Medicaid Defense in Pennsylvania, w/ Nijmie Dzurinko

This transcript was automatically generated and may contain minor errors.

Cayden Mak: [00:00:00] Welcome to Block and Build a podcast from Convergence Magazine. I’m your host and the publisher of Convergence Cayden Mak. On this show, we’re building a roadmap from the movement that’s working to block the impacts of authoritarianism while building the strength and resilience of the broad front that we need to make.

This week on the show, I’m joined by the co-founder and coordinator. Put people first, PA Zuko discussing ground level organizing in Pennsylvania against Medicaid cuts and mass hospital vouchers, and how the multi-state nonviolent Medicaid army is taking those efforts nationally. But first, these headlines, it’s official, the Corporation for Public Broadcasting is shutting down operations at the end of September.

This was announced last week and bodes ill, especially for NPR and PBS stations outside of major metropolitan areas. While N-P-R-C-E-O, Katherine Maher has explicitly stated that her intention is to support that national network, it’s really hard to say exactly what [00:01:00] impact this will have on public media in the United States in the long term.

I cannot emphasize enough that the media system in this country badly needs a rethink. It’s not just the public media is under threat due to budget cuts. It’s that a consolidated corporate media system that is largely run by people who are indifferent at best to working people is the only thing there to take its place.

This is the logical end game of the decades long strategy we often talk about here on this show. Meanwhile, Texas Governor Greg Abbott has been trying to jam through a highly partisan redistricting plan in the state, prompting democratic lawmakers to leave the state and protest. While Abbott and his State Attorney General Ken Paxton have been bloviating about punishing the lawmakers, these legislators themselves acknowledge that Breaking Quorum is only a tactic to delay the inevitable.

Another response to Abbott’s plan came from New York Governor. California Governor Gavin Newsom, who suggested that if Abbott wants Gerry, Texas so severely that they’ll Gerry New York and California more aggressively in response. While I’m [00:02:00] pleased to see a little more fight from state leaders, it’s not hard to imagine the negative long-term consequences of this nuclear option.

Arms race in our democracy. If we’re gonna take seriously the problem that people are losing trust in democratic systems, do we really think that making elections more rigged regardless of who it’s for, is gonna do anything to solve that long-term issue? Look, I don’t have the answers here personally, but I think that we’ve got to be thinking a little more creatively and more grassroots for the real solution to this problem.

After all, the party in power gerrymandering themselves into continued power isn’t exactly a new phenomenon. The missing element in this gubernatorial brinkmanship, of course, is organized people power. Speaking of which I wanna highlight an organizing win this week from Tucson, Arizona, where the city council voted unanimous.

To block the development of Amazon’s project, blue Data Center in their city. Public meetings on the project drew crowds of up to a thousand people over the past few weeks who showed up to express their concerns and disapproval of the $3.6 billion project, which would consume more water in the first [00:03:00] two phases of construction than nearly 7,000 homes due in a month.

And this in an arid desert city. It’s intended to store data owned by Amazon for ICE and predictive policing efforts, which we know do jack shit. We love to see folks at the local level wake up to the fact that big tech and AI are not our friends. Tucson caught on to the predatory development of these centers for the fascist data hoarding and deadly pollution spewing stains.

They are and said, no thanks. I’m really hoping this trend catches on. Before today’s interview, I wanna take a moment to ask you to support convergence during our annual summer fundraising drive. Reader and listener support is critical in a time when independent media is under existential threat. So if this podcast has in fact helped consider what you can do to give back, to make sure that we can keep making it.

Anyone who starts an annual or monthly subscription gives $25 or more, or upgrades, their subscription will receive a special thank you gift. Head over to bit ly slash Summer fund Drive, all one word to make [00:04:00] your contribution today. You’ll also find that link in the show notes. As we all know, massive cuts to Medicaid in the pipeline for states all across the country.

On this show, we’ve highlighted state by state efforts to protect folks dependent on Medicaid who are fighting back. This week I was joined by the co-founder and coordinator of Put People First Pa nmi zko, to talk about how this organization and others that she’s involved with are fighting ongoing Medicaid cuts and hospital closures in Pennsylvania.

