2023! What a year! Overall, it probably wasn’t the worst year ever: On the positive side, we had Barbenheimer, the Titan Submarine implosion, congressional hearings on UFOs, and all the Taylor Swift gossip you can handle. On the negative side, we had long Covid; the deaths of Matthew Perry, Andre Braugher, and Twitter; war in Gaza , war in Ukraine, and Kanye West is an antisemite now. So yeah… overall it was pretty bad. But what about the very specialized world of American healthcare? How did everyday folks fair when it came to getting the care they needed? In this episode, we’re breaking down the highs and lows of healthcare in 2023, from Mifipristone access to Medicaid unwinding and everything in between!

Reflecting back on 2023 in healthcare, Ben & Gillian wrote up some Naughty & Nice lists! They start with the Naughty, since it’s better to end on the victories for all of our mental health going into the holidays.

The Naughty List

Starting big picture, Ben pulls out some of the basic data from the Commonwealth Fund’s 2023 Health Care Affordability Survey, which captured the state of access to healthcare in the middle of this year. The big takeaway – our access to care is getting dramatically worse, not only because the healthcare system is getting more expensive, but because inflation has been squeezing everyone’s ability to afford those big cost barriers. Top-lines from the survey:

• “Half of working-age adults said it was very or somewhat difficult to afford their health care costs.“
• Why? “Nearly two-thirds of working-age adults said that price inflation in the past year affected their family’s ability to afford health care.”
• “Nearly two of five working-age adults reported delaying or skipping needed health care or a prescription drug in the past year because they couldn’t afford it.”

Gillian added some staggering findings from the survey relating to medical debt and people avoiding care due to costs:

• “Nearly one-third of working-age adults reported having medical or dental debt they were paying off over time.“
• 22% of people with medical debt had $5k or more
• The toll this took on our health outcomes? “More than half of working-age adults who said they delayed or skipped care because of costs said a health problem got worse as a result.“

Also on the Naughty list for 2023, Gillian adds the devastating “unwinding” of Medicaid, which kicked 9 million people off of their Medicaid coverage, most of whom are qualified for Medicaid but were churned out due to administrative barriers or errors. Of those 9 million, Gillian’s home state of Texas alone is responsible for kicking 1.7 million residents off of Medicaid.

The Medicare for All podcast has covered several dangerous/naughty trends in 2023, including the right-wing now.org/blog/transgender-healthcare-under-attack/">attacks on gender-affirming care in many states, and obviously the attacks on reproductive health in the wake of the Supreme Court overturning Roe v. Wade.

Gillian adds to the Naughty list Donald Trump’s recent attempt to resurrect efforts to “repeal and replace” the Affordable Care Act, despite having completely failed at the effort in his first year as President in 2017.

And lastly, Ben wants to add to the Sad List (moreso than the Naughty List) the looming departure of Stephanie Nakajima, former Director of Communications for Healthcare-NOW and former co-host of this podcast, who will be moving to Denmark with her husband at the end of the year. Stephanie worked at Healthcare-NOW for 6 years before serving as the Executive Director of Mass-Care, the Massachusetts Medicare for All grassroots organization. We love you Stephanie and will miss you!

The Nice List

What were some of the things that really went right in 2023, from an organizing and a policy perspective?

• Gillian starts with the introduction of the two Medicare for All bills in Congress this year: both bills added explicit language that guarantees access to abortion and all other reproductive health services for all Americans, and also added explicit language making access to gender-affirming care a right. These are language changes Healthcare-NOW has been fighting for for over decade now!
• The bills were also introduced with the same number of co-sponsors as last session, which was an incredible organizing accomplishment given the loss of Democrats in both the House and the Senate (including many, many former co-sponsors).
• Ben notes that the M4A movement also made major inroads this year pushing back against the privatization of Medicare. Every session the health insurance industry lobby (AHIP) circulates a letter calling for unfettered support and expansion of Medicare Advantage plans, which is signed by many Republicans and Democrats. In response to grassroots pressure, this year the Senate letter saw a decline in signers as several Democrats dropped their support, and the House letter lost so much support that AHIP declined to release it at all.
• In 2023 Healthcare-NOW launched its now.org/voices-of-us-healthcare/">“Voices of U.S. Healthcare” project, which we’re incredibly excited about and is designed to capture the stories of thousands of American residents who have been impacted by our broken healthcare system. now.org/tell-us-your-healthcare-story/">Share your story with us if you haven’t already!