Families of Victims Who Died From Heat in US Prison's Fight to Prevent More Deaths

Over 200,000 incarcerated people face deadly summer heat in California and Texas.

By Victoria Law , 

Truthout/TheAppeal

June 6, 2026

Demonstrators make their way into the Texas State Capitol building in Austin, Texas, on July 18, 2023. Activists visited the capitol to discuss the need for air conditioning in Texas state prisons, citing the harsh conditions and multiple deaths related to the heat and lack of relief from it.SERGIO FLORES / AFP via Getty Images

The Central California Women’s Facility, the nation’s largest women’s prison, is in Chowchilla, where temperatures reached past 90 degrees by the second week of May. The prison lacks air conditioning or any facility-wide cooling system, turning cells into saunas.

“I dread going to my groups at night because we have to wait forever at the gates and we cannot bring water with us. We can’t take water bottles to the main yard and my groups are on the main yard, so I am SOL,” 45-year-old Tien Mo wrote on May 11, an afternoon when temperatures reached 96 degrees.

Dehydration is just one concern. People behind bars are particularly vulnerable to heat-related harm, including death. A 2019 study by the Prison Policy Initiative found that 13 states in the hottest parts of the U.S. lack universal air conditioning in their prisons, meaning that while some areas, such as the chapel, visiting room or administrative offices, might have air conditioning, others, such as housing units, do not. A 2023 study found that extreme heat was associated with higher overall mortality behind bars. Researchers found that, for every 10 degrees increase above the prison’s mean summer temperature, nearly five percent of deaths (from all causes) could be attributed to the heat.

Two years ago, on July 4, 2024, temperatures at Chowchilla reached 109 degrees. That day, 47-year-old Adrienne Boulware waited for her medications in the yard. Later that day, she became incoherent, dropped to the ground, and began shaking. She was transported to the hospital and died two days later.

She was one year from a parole hearing.


8 Prisons in Virginia Lack AC in 108-Degree Heat. I Am Stuck in One of Them.
My bunk gets sweaty when I lay it in. The walls sweat, too — you can see it. We’re in an oven. It’s too hot.  By Tutankhamon Waterman , Truthout/Inques tJuly 31, 2025

Now, her family members are among those pushing for Adrienne’s Act, which would implement relief measures during extreme weather events, including the punishing heat and wildfire smoke that pummels California every year between May and October. It would require the California Department of Corrections and Rehabilitation (CDCR) to implement a plan ensuring that living quarters, work areas, and recreational spaces have cooling systems and shade structures. It would also require that officials monitor indoor temperatures, investigate and document heat-related incidents, and develop emergency response protocols during extreme weather events, which include extreme heat.

Adrienne’s Act also establishes the Climate Justice in Prisons Emergency Response Act, which directs the state prison agency to issue summer-appropriate clothing, such as shorts, identify additional shade structures in yards and exercise areas, and allow increased access to showers and personal fans during excessive heat or wildfire smoke. It would also require prison medical staff to conduct regular assessments to identify those at risk for heat-related illnesses (such as those who are elderly, on medications that increase their risk, or have preexisting health conditions), to monitor symptoms for heat-related illnesses and provide prompt medical attention, and to document heat-related illnesses, symptoms, and treatment, establishing relief measures such as access to cool drinking water and cooled indoor areas, and modifying work and program requirements for those with risk factors.

Had such measures been in place, Boulware would not have died, her daughter Tyresha Reed told Truthout.

In an email, CDCR spokesperson Mary Xjiminez stated that, “after a thorough autopsy including ancillary testing, the Madera County Coroner ruled Ms. Boulware’s cause of death as undetermined.” She directed Truthout to the coroner’s report which found it unlikely that Boulware was “significantly hyperthermic leading to her demise. It was possible that her increase in body temperature was secondary to seizure activity.”