We also wanna just throw it out there that if you or somebody that you know is involved in this type of organizing in your own state or city, let us know and we might feature your story in a future episode. You can reach us at mailbag at convergence mag com. Now here’s my interview with Niemi zko, which was recorded two weeks ago.

Nmi, thank you so much for joining me today. 

Nijmie Dzurinko: Thanks, Caden. I’m really happy to be here. 

Cayden Mak: Tell me a little bit about the campaign that you are working on. Who’s in your coalition and what is the sort of political terrain look like in Pennsylvania? 

Nijmie Dzurinko: Yeah, so I’m a co-founder of Put People First pa. We’re a statewide member [00:05:00] led staff free organization.

We’re 13 years old this year, and we’re also one of the co-founders of what’s called the Nonviolent Medicaid Army, which is now operating nationally. In terms of the political terrain in Pennsylvania, I always like to back up and give my keystone state pitch. Pennsylvania is called the Keystone state.

The Keystone state. The keystone is the stone in architecture that kind of holds the structure together. And so we like to think about Pennsylvania as this state of 13 million people, but it’s part of so many different regions in the country. It’s actually right on the Mason-Dixon line. So the line that kind of officially separates the north from the south, it’s part of the Northeast corridor, it’s part of the Rust Belt, it’s part of Appalachia.

So we’ve actually got this incredible mix of all different kinds of regions and influences and people across our state and put people first. PA is explicitly. Politically independent, which means we’re [00:06:00] independent of both parties. And we also focus on uniting across lines of division, including the urban, rural divide, the racial divide, and the party divide.

And so to speak to this question of, our organizing drive around Medicaid, we call it the Medicaid cutoffs organizing drive. We actually started this organizing drive in anticipation of the purge that happened under the last administration. So with the ending of pandemic protections, starting on April 1st, 2023, 25 million people were actually cut from Medicaid under the last administration.

In Pennsylvania, we had over 600,000 people cut from Medicaid. About half of them actually for procedural or paperwork reasons, the other half because of income fluctuations. So we’ve actually been in the thick of the cutoffs of Medicaid, people losing their healthcare now for several years. And so we are in a position to know that [00:07:00] Medicaid cuts equals death.

That’s actually one of our slogans. Medicaid cuts equals death. And so we have been tracking and following what we call the big beautiful bill for billionaires, which now has passed. Because that is, that is, it’s a big, beautiful bill if you’re a billionaire like that, that much is true.

We just have to add that part onto the end. And so this organizing drive is a way of one directly organizing people who are on or unfairly excluded from Medicaid, put people first. PA is the only organization in Pennsylvania led by people on or unfairly excluded from Medicaid. And the Nonviolent Medicaid Army nationally is the only national network that is led explicitly by people who are on or excluded from Medicaid.

And so this organizing drive has been. Holding kind of base building tactics like free people’s clinics throughout our states. It’s also been educating folks on our rights. So everyone who gets cut from Medicaid has the legal right to an appeal, and we’ve [00:08:00] been raising consciousness about that, but also using Medicaid appeals as an organizing tactic.

And last year in Pennsylvania, we had a 93% success rate. With the appeals that we collectively filed. So when people came to us and said, Hey, I’ve gotten cut off of our Medicaid, my Medicaid filing those appeals as an organizing tactic, we had a 93% success rate in keeping people on their healthcare Nice.

Which we feel really proud about. And we’re gonna continue to do that through what’s coming. And I think, in the wake of what just passed at the federal level, we’ve then been taking up this issue at the States to push back against. Implementation of draconian measures, at the state level.

But we also have been tracking the fact that most governors, be they Republican or Democratic, are clearly stating that they are not gonna backfill the funding for Medicaid from state budgets. And so this is truly a massive crisis, just as the great Medicaid [00:09:00] purge under President Biden also was.

Cayden Mak: No, that’s really interesting. I think the, a lot of people are probably the Medicaid cuts under Biden are not super top of mind to people, but it does bring to mind the way that, in a lot of ways the pandemic. Open this door to be like, how could things be different if we actually had the political will to make it and in a lot of ways it feels like what we’re living through now is still this sort of like long pandemic hangover in terms of like even the backlash right against Biden.

It’s like very much part of that big pandemic hangover. 

Nijmie Dzurinko: I would agree. 

