Why Medicare for All Must Be Part of the Green New Deal

In 1991, Larry Barragan got word that the oil refinery in Long Beach, California where he was working would be closing. It was one of the scariest moments of his career. Barragan was nervous about losing his income, but even worse was the thought of losing his health insurance, especially because his wife was pregnant at the time.

“That’s the first thing that came to my head,” he said. “I thought, ‘oh my god what I’m going to do?’ I needed to have…medical benefits because I had a child coming in seven or eight months.”

Since the most common way that Americans get their health care is through an employer, many lose their insurance when a company shrinks or folds. As the need to move away from fossil fuels becomes more acute, so does the need ensure workers in the industry are taken care of. When it comes to health care, Medicare for All would be among the easiest paths to do just that while supporting millions of other Americans.

Barragan never did get laid off because months before the refinery shut down, he managed to find a new job with medical benefits operating pipelines that ship refined fuels from California to Nevada and Arizona. He’s held the position ever since. But many others in his union, the United Steelworkers Local 675, haven’t fared so well.

“Through the years we’ve seen, due to climate change and restrictions for climate, the industry change,” he said. “Our local union at one time had close to 10,000 members 30 or 40 years ago. Now, we’re a little over 4,000. It’s layoffs, it’s downsizing.”

On Wednesday, 111 House Democrats are reintroducing a piece of legislation that could would make Medicare for All a reality. And though the new rollout is not being billed a climate policy, the crisis in the oil and gas industry shows why it’s so central to ensuring the next decade is fair to workers who have helped power the past century.

Liberals and conservatives alike have scoffed at the idea that Medicare for All should have a place in climate policy. But for those transitioning out of polluting industries, it would be a gamechanger.

“If we had Medicare for All, there would be so much less to worry about,” said Barragan.

Barragan was one of more than 100 people interviewed for a new report from the Labor Network for Sustainability on how workers and communities have been affected by plant closings and other major shifts in economies. The report, released Wednesday, draws on experiences from those in transitioning industries, including not only oil and gas, but also other sectors like steel and paper mills which are downsizing amid increased environmental controls, and grocery stores, which are seeing clerk jobs replaced with automated self-checkout counters. Though it’s not tied to the reintroduction of Medicare for All, it explicitly calls for universal health care and shows how climate and health policy are intimately linked.

Mijin Cha, assistant professor of urban and environmental policy at Occidental College and a lead author on the report, said that health care was among the top concerns keeping workers in these sectors up at night.

“No one should have to be in that position,” she said.

If insurance was provided by the state instead of employers, this wouldn’t be an issue. Right now, unions have to fight hard to secure health care benefits from employers. Not having to worry about that could create the opportunity to make bigger gains in other parts of severance packages.

“We could win more for people who lose their jobs during closures,” said Barragan. “Right now, whatever is negotiated relating to health benefits will ultimately affect the cost of other benefits that the worker will get.”

Barragan said currently, his colleagues are often willing to make sacrifices in other areas to protect their health insurance, especially because polluting industries like oil and gas put employees at risk of all sorts of health issues just by going to work every day. Constant exposure to pollution tied to extracting and burning fossil fuels can increase the risk of asthma and cardiac disease. Studies also show that workers in offshore oil and oil refineries face higher risks of contracting cancer.

“In 29 years, two of my [coworkers] have passed away from cancer,” said Barragan. “And I have two retirees that retired within the last five to eight years, who were diagnosed after retirement with cancer.”

The toll of working in the fossil fuel industry isn’t just physical, it’s also psychological. The new report details the mental health crises that the looming threat of job loss can create for many people.

“A lot of these folks have been in a period of uncertainty and insecurity for a long time. So it’s like, you don’t know what’s going to happen to your job…Nobody knows what’s happening, nobody knows what to do. And then you add on top of that, the real stress of how to meet your material needs,” said Cha. “The mental health effect is phenomenal.”

Medicare for All would ensure that regardless of employment status, all people have access to mental health services, which would be a huge benefit to those experiencing these struggles.

The health risks to both workers and communities is one reason that the industry must be wound down. Another is the existential threat of climate change, which is itself creating public health crises that have become multi-billion-dollar drags on the economy. To ensure the impacts don’t worsen will require a rapid transition to a no-carbon economy over the coming decades.

Yet that transition may already have begun since covid-19 led to a downturn in oil and gas demand. The sector has laid off more than 100,000 workers, and that number is rising. So far, that’s happened in a haphazard manner with little oversight or support for workers. But to make sure the transition away from oil and gas is fair, the millions of people who work in the American oil and gas must be taken care of. That includes ensuring they have access to basic human needs.

“We will need time to invest in new industries and to diversify economies. That can’t happen overnight,” said Cha. “So if we could give assurance that these workers will be supported through this transition, that I think removes a lot of reasonable opposition that comes from that primal survival instinct we all have.”

Those new industries would also benefit from the Medicare for All just as the fossil fuel sector would.

“It’s pretty widely known that the jobs in the new green economy have so far been largely non-union, they don’t always pay that well, and they often don’t provide benefits [like] health care,” said Cha. “Right now, getting employers to give people health care is a fight. But when you have health care guaranteed for everybody, you don’t have to bargain for it. So it’s not like this huge employer giveaway if they give you health insurance, and instead you can focus on improving things like wages and other benefits like pension support.”

To avert the worst consequences of climate change and limit the safety risks it creates, the U.S. will have to make huge changes to its economy. But there’s no reason that should put workers—or anyone—at risk of losing their health care.

“If we had Medicare for All, we’d just have a healthier society,” said Cha.

Barragan agrees, and also thinks it could afford him a safer and more fulfilling life personally. He’s 58 years old, but his job doesn’t include a retiree medical plan, so he plans to spend another seven years doing physically taxing labor until he qualifies for Medicare.

“If they had Medicare for All, I’d be lining up my ducks in a row right now to retire,” he said.

If he could retire, Barragan said he’d be devoting more time to labor organizing and to his family’s cancer aid charity, as well as “booking a trip to Hawaii.” After nearly 40 years in the oil and gas industry, he deserves it.