Demonstrators take part in a 2024 rally outside the Central California Women’s Facility following Adrienne Boulware’s death.Leesa Nomura, California Coalition for Women Prisoners

“This Could Have Been Preventable”

In March, more than 10 of Boulware’s family members traveled to Sacramento for a committee hearing on the bill. The family who were present included Boulware’s siblings, cousins, daughters, and nine of her grandchildren.

“My mother left behind four kids, 12 grandkids who she loved dearly, a lot of other family members as well,” Reed testified at a March 24 hearing before the California State Assembly committee on public safety. “My children and my siblings’ children cry every single day because their nana was supposed to come home and she didn’t, and this could have been preventable.”

“I believe that the dead can speak from the grave, and she’s speaking loud and clear,” testified bill sponsor Assemblymember Mike Gipson. “She’s saying that we must do something, and we must do something now. I respectfully ask for a strong aye vote in the memory of not only her, but those who’ve come before her as well.”

The seven committee members unanimously voted to approve the bill. It then moved to the appropriations committee. In mid-May, it passed that committee.

Adrienne’s Act notes that California’s Legislative Analyst’s Office (LAO) has found that closing prisons can allow the state to avoid costly infrastructure improvements at those facilities and concentrate resources at the remaining prisons. The LAO has recommended that the state prioritize closure of certain prisons as a first step in managing prison infrastructure.

While CDCR does not comment on pending legislation, its press materials note that cooling its 31 prisons would cost the state approximately $6 billion. It has rolled out an air cooling pilot program at the Central California Women’s Facility as well as Kern Valley State Prison and California State Prison.

The California Coalition for Women Prisoners notes another way to save money — decarcerating the aging. Roughly one in five people in California women’s prisons are over age 50. The state spends up to $300 million each year incarcerating approximately 740 elders in its two women’s prisons. None of that money is allocated to air conditioning or other means of cooling the housing units even though in 2024, the year that Boulware died, Chowchilla had 28 days when temperatures reached or surpassed 105 degrees.

“Women in prison over 65 used to be a rarity here,” said Christie, now in her 80s. (Christie asked that her legal name not be published to avoid retaliation.) “Now there’s a whole herd of us.” And the combination of climate change and aging has taken its toll on this growing herd.

“Absolutely, extreme heat is way less tolerable as I have aged,” 71-year-old Mindy, incarcerated at the California Institution for Women in southern California, told Truthout. “It makes it more difficult to walk to work and any other activity. It makes me feel sick to my stomach, exhausted, and my high blood pressure issues increase.”

Mindy was able to buy two fans, but notes that those who lack money or outside support are only issued one.

“This became a real call for action prior to last year because they were giving free fans to the dogs in the puppy program but humans were given nothing! It took a death for policy to change,” she said.

“Our buildings reach temperatures in the 90s and NEVER COOL OFF in the summer,” Christie told Truthout in an electronic message. “I feel we are being cooked to death.”

The California Institution for Women has a cooling area for senior citizens, but Christie notes that it is only open on weekdays from 8:30 am to 3 pm. CDCR stated that the hours are based on when count occurs and that the cooling area cannot be opened after count time because staff are not available to supervise. But temperatures are often hottest in the mid-afternoon.

At the 36-year-old Central California Women’s Facility, 54-year-old Ezekiel Teaque hasn’t noticed any construction or indoor temperature changes. “I really don’t believe we got a new cooling system because the roof is literally falling in and … water is just leaking all over the place,” he wrote in early June on a day when temperatures exceeded 90 degrees.
“I’m Not Going Out”

At least 41 people incarcerated in Texas prisons died during a 2023 heat wave when prison heat readings regularly read 100 degrees or higher. This included 37-year-old Elizabeth Hagerty, who was scheduled for parole one month after guards found her unresponsive in her un-air-conditioned cell. As previously reported in Truthout, temperatures had reached nearly 100 degrees the day before she was found.

The previous year, a study of Texas prisons found that even a one-degree increase above 85 °F in prisons without air conditioning was associated with a 0.7% increase in the risk of mortality. Researchers estimated that 13 percent of deaths in Texas prisons during warm months between 2001 and 2019 may be attributable to extreme heat.