Cayden Mak: Yeah. And I’m curious how the pandemic changed y’all’s work, to be honest. Like in that slightly longer term view. 

Nijmie Dzurinko: Absolutely. Yeah. No, I really appreciate your last point, Kate. And I wanted to make that point that I feel like the and I think our collective analysis and put people first in the nonviolent Medicaid army is that part of what got us here today to the current administration that we have was this [00:10:00] rollback of all of this.

Actual attempts to meet human needs, right in the context of this pandemic that then were taken away. And so I think for politicians and folks in Congress, and even Democrats right, who campaign on universal healthcare and who campaign on Medicaid expansion, what we saw during the, that era of those pandemic protections, which was short-lived, was a, the Medicaid role swelled to over 90 million people in this country.

And that is a move toward universal healthcare, right? That is an expansion of Medicaid actually, right? That is actually moving us more toward the kind of society that we wanna have. But then it was stripped away, right? And that was a bipartisan decision that was signed by President Biden in the Omnibus bill that was signed in December of 2022.

And then those cuts went into effect on April 1st, 2023. And so I think that’s a really important context to have, and again the numbers that we’ve looked at in Pennsylvania that come [00:11:00] directly from the Department of Human Services website because they’ve been tracking, they tracked the unwinding, which we call the Medicaid purge, and that showed that in just one year.

Some, a little over 600,000 people lost their Medicaid in Pennsylvania. And that’s a similar number to what is projected to happen under the big, beautiful bill for billionaires. Over the next 10 years, a very similar number of 600,000 in terms of how the pandemic changed our work. We’ve been statewide for the entire existence, and so that’s in some ways that forced us to get familiar with things like Zoom and familiar with remote meetings and organizing. We, we did a lot more in person of course, before the pandemic, but we were in a pretty good position to move some of our things online during the course of the pandemic.

We also have a really robust system of community care within the organization and what we call projects of survival. And so we were in a position to support leaders through some of the crises. Of the, that period. So I think, [00:12:00] we were impacted by it as were was everyone. But I think in some ways we’ve been able to weather those conditions in a pretty good way and actually continue to grow throughout the pandemic.

So we didn’t experience sort of a contraction in our membership. We actually really experienced a growth. 

Cayden Mak: Yeah, that makes a lot of sense that the, something like a pandemic would be the kind of crisis that contains a lot of opportunity for an organization like yours. You mentioned, this thing that we’re hearing from a lot of states that a lot of governors are like, no, we’re not gonna backfill the cuts.

So clearly a lot of the sort of like executive branch in the states are not our friends. Are there political allies that you all have been finding and have you been able to build with. Decision makers at other levels who are willing and excited to fight for Medicaid. 

Nijmie Dzurinko: So I think we’ve found an entry point into this conversation specifically around the question of hospital closures.

We have an epidemic of hospital closures in Pennsylvania that’s been ongoing. It’s not new. I think [00:13:00] this is also, shared across the country. Think something like 22 hospitals have closed in Pennsylvania in the last five years alone. And I think that with people, if your listeners and your viewers look into the record in their states.

They’ll may also see that there’s a lot of hospital closure activity. And this is for us, a symptom of the fact that Wall Street is really in charge of our healthcare system. Private equity has an increasing role in our healthcare system and profiteers, be they for-profit or nonprofit.

Go by the same logic, which is that if a hospital is not profitable enough, then it’s gonna get shut down. And our hospitals are being treated like a McDonald’s franchise or a GameStop, or, another sort of asset. And we find that is completely incompatible. With our human right to healthcare.

But the reality across Pennsylvania is that in all kinds of districts, be they urban, rural, suburban, or small town hospitals are threatened with closure. And that’s something that local [00:14:00] officials, state representatives, and state senators and the governor’s office are starting to take a lot more seriously because it.

A clear expression of this crisis. And so we’ve absolutely been connecting with legislators across party lines, around what is happening with our hospitals, which is very connected to what’s going on at the federal level, and as I said, has already been a serious issue even before this big, beautiful bill for billionaire.

Cayden Mak: Yeah, that, that resonates. ’cause I feel like, even here in California, like the, it’s both the consolidation of hospital systems, right? Under like just a few major operators. Plus the fact that especially in rural areas, there’s not the money to keep these things open in the eyes of the people who were in charge.

