Medicare for All, 55 percent to 40 percent). Even so, policies can be broadly popular without being the deciding factor at the ballot box. After all, Joe Biden, who hinted that he might veto Medicare for All, beat out all of its supporters in the Democratic primary before going on to win the presidency during this very same pandemic.

Moreover, the left already has its primarying work cut out for it; there are more than 100 Democrats who have not co-sponsored the bill. YouTuber Kyle Kulinski argued that Tea Party tactics worked on Republicans by forcing their House leadership to step down; the problem is that the party seemingly dedicated to helping more people isn’t so keen on grievance, anti-government politicking. Without even the author of the House’s Medicare for All bill, Representative Pramila Jayapal, or allies like the Nurses National United joining the effort, the Force the Vote cause simply never caught on outside very online left aeries, where it all ended up devolving into fractious, vengeful chatter of primarying Ocasio-Cortez for not opting to carry its banner. Once the politics of insurrection and impeachment took over the broader discourse, memories of this effort evaporated.

The Force the Vote crowd, though, did have a point: The moral argument—that more than 25 million uninsured Americans urgently needed quality health care, particularly during a global pandemic—was unquestionable. As President-elect Joe Biden heads for the White House, with the slimmest of majorities in the Senate and House, he’ll be facing an out-of-control pandemic, cratering economy, and all-out assault on American democracy. And while he’s put the old canard on deficit spending to rest, his legislative slate will most likely include popular and passable programs, such as vaccine distribution, Covid-19 relief, and infrastructure. It’s unlikely he’ll spend an ounce of political capital on Medicare for All, which doesn’t have enough votes to pass either the House or the Senate, relegating it to a kind of political wilderness for the time being. The YouTube pundits are right: Medicare for All needs robust political organizing behind it. And there just might be a more effective template for it: the youth climate organization, the Sunrise Movement.

Like Medicare for All, which would reshape one-sixth of the American economy and faces powerful opposition from the insurance industry, climate action has daunting enemies in the fossil fuel industry. And while climate action polls well and has historically had an army of advocacy organizations behind it, for a long while it was not a cause that motivated a critical mass of voters or drove elections. In a short few years, that’s changed, and the Sunrise Movement’s savvy mix of confrontational direct action with highly coordinated get-out-the-vote efforts deserves a lot of credit for the transformation.

The Sunrise Movement, founded with support from the Sierra Club, has been building an electoral infrastructure for years, putting dozens of full-time activists through training boot camps and then placing them in “movement houses” to work on political campaigns around the country. The young activists build on the lessons of veteran organizers, with “coaches” from other movements like Black Lives Matter, and model their movement houses after those of the Student Nonviolent Coordinating Committee in the 1960s. The Sunrise organizers endorse candidates who sign onto their policy program, and then they hit the streets and the phones for those candidates in the hopes of both boosting their chances and converting them into climate policy loyalists. At one point, the then little-known Ocasio-Cortez was the beneficiary of Sunrise’s organizing. The turning point came just two years ago, when about 200 baby-faced climate activists crowded Pelosi’s office demanding that she back the Green New Deal, and newly elected phenom Ocasio-Cortez remembered what they’d done for her and stopped by to greet them.

Ocasio-Cortez’s star power catapulted the youth organization into the spotlight, generating dozens of articles and blowing up its 15 chapters to more than 200 nearly overnight. A few weeks after the sit-in, Massachusetts Senator Edward Markey reached out to Ocasio-Cortez to turn the Sunrise Movement’s demand for a climate committee into a bill that activists could organize around. Soon the Sunrise Movement would return the favor.

When Representative Joe Kennedy III challenged Markey, in what quickly became one of 2020’s most high-profile Senate primaries, the incumbent, who quickly found himself down 17 points in the polls against the state’s most beloved political dynasty, was practically pronounced dead. But Sunrise started organizing for Markey, producing what Forbes called “the campaign ad of the year” and rebranding the 74-year-old as a cool, progressive grandpa. Markey ended up winning the race by 10 points. In The New York Times, Michelle Goldberg raved about “How the Green New Deal Saved a Senator’s Career,” further publicizing the group’s political might.

Since then, the upstart activists have amassed bigger wins, phone banking for primary challengers turned Representatives Cori Bush of Missouri and Jamaal Bowman of New York (who says they made 865,000 out of the total 1.2 million calls for his campaign), and getting most of the Democratic presidential candidates to sign onto the Green New Deal by “relentlessly confronting them at all of their campaign events across the country.”

After Biden, whose climate plan Sunrise first gave an “F,” prevailed over Sunrise’s preferred candidate, Bernie Sanders, the group issued a letter congratulating him but outlining what it saw as his shortcomings. The Biden campaign reached out for its input, and a new climate plan soon followed, including a $2 trillion investment for a renewable energy economy with 40 percent of the funds going to disadvantaged communities. Sunrise subsequently put its get-out-the-vote network to work on Biden’s behalf for the general election. The campaign also created a Biden-Sanders Unity Task Force on climate, with Ocasio-Cortez as co-chair and Varshini Prakash, co-founder and executive director of the Sunrise Movement, serving as the Sanders surrogate. Biden’s pick for secretary of the interior, Deb Haaland, was also on a list of Sunrise Cabinet recommendations.

Sunrise hasn’t gotten everything it’s asked for: Its other recommended picks for Cabinet positions didn’t make Biden’s, some of their endorsed candidates lost, and their request to the Democratic National Committee for a primary debate dedicated to climate change was ignored. But more politicians are taking notice, including on the state level, where changes can be more quickly enacted and which can serve as a testing ground: The New York City mayoral front-runner, comptroller Scott Stringer, embraced activist recommendations with an ambitious climate plan, including banning fossil fuels; Boston city councillor Michelle Wu, a leading contender for the mayoral race there, just released a 49-page Boston Green New Deal.

By growing and reinforcing a trained activist organization across the country, scoring some undeniable electoral wins, and moving the president-elect leftward, the Sunrise Movement has advanced the cause of climate action in some substantial ways in a short amount of time. Medicare for All supporters might look to Sunrise as a model if they want to gain similar ground in the coming years. The task is by no means uncomplicated: Single-payer health care hit serious and complicated financing roadblocks in Vermont, where conditions (a healthy and liberal populace, and willing political establishment) were ideal. The push for expanded health care could use more local political successes, even as simple as candidates winning on expanding Medicaid in states that rejected it.

Medicare for All activists understand that the inequities of our health care system remain as durable a problem as climate change, and the pandemic has only exposed how urgently this matter needs to be remedied. So you can hardly fault lefty YouTube pundits for recognizing that there was a void of highly visible organizing for health care and attempt to fill it. But when their single, desperate strategy failed, there was nothing else to pursue, and the passion for the cause quickly fizzled into misdirected anger. Medicare for All needs a multiprong strategy and a high-impact organizing base working year-round, staffed with versatile and well-trained organizers who can offer candidates tangible rewards for their support. The Sunrise Movement is the model for getting off the tweets, onto the streets, and into office.