In 2025, federal judge Robert Pitman ruled that housing people in prisons that lack air conditioning is “plainly unconstitutional.” But he declined to force the Texas Department of Criminal Justice (TDCJ) to immediately install either temporary or permanent air conditioning.

The issue came before Pitman again in 2026, when incarcerated people and advocacy groups filed a federal lawsuit in an attempt to force the state to provide air conditioning in all of its prisons. TDCJ argued that it would cost $1.5 billion to install air conditioning in all prisons. The two-week trial ended in early April. Pitman has yet to issue a ruling.

This leaves 59-year-old“Jack” sweltering in a cellblock that will soon become a sauna. Jack asked that his full name not be published so as not to affect his chances at parole. Jack was recently transferred from a prison which had full air conditioning to one that had none.

“Several of my medications have heat, humidity, and sunlight restrictions which make me more susceptible to the elements,” he told Truthout. “I can’t even open my window due to a wasp nest being somewhere near my window.” After being stung twice, he keeps his window closed.

“Fans do no good in the summer because all they do is circulate the hot air,” he said. “I am unable to go to outside recreation and this unit has no awnings, so I often am in the sun.”

When previously confined to hot units, Jack resorted to wearing a wet sheet like a toga and laying on a flooded cell floor to keep from overheating. He plans to revert to those practices this summer.

Aisha Bailey has been in Texas state prisons since 2004. “My tolerance to heat has gotten worse because the heat itself has gotten worse,” the 49-year-old told Truthout. “Even though recreation is offered less and less due to staffing issues, I still don’t want to go outside when the opportunity does come. Once we go to outside recreation, we are usually left out there for hours due to the officer forgetting or being too busy.”

During the summer, she avoids programs during the hottest part of the day.She also requests that her medications usually dispensed in the afternoons (between 2 pm and 5 pm) be changed to the mornings (3 am to 6 am), which she says providers are willing to accommodate.

Bailey was recently transferred to the Lane Murray unit. In 2024, officials installed an air cooling system in its segregation unit after the 2023 death of Hagerty and multiple op-eds by incarcerated journalist Kwaneta Harris on the blistering heat. General population cellblocks, however, remained uncooled.

Earlier this year, Harris was transferred from a non-solitary unit, which lacked air conditioning, to the fully air-conditioned Patrick O’Daniel unit, a six-minute drive from the Murray unit.

While the cellblock has air conditioning, she must walk through the yard to go to the cafeteria. On an 88-degree day, the three-minute walk leaves her dripping with sweat. The cafeteria only has fans which push around the hot air.

As temperatures rise, Harris plans her meals from the foods bought from commissary. “I’m not going out,” she said.

When asked about Haggerty’s death, air conditioning, and heat mitigation efforts, TDCJ spokesperson Amanda Hernandez directed Truthout to the agency’s page on air conditioning construction projects, which notes that 38 prisons are fully air conditioned and 52 are partly air conditioned. TDCJ has 100 facilities.
“One Person Can Change Someone’s World”

Tyresha Reed is somber when she talks about her and Boulware’s plans. Reed had moved to a bigger house so that Boulware could live with her and had even furnished her mother’s room.

“She wanted to get all her grandkids together at one time,” she said. “You can only have six people at a visit, so there was no way for her to see all her grandkids at one time. That was something she really wanted to do.”

Boulware also looked forward to tasting her adult daughters’ cooking. “When I cooked for the kids, she would have me send her pictures,” Reed recalled. She was especially looking forward to trying what Reed called a chicken roast. “It’s chicken, potatoes, bell peppers, mushrooms, onions all cooked together in the crock pot,” she explained.

Now, instead of gathering grandchildren or ingredients, Reed is learning how to advocate for a life-saving law. She has joined All of Us or None, a group fighting for the rights of currently and formerly incarcerated people and their families.

“I always tell my kids, one person can’t change the world, but one person can change someone’s world,” she said.

In early June, however, Reed and other advocates learned that Gipson’s office decided to “gut and amend” the bill.