And I do think that yeah, the comparing it to like, how do we franchise like a fast food joint or honestly even scarier, turn it into an sort of like an unsecured speculative like financial instrument. Not, more than [00:15:00] just a, something that operates in this sort of quote unquote regular economy of goods and services like that it’s financialized is even scarier.

I think that makes a lot of sense. And I’m, I think that there’s it sounds to me like there’s a deep strategy in looking at hospital closures as like a material representation of harm and that, that touches people who are not just folks who are on Medicaid. That this has a consequences for folks who have private health insurance.

And that, that feels like a really important piece of the power analysis here. Could you talk a little bit to that and how you’ve been able to find. And build alliances beyond your base. 

Nijmie Dzurinko: Yeah, absolutely. One thing I just wanna say is that our base is. In terms of folks who are on or excluded from Medicaid, I’m also part of the Poor People’s Campaign, a National Call for Moral Revival.

And one of the great things about that campaign is that we put on the map the concept that there’s 140 million people in this country who are poor or near poor. Meaning [00:16:00] that they’re either living in poverty now or they’re one paycheck, one healthcare crisis, one housing crisis, one climate crisis away from poverty.

And that figure of 140 million is pretty much half the country. Yeah. And so I think it’s out there now. It’s no longer looked at as this marginal group of people, or, it’s just some sort of accident. Because we’ve gotta continue to lift up, right? That there’s really no wealth without extreme poverty.

And so the extreme accumulation of wealth that we see on one side of the scale is accompanied by. Mass poverty on the other side. And similarly in Pennsylvania, there’s more than 3 million people who are on Medicaid and then many millions more who are just a little bit away or unfairly excluded because of other reasons, their documentation status or other things.

So I think we already have an extremely large base that we’re seeking to move. And those folks. Those of us who are on or excluded from Medicaid come from every county in the 67 counties in this state. Every political persuasion, every party, every background and all of [00:17:00] that. But I think absolutely we unite with all of those.

And this is something that we talk about. We really unite, we. All of those whose families have been harmed or killed by the healthcare system, which is practically everyone has a horror story about the healthcare system in some way or another. Even as you said, people who have good insurance.

Even people who are insured through their union job, even people who are on the private market or have a CA plans, like everybody has an experience and it’s one of the. Leading, if not the leading cause of bankruptcy in this nation. Which shows a lot about, those are the folks that are going bankrupt are the folks who are paying for healthcare.

Yeah. And like that’s a large section of people too. And so we absolutely work across folks who are on or excluded from Medicaid. Folks who’ve just been impacted by the system as well as healthcare workers as well, right? A lot of healthcare workers who are on the front lines and see every day, how much time they spend just dealing with administration and paperwork, when they really want to be [00:18:00] providing care, and also how they’re caught in the middle of denials and having to tell people that they cannot be cared for, which is a huge moral indus injury to millions of healthcare workers across this country.

Cayden Mak: No, that’s, I, that’s definitely like when I think about what the folks that I know who are, I have friends who are nurses, I have friends who are nurse practitioners or doctors that like, or physician’s assistants, like the kinds of things that they have to deal with because of this, like accelerating crisis is really, it’s not what they got into the profession for sure.

Could you tell me a little bit about the nonviolent Medicaid army, how that. Formation came together and what states are you all operating in? 

Nijmie Dzurinko: Yeah, so it started here in Pennsylvania. It actually started after a two year struggle that we had with the Pennsylvania Insurance Department where we did get some concessions.

They were, we found out that. They didn’t hold public hearings on rising insurance rates. They just did it behind closed doors. And so in 2016 and [00:19:00] 2017, actually during the first Trump administration, we waged a campaign to get the Pennsylvania Insurance Department to hold public hearings on rising insurance rates, and we won that campaign in 2016.

They held the first ever public hearing on rising insurance rates. It was a huge organizing opportunity, right? We always say that everything we do to develop leaders. So we’re not simply going for these kind of like on paper wins that we just check off. We’re actually doing it to really build our base and develop our leaders, and we definitely did it that year through that process.

But we also inoculated our people. This is a term we use in organizing, right? To prepare people and understand this is really what we’re up against, right? And so here’s what we can expect. We knew that by doing what we did, just because we got a public hearing, it wasn’t gonna mean that they actually reigned in the insurance companies, because in the end.

