If you feel a little pessimistic about the prospects for winning Medicare for All, it’s understandable. Bernie Sanders lost the 2020 Democratic primary. A deadly pandemic has not convinced the ruling class of the cruelty of a privatized health care system. The presidency is occupied by Joe Biden, who has vowed to veto Medicare for All should it come to his desk. And the likelihood that Medicare for All will reach Biden’s desk in the first place is, in any event, nearly zero. As Ben Burgis points out, even the achievement of a symbolic victory for Medicare for All in the lower chamber of Congress, before being tossed into the dustbin by the Senate, is unlikely.

In some states, however, the outlook is far less grim than it is on the national level. Single-payer bills have been introduced into eighteen state legislatures since the beginning of 2021. The prospects of passing a single-payer bill in some of the state legislatures are looking much better than in Congress.

For instance, the single-payer bill introduced to New York’s state legislature received a majority of cosponsors in both chambers for the first time in January of this year, although it was not brought to the floor for a vote in the state assembly before the end of the legislative session.