“This means all existing bill language, everything that made up Adrienne’s Act, will be removed, and only the bill number will remain,” explained Ravyn McCullough, a member of California Coalition for Women Prisoners. “This gives the author’s office the authority to transfer language from a previous bill that died.”

Gipson’s office declined to comment.

As for Reed, she’s determined to keep fighting to ensure that no one else goes through the same tragedy. “I’m going to keep fighting until a change is made,” she said.

This article is licensed under Creative Commons (CC BY-NC-ND 4.0), and you are free to share and republish under the terms of the license.

Victoria Law

Victoria Law is a freelance journalist who focuses on incarceration, gender and resistance. Her books include Resistance Behind Bars: The Struggles of Incarcerated Women (2009), Prison by Any Other Name: The Harmful Consequences of Popular Reforms (2020), “Prisons Make Us Safer” & 20 Other Myths about Mass Incarceration (2021), and Corridors of Contagion: How the Pandemic Exposed the Cruelties of Incarceration (2024).

Trump's big promise to financially 'benefit' Americans implodes in real time: report

Alexander Willis
June 7, 2026

RAW STORY



U.S. President Donald Trump looks on as he signs an executive order recommending loosening the federal regulations on marijuana, in the Oval Office at the White House in Washington, D.C., U.S., December 18, 2025. REUTERS/Evelyn Hockstein TPX IMAGES OF THE DAY

President Donald Trump vowed back in January that his administration’s takeover of Venezuela would “benefit” Americans, and yet, just over six months later, that promise appears to be imploding after key players have reportedly gotten cold feet, The Washington Post reported Sunday.

In the immediate aftermath of the unprecedented U.S. attack on Venezuela earlier this year, the Trump administration took control of the nation’s oil revenue, which Trump claimed at the time would be “used to benefit the people of Venezuela and the United States.” The Trump administration had hoped U.S. companies would invest $100 billion into the South American nation’s energy infrastructure.

“But businesses don’t want to spend big on capital-intensive projects to extract heavy crude, which take decades to pay off, if there’s a high chance the government will backslide,” the Post’s report reads.

“ConocoPhillips CEO Ryan Lance said recently that Venezuela has ‘a lot more work to do on their side of the equation.’ He said the overhaul of the hydrocarbon law was insufficient ‘to attract a whole lot of investment’ because it could amount to a ‘95 percent government take.’ Chevron CEO Mike Wirth has expressed similar sentiments.”

The Trump administration was recently in hot water over its handling of Venezuela’s oil revenue. Rep. Sydney Kamlager-Dove (D-CA) pressed Secretary of State Marco Rubio last week during a congressional hearing on whether the administration was concealing lucrative private contracts related to Venezuela’s oil.

“The Venezuelan government’s illegitimacy raises the risk of investing capital,” the Post’s report reads. “Once real elections are held, U.S. companies will gain a clearer sense of whether it’s worth pouring in money.”

Report Highlights ‘Uniquely Poor Performance’ of US For-Profit Health System Compared to Other Nations

“We know what high-performing health systems look like—other countries have them and are building them. It’s high time the US did better.”


Members of National Nurses United rally with lawmakers to show their support for the Medicare For All Act in Upper Senate Park on Capitol Hill on April 29, 2025 in Washington, DC.
(Photo by Chip Somodevilla/Getty Images)

Julia Conley
May 28, 2026
COMMON DREAMS

An annual analysis that examines healthcare systems across nearly two dozen wealthy countries around the world once again highlighted the United States’ “uniquely poor performance relative to its peers,” with this year’s US Health Care from a Global Perspective report focusing on “insurance coverage and access to care, affordability of care, delivery of care, and equity of health outcomes.”

As advocates for expanding the US Medicare system to the entire population have long warned, the country’s for-profit healthcare system—which ties the ability to get care to one’s employment and allows insurance companies to boost profits by denying care to patients—“The US, on average, has the poorest health outcomes of any high-income country,” the Commonwealth Fund’s report reads.