The insurance department after, empathizing with our stories and telling us how much they appreciated all of our sharing for three hours of [00:20:00] testimony. They then gave the insurance companies higher increases than they had even asked for. They gave them an average of 32.5% rate increases. We learned through that process.

Yeah, it’s pretty shocking. We learned through that process that the insurance department is actually charged. They’re a state agency, but they’re actually charged with helping make sure that the insurance companies stay in business. And so we’ve that is actually part of their charter. That’s actually part of their job responsibility.

So then the next year we actually got them to do town halls across the state. We built new healthcare rights committees out of that process, but we learned through that, hey, the insurance department’s really not on our side. That’s, we started developing a vision for a public healthcare advocate out of that, but we also decided to really pivot.

And think about how we really focus in on our base when we talk about directly impacted people, right? And the sort of leading social force, the group of people who have the most to gain and the [00:21:00] least to lose from a fundamental transformation of society. We really decided to hone in on folks who are on or excluded from Medicaid because the folks who were impacted by those rate hikes, that was something like half a million people.

But the people who are impacted by what happens with Medicaid, as I said, is over 3 million people. And so the language of the nonviolent Medicaid army comes from Dr. King MLK’s call at the end of his life to build a nonviolent army of the poor. That’s what he was talking about in the context of the First Poor People’s campaign.

And so for us it was like, oh, the nonviolent army of the poor. That’s the nonviolent Medicaid army. Because folks who are on or excluded from Medicaid, that is the nonviolent army of the poor. That is the 140 million people. That we talk about in the Poor People’s Campaign. So we started that here, coming out of that two year struggle, and we decided to make this pivot.

In 2018 and then in 2020, our mentors and some people around us were you gotta take this thing national, right? You gotta take this thing outside of [00:22:00] pa. And so we basically put out a call and said, Hey, we’re, we’re bringing this nonviolent Medicaid army formation and we wanna invite people to take this up, right?

Which means. Focusing in your state on organizing people who are on or excluded from Medicaid using healthcare as a strategy, unite people across lines of division, organizing statewide across that urban, rural divide in particular, right? And organizing from a lens of political independence, which again, it doesn’t mean that we don’t engage politically and hold all power holders accountable.

It just means that we don’t take our marching orders from the parties of Wall Street. And in that time, people gravitated toward us. We had our first national week of action in 2020 and it’s grown from there. It’s really been a beautiful process. Ups and downs, of course. It’s not linear, it’s all kinds of different things, but it’s been growing and developing as a national formation.

Some of the states who are in the nonviolent Medicaid army, I’m trying to rattle them off from top of my head, Georgia, Texas. [00:23:00] Ohio, Indiana, Maryland, Pennsylvania, Vermont, Massachusetts, New York. We’ve had North Carolina Illinois. And then there’s a few other states that are just starting to get organized with us.

There’s some folks in Arizona, there’s some folks in Connecticut and some other states, but there’s about 12 states that have been pretty active in the nonviolent Medicaid army. 

Cayden Mak: That’s awesome. Yeah, and it’s, it sounds like it’s, that’s quite a like broad range of in-state political terrain too, which is really interesting.

’cause I think that one thing I’ve been thinking about a lot about on the show is like the ways in which different states political terrain create opportunities to fight back against authoritarianism in different ways. And the knowledge that people have. I’m curious if that variety of states has really.

Allowed you all to deepen your political analysis and develop new strategies because. Just being able to share information about what’s going on [00:24:00] seems huge. 

Nijmie Dzurinko: Absolutely. Kay. And I think that’s a great point. And I think just like in our states, when we are base building with new people and we talk about, hey, like your problem is not just your individual problem, it’s shared by millions.

And we coordinate across the state because even within states, as we know, folks can be so isolated, right? Yeah. In one place and kind of not know what’s real out there, what’s really going on. I think the same thing is absolutely true across the country, and it’s absolutely a core focus of ours and a strength that, we do share that information.

We have a national call the fourth Thursday of the month at 7:00 PM so we have one coming up this week. We have a monthly Saturday. So we’re constantly, yeah. Comparing notes, looking at the terrain. We actually do a landscape assessment in every state, and so we actually help every state to get an assessment of their landscape, specifically using the lens of the healthcare crisis.

