I supported single payer style healthcare for nearly 20 years, a decade before Bernie Sanders made Medicare for All a popular progressive stance.
There was a single, little known event last year that has completely changed my mind on single payer:
Federal employee health plans stopped covering gender affirming care.
Few people know about this. It didn't make the news. But in response to trump's executive orders in 2025, all healthcare plans offered to federal employees stopped providing certain healthcare coverage to trans folks at the start of 2026.
The federal government is the largest employer in the country. This affected millions of people overnight.
There is very little legal basis to challenge this. The Supreme Court ruled years ago in Hobby Lobby that employers can choose what coverage to offer their employees. So at the stroke of the pen, the president took away access to certain care for millions of people. And there's really nothing anyone can do about it.
Yes, only a fraction needed that care. But this is the foot in the door. First trans healthcare, then it'll be contraception, then vaccines, then routine care. First federal employees, then medicare and medicaid.
This isn't even getting started on how hospitals and doctors aren't covering any gender affirming care for minors anymore based on threats from the trump admin alone.
And I reiterate: employees can choose what to cover, and there's really nothing you can do about it, except pay out of pocket, buy your own insurance, or go to a different employer.
If the federal government becomes the sole source of healthcare coverage under a single payer system, the federal government can also take it away, and there will be nothing you can do.
Under a single payer system, an insane president or HHS secretary can take away whatever care you depend on at the stroke of a pen. I don't care how strong the enacting laws are. They can just stop paying.
So I can't support single payer anymore. This was the longest and most enduring progressive position I've held, and I can't abide it anymore. Like. This position hurts me to abandon. It was quite possibly my first and strongest political opinion from when I was young and my mother, a single mother and a nurse, taught me about the iniquities of the healthcare system before Obama was even elected and passed the Affordable Care Act. As an economics major, under a rational system, it should make sense and be the most efficient and cost effective. I built my goddamn political identity around single payer when I was in high school before Bernie was even elected to the Senate.
I don't know what the solution is to get to universal healthcare. Healthcare policy is not my forte. I'm still meditating on it now that I can't support M4A. But I don't think single payer is workable or secure enough.
dailybridgerton
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jacobvanloon
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