The report examines the US system compared with other countries in the Organization for Economic Cooperation and Development (OECD), including the United Kingdom, France, New Zealand, Japan, and Mexico.

It finds that the US spent 18% of its gross domestic product on healthcare in 2024—nearly twice the OECD average.

Life expectancy in the US reached an all-time high in 2024, but was still among the shortest when compared to the 19 other countries, nearly five years shorter than Japan, Spain, and Switzerland, and longer than the average lifespan in Turkey and Mexico.

While the US and Mexico also both rank high on the list in terms of preventable deaths, the latter nation announced last month that it would soon be joining every other country included in the analysis by shifting to a universal, government-run healthcare system.

In the United States, the for-profit health sector—which spent a record $877.69 million on lobbying last year—contributes to the high number of avoidable deaths, which stands at 312 per 100,000 people. About 27 million Americans are still uninsured, more than 16 years after the passage of the Affordable Care Act, and the Republican Party’s refusal to continue ACA subsidies last year as well as its $1 trillion in Medicaid cuts over the next decade, according to Thursday’s report, are “projected to increase the number of uninsured Americans by an additional 17 million by 2034, potentially leading to more than 50,000 additional preventable deaths annually.”

“By contrast, Mexico’s recently established Universal Health Service will provide all residents with access to free care at any public health institute, starting in 2027,” the report states. “The US is one of the only countries to have enacted policies that reduce coverage.”

High out-of-pocket costs may also contribute to poor outcomes and the high number of preventable deaths in the US, the Commonwealth Fund suggests. Americans spend $400 per person, per year, on out-of-pocket costs for prescription drugs, while people in France spend $100.

“The US is one of the only countries to have enacted policies that reduce coverage.”

“In the US, where approximately 8% of the population is uninsured and one-quarter has coverage that comes with high out-of-pocket costs or deductibles, people are far more likely to forgo needed care because of costs than people in peer countries,” reads the report. “This can mean not filling prescriptions, not obtaining diagnostic tests, treatment, or follow-up care, or being unable to adhere to clinician-recommended care plans.”

The report also identifies the US as a country that lags behind its peers in producing new doctors, contributing to a crisis in primary care, with the US having the fewest number of primary care providers per 1,000 people. The country also has the “highest medical tuition fees of any country in our analysis,” said the Commonwealth Fund.

The organization also found that in 2023, the US had nearly 19 maternal deaths for every 100,000 live births, representing a decline for the country that has long had “among the highest rates of maternal deaths related to complications of pregnancy and childbirth.”

“By contrast, in 11 of the 18 countries we studied there were less than five maternal deaths per 100,000 live births,” reads the report, which also notes that in the US, maternal mortality is “exceptionally high” among Black women, at 50 deaths per 100,000 live births.

“This far exceeds national maternal mortality in any of the other countries,” the report states. “Inequities in access to care and patients’ care experiences—often rooted in discrimination and clinician bias—may be prime contributing factors.”

Dr. Joseph Betancourt, president of the Commonwealth Fund, noted that “the US has long prided itself on having the best healthcare in the world, but the population benefits from this excellence unevenly, and it remains largely out of reach for many Americans.”

“We spend more than any other nation on healthcare, so our poorer health outcomes aren’t due to a lack of resources—it is about how we choose to use them,” said Betancourt. “We know what high-performing health systems look like—other countries have them and are building them. It’s high time the US did better.”

“Other countries have shown that alternatives work. What’s striking isn’t the absence of solutions; it’s our reluctance to implement them.”

The report does not explicitly call on the US to shift to a universal, government-funded healthcare system, but studies have shown that expanding Medicare to the entire US population, as lawmakers including Sen. Bernie Sanders (I-Vt.) and Reps. Pramila Jayapal (D-Wash.) and Alexandria Ocasio-Cortez (D-NY) have consistently demanded, would address many of the problems listed in the report.

Studies by the Congressional Budget Office and Yale University have shown that Medicare for All would save an estimated $650 billion and prevent 68,000 avoidable deaths each year.

The policy, which has been proposed in Congress numerous times, is also broadly popular; 65% of US voters—including 78% of Democrats, 71% of Independents, and 49% of Republicans—support creating a national, government-run healthcare program, according to a Data for Progress poll last year.

Despite this, both Republican and Democratic lawmakers continue to insist the proposal is unpopular and too expensive, with Michigan state Sen. Mallory McMorrow (D-8), who is running against vehement Medicare for All advocate Abdul El-Sayed in the Democratic US Senate primary, insisting recently that “the support for a true single-payer system isn’t there yet.”

Reginald Williams II, senior vice president at Commonwealth Fund, emphasized that it is “not inevitable” that “Americans pay more for healthcare and get less in return.”

“It’s the result of different choices,” he said. “Other countries have shown that alternatives work. What’s striking isn’t the absence of solutions; it’s our reluctance to implement them. The failure of the US health system is not a failure of ideas. It’s a failure of will to act on them.”

Universal Health Care Once Seemed on the Horizon in California. What Happened?

Among California’s top five gubernatorial candidates, only one unequivocally supports state-based single-payer.

By Sonali Kolhatkar

May 28, 2026

Source: TruthOut

Universal Health Care july 2018 by Mirarkitty is licensed under BY-SA 4.0 / wikimedia

Fighting for Our Lives: The Movement for Medicare for All

California voters are in the thick of a high-stakes governor’s race, in which single-payer health care, an issue that was once central to state politics, has been pushed to the sidelines. Of the top five candidates, only one unequivocally supports a health care model that would finally put California on par with the rest of the industrialized world.

Billionaire Tom Steyer, running as a Democrat, says single-payer is the only way to bring down spiraling health care costs. In 2020, Steyer ran for president on a platform touting a “public option,” and attacking Senator Bernie Sanders’s single-payer health care plan. Now, Steyer has reversed that position, earning the coveted endorsement of the California Nurses Association, one of the state’s most aggressive proponents of single-payer.

Sanders is widely credited with popularizing single-payer or “Medicare for All,” which would make health care a freely available and publicly funded resource much like public schools or libraries. In the face of federal intransigence, single-payer proponents have advocated for states to enact their own programs. Indeed, California has come close to enacting “CalCare,” its own version of single-payer, several times in recent years.

Steyer’s opponent and fellow Democrat Katie Porter has also said she supports single-payer but worries about its feasibility. In a public forum hosted by Politico last year, she said, “I don’t think it’s realistic in the next couple of years for the state to push forward on that,” adding that she believed it was more appropriate for the federal government to take it on instead.

Meanwhile, the current frontrunner, Xavier Becerra, has backed away from supporting single-payer. Becerra, who won the endorsement of a powerful, anti-single-payer lobby group called the California Medical Association, is running on a platform of preserving the status quo.

Meanwhile, the two Republicans polling well enough to potentially win a spot on the November ballot in California’s “free-for-all” primary are Steve Hilton and Chad Bianco. Hilton, a former Fox News host, and Bianco, who is Southern California’s Riverside County Sheriff, are both running on reducing access to state-funded health care, primarily for undocumented immigrants.

At a time when the cost of living in California continues to skyrocket, single-payer health care has been oddly low on the list of candidates’ talking points. Dr. Paul Song, a member of Physicians for a National Health Program and former co-chair of the Campaign for a Healthy California, said there’s good reason for that.

“The number of uninsured as a percent of our California population is at the lowest it’s been in a long time,” Song said in an interview on Rising Up With Sonali. That’s because Governor Gavin Newsom recently oversaw the expansion of insurance coverage to most Californians.

In 2018, then-candidate Newsom won the California Nurses Association’s endorsement for embracing single-payer. But his support for a system that would cover 100 percent of the population over time morphed into what he now calls “universal access to health care coverage.” While it might sound a lot like universal health care, this shift is a sleight of hand. Newsom’s chosen policy merely means almost everyone in the state has some form of private or public health insurance — but it doesn’t address the rising costs of premiums, co-pays, and high out-of-pocket charges.

“It’s easy to have become discouraged based on the false promises of Gavin Newsom when he ran and said he was going to run as a single-payer candidate,” said Song. Since 2018 there have been “numerous attempts where activists have tried to advance legislation only to see it just killed in Sacramento and not even be brought up for a vote,” he added.

Newsom has been accused of deliberately “slow-rolling” single-payer as governor. Song recalled a 2020 incident in which the governor caused a scandal by attending a dinner party at a high-end restaurant during the state’s strict COVID lockdown. “The person he was having dinner with was Dustin Corcoran from the CMA, the California Medical Association, who was one of the largest opponents of our single-payer system,” said Song. It’s the same organization that has backed Becerra for governor, a candidate who only recently surged in the polls after Congressional Rep. Eric Swalwell dropped out of the race.

Angered by Newsom’s backtracking, the California Nurses Association lambasted him in 2023 over his signing of SB 770, a bill that undercut single-payer efforts by expanding health coverage through private insurers. The union called it “a complete betrayal of nurses’ fight for a single-payer health care policy, a fight striving to achieve health justice for our patients and our communities.”

California Nurses Association President Michelle Gutierrez Vo, an adult family medicine nurse at Kaiser Fremont, explained why the union now supports Steyer in an emailed statement. “As a frontline nurse who cares for patients, I know Californians want a governor who supports CalCare.” According to Vo, her organization backs Steyer because he, “understands that we need to take on deep-rooted systematic failures in Sacramento, and that we cannot allow the next governor to repeat the political opportunism that has dominated this issue for too long.”

Song took a dim view of Becerra, saying, “There have been times where he said he was in favor of [single-payer], but you never saw him actively trying to propose anything to make that possible.” Becerra, who made history as the federal government’s first Latino Secretary of Health and Human Services during President Joe Biden’s administration, faced pressure from single-payer advocates to protect Medicare from privatization. According to Song, “What I saw under his watch was the even greater privatization of our health care system.”

Perhaps the largest reason why single-payer is no longer a key issue in the governor’s race is the supposed price tag of government funding for health care. Estimates range from more than $400 billion to $731 billion per year. Given that the state’s projected 2027 budget is on the order of $349 billion annually, single-payer opponents are quick to claim the state simply can’t afford it.

But Song says such estimates don’t account for the savings from switching to single-payer. “If you look at the total number of dollars that are spent on health care, and not to mention the amount of money that comes out of our pocket for co-pays or deductibles, or because we have an employee-sponsored plan, the number of dollars that we don’t get in our salary because the company has to deduct that to pay for health care, we are paying essentially for a universal health care system or a single-payer system, we just are not getting one,” he said.

Many studies have shown that single-payer would garner net savings for individuals. The trouble is that in order to enact it at the state level, state governments need permission from the federal government to divert Medicare and Medicaid funds toward a single-payer system — a request that is highly unlikely to be granted under the Trump administration. Newsom did not attempt to obtain a federal waiver under the Biden administration, although even if he had he would have been unlikely to succeed given that the Democratic president was also an opponent of single-payer.

Ironically, in 2017, Newsom declared on the social media platform X, “I’m tired of politicians saying they support single payer but that it’s too soon, too expensive or someone else’s problem.” Within a few years, he had become precisely such a politician.

Worse, Newsom’s touted substitute for single-payer — “universal access to healthcare coverage” — is about to come apart at the seams. In October 2025, his administration warned that health care costs were about to double thanks to congressional inaction, with insurance premiums for state insurance exchange plans potentially jumping by a whopping 97 percent. To make matters worse, Newsom just released a state budget that includes cuts to immigrants’ health care coverage — the same funding that helped achieve the near-universal health coverage of which he previously boasted.