But the reality is that the healthcare crisis is at the, in it’s an interconnected point of. Everything right? It’s an interconnected [00:25:00] point with climate change and public health, with mass incarceration, with jobs, living wages. There’s nothing that doesn’t connect to healthcare in some way.

And yeah, we do a landscape assessment. We talk about the conditions going on in our states, and we also really try to support and help each other to, learn from. Each other, learn from the history of our organizations and groups and make new mistakes, right? We’re always talking about that let’s make new mistakes, let’s not make the same mistakes.

So we really try to live into this network form of organizing. 

Cayden Mak: Yeah that’s really awesome and like extremely heartening to hear that I feel like the emphasis on making new mistakes feels really big to me in this time. That like we all need to lead into making some new mistakes these days.

So if folks wanna learn more about your work, if they wanna maybe plug into networks in the states or learn more about the nonviolent Medicaid army in general where would you point people? What, how can people plug in? 

Nijmie Dzurinko: Absolutely. Yeah. Thanks for asking. So we have a website, [00:26:00] nonviolent medicaid army.org.

And one of the things on that website, there’s a link when you go there that’s called Medicaid Mondays, and that’s actually a story sharing campaign that we have as part of this Medicaid cutoffs organizing drive. We draw on the history of the abolitionist movement, right? And the vigilance committees and how coming into the movement, one of the first things you would do is tell your story.

And so we draw on that and we have that. And so invite people to take part in that. We’re also on Facebook Nonviolent Medicaid Army. We’re on TikTok, nonviolent Medicaid, army and Instagram. So that’s a great way to following us on social media is a great way to just stay up to date on different things that are happening.

And then you can also send an email to nonviolent Medicaid [email protected] if you’re just interested in saying, Hey, is the NVMA in my state? Or how can I get organized? Or How can I get involved? And when you follow the social media, you’ll also see the announcements for the national call, which is always the fourth Thursday, and it’s open.[00:27:00] 

It’s an open call for anyone to get involved and our Saturday schools, which are generally on the first Saturday of the month, and that’s a political education and organizing and coordination space as well. 

Cayden Mak: Awesome. Thank you so much. Is there anything else that you think that our listeners should know about the work that you all doing, things you’re learning through these campaigns?

Nijmie Dzurinko: I think that there’s just a really important period right, of organizing here. I don’t wanna call it a moment, I think it’s a period, and I think we’ve gotta know, where we came from, how did we get here what is the context for what we’re experiencing now? And then we’ve gotta, I think, really see the potential.

And power in organizing, right? We talk about building permanently organized communities, and I think mobilizations are very important, but organizing is incredibly important and essential, and so I just think that we all need to think about and consider the importance of [00:28:00] organization. That is statewide, that is crossing, that geogra, those geographical divides and is connecting with people on the basis of where we’re hurting and then bringing people into a long-term process of leadership development and political education.

That helps and enables us to build more leaders who really can wield strategy and tactics, not just show up, hold signs, tell stories. But maneuver on a very complicated terrain and we need many leaders in order to do that. And I think we have figured out some, something about that. The nonviolent Medicaid army.

I’m really proud of it and we’re definitely looking to connect up, with others who are interested in these questions as well. 

Cayden Mak: Amazing. Nmi, thank you so much for making the time to talk with me today. It’s, I’ve been an absolute pleasure and really interesting work. Thank you so much.

Nijmie Dzurinko: Thank you Caden, and thanks to your whole team. Really appreciate you all. 

Cayden Mak: My thanks again to NMI for making time to join me. You can find ways to connect with their work in the show. This show is published by [00:29:00] Convergence, a magazine for radical insights. I’m Kaden Mock, and our producer is Josh Stro. Kimie David designed our cover art.

If you have something to say, please drop me. You can send me an email that will consider running on an upcoming mailbag [email protected]. And finally, if you would like to support the work that we do at Convergence, bringing our movements together to strategize, struggle, and win in this crucial historical moment, you can become a [email protected] slash donate.

Even a few bucks a month goes a long way to making sure that our independent small team can continue to build the MAP firm. I hope this helps.