Viewpoint: How SEIU’s Medicaid Fight Can Shift Gears to Win Big

I’m a primary care doctor and Service Employees (SEIU) member in Doctors Council. The Medicaid cuts proposed by Trump and Congressional Republicans will hurt and kill my patients, defund our hospitals, and decimate our unions. SEIU leadership recognizes the threat but their current approach is not enough.

SEIU has offered social media toolkits and a call-in tool to pressure House Republicans, but these digital tools rot in members’ inboxes. SEIU organized a DC lobby day, but most members were unaware of it or were not supported to get there. SEIU and locals are cosponsoring protests and sharing them with members but these often aren’t focused on the districts of the Republicans who matter. This isn’t the serious campaign we need to win. We need one that’s more strategic, relentless, and member-powered.

HOW WE BEAT TRUMPCARE IN 2017

In 2017, a coalition of health organizations and grassroots groups stopped Obamacare repeal multiple times despite Republican control of the House, the Senate, and the White House. This was because there was constant pressure on key Republicans, large numbers of people participating, and escalating tactics. We called them daily. We protested their district offices. We packed town halls with angry constituents and concerned health workers. We birddogged them every time they went in public. There were civil disobedience actions in Congress. And it worked.

Today, the Republicans have a House majority of only seven votes. Some House Republicans are already wavering. We can defeat these cuts. To truly do our part in this fight, SEIU must have many more members much more focused to pressure key representatives.

FLAWED FIGHT

There are a few key issues with SEIU’s current approach.

First, SEIU and our locals are doing digital mobilizing instead of personal organizing. Email fatigue is real, so emails get ignored. Members don’t see how they are part of a path to victory, so most sit on the sidelines. And who can blame them? SEIU and our locals know how to organize: there should be personal outreach, workplace meetings, a menu of options for actions, support for members to engage their co-workers, and follow up where deeper actions are encouraged as the campaign unfolds.

Another big issue is that there isn’t a focused, escalating campaign. We should target a set of House Republicans who we think we can move: the ones with the most constituents covered by Medicaid, the ones who have expressed concern about Medicaid cuts, the ones with the narrowest wins in 2024.

From there, SEIU should provide the backbone for district-level campaigns across locals.

Instead of one-off actions that don’t build on each other, this district-level fight would make it so a phone call to a Representative informs a demand at a lobby meeting and the staffer’s response at a lobby meeting informs the messaging at the protest. Along the way, members hear about wins in their district and about wins nationally, which means our campaign builds energy as it goes.

A SPRINT TO WIN

Time is short, and the current low-participation and low-impact tactics aren’t doing much, but we can shift gears and mount a stronger campaign for this final stretch. We are 2 million workers in SEIU and together we can stop these cuts.

Right now, SEIU leadership can commit to a final sprint targeting 40 House Republicans. They can assign a lead organizer across locals for each district. They can start holding weekly Facebook Live updates for our union members. They can go to each district to show progress and rally members.

In target districts, SEIU should encourage and support locals to do tactics beyond phone calls and protest attendance, such as member organizing, district office lobbying, op-eds in local media, deep canvassing, civil disobedience, attending town halls where they exist or creating ones when they don’t, and more.

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As any key vote nears, SEIU can invest more in turnout to ensure massive participation in DC lobbying, protests, and civil disobedience.

Leadership at SEIU locals can pressure SEIU leadership to fight harder and better. Locals can cut lists of members who are constituents of target House Republicans, and devote staff organizer and member leader time to engage these workers individually and through workplace meetings.

Members can demand a better campaign from their local and from SEIU nationally. Members can commit to action and engaging their co-workers. Members in target districts can make daily or weekly calls to their Representatives, and can do higher impact actions that make sense to them. Members not in target districts can activate those they know who are.

When we stopped Trumpcare, we didn’t just protect health care, we derailed Trump’s whole first term. This fight has the same potential. I hope all unions, especially those with health workers (not just SEIU but others like National Nurses United, AFSCME, AFT, NUHW, UFCW, Teamsters), will do as much as they can, as strategically as they can, to win.

SEIU has its part to play in this and our leaders must go beyond go all-in on member-powered organizing in districts where the fight matters the most with the types of actions that will make the biggest difference. Our patients’ lives are at risk. Our unions are on the line. Now is the time to fight like we actually want to win.

Andrew Goldstein is a primary care doctor at Bellevue Hospital in New York and a member of Doctors Council SEIU.