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Sonali Kolhatkar

Sonali Kolhatkar is an award-winning multimedia journalist. She is the founder, host, and executive producer of “Rising Up With Sonali,” a weekly television and radio show that airs on Free Speech TV and Pacifica stations. Her most recent book is Rising Up: The Power of Narrative in Pursuing Racial Justice (City Lights Books, 2023). She is a writing fellow for the Economy for All project at the Independent Media Institute and the racial justice and civil liberties editor at Yes! Magazine. She serves as the co-director of the nonprofit solidarity organization the Afghan Women’s Mission and is a co-author of Bleeding Afghanistan. She also sits on the board of directors of Justice Action Center, an immigrant rights organization.

The VA Is a Model for Public Health Care. We Need to Protect It.

By Suzanne Gordon

May 26, 2026

Source: Barn Raiser

Image by Tony Webster/Wikimediacommons, licensed via CC BY 2.0

Bruce Carruthers is a Vietnam veteran who served in the Army and now lives in Waynesville, North Carolina. At age 81, Carruthers could be spending more of his time with his three sons and grandchildren, traveling or focusing on the woodworking projects that he enjoys. Instead, for the last six years, he’s devoted hours each week to stop efforts to privatize the nation’s largest and only publicly funded health care system, run by the Department of Veterans Affairs (VA).

Carruthers has a long and deep connection to the Veterans Health Administration (VHA). For 30 years, from 1974 to 2002, he worked first in VHA’s Human Resources department and then in hospital administration at hospitals like the Rocky Mountain Regional VA Medical Center in Denver, Colorado.

Several years after his retirement, he became a VHA patient. He now drives 36 miles from his home to the Charles George VA Medical Center in Asheville, North Carolina, where, most recently, he’s received treatment for prostate cancer (most likely as result of his exposure to Agent Orange in Vietnam).

“I feel I’ve gotten not only excellent but incredibly responsive care at the VA,” he says. “One of the great things about it is if I have a question, I can email my primary care provider and get a response within hours. If I need one, they make an appointment for me.”

Several weeks ago, Carruthers noticed a bluish-purple mole on his neck and wrote his physician. The doctor responded immediately with a referral to a dermatologist, who quickly booked an appointment with Carruthers. “This would never happen in the private sector, at least not in rural America. I would have had to wait months to see a dermatologist in my area of the country.” 

Like so many other veterans, he values a health care system designed specifically to meet the needs of veterans. Carruthers serves as President of the Veterans Healthcare Policy Institute (VHPI), a think tank that focuses on stopping VA privatization. He’s also a steering committee member of the Veterans For Peace Save Our VA Campaign (SOVA), which has the same goal.

“At 81, my time on this planet is obviously limited,” he says. “But I’m dedicated to making sure veterans, especially younger vets, receive the same kind of excellent care I’ve received at the VA.”

Over the past decade, a right-wing attack on the VHA has jeopardized the continued availability of this kind of care. Today, efforts to privatize the VA now threaten the very existence of the nation’s largest health care system. (Read my previous coverage on this issue for Barn Raiser here and here.)

In this first article of a multi-part series with Barn Raiser, I want to explain just what the VHA is and what it does, not only for rural veterans but all Americans. Subsequent articles will then describe the forces who have launched this assault against the VA, how veterans and rural Americans are organizing to protect the VA, and what you can do to protect this one-of-a-kind system.

The VHA is in fact, become the nation’s only socialized medicine system—albeit one that serves a small slice of the American population. Like the United Kingdom or Scandinavian health care systems, the government owns and operates all VA health care facilities, and all VA employees are on salary. VA physicians are not paid on a fee-for-service basis but are salaried and thus have no incentive to overtreat patients because they benefit financially from delivering unnecessary treatments or procedures. For example, studies have shown that the VA is the only health care system that follows standard of care for patients with low-risk prostate cancer, which is watchful waiting. Outside of VA, men with low-risk prostate cancer are far more likely to receive unnecessary surgery or invasive radiation treatment.

Although the VA is not a classic single-payer system, it is a national health system that both pays for and provides care, which makes it far easier to innovate within the system. VA innovations are legion, including medication barcoding, the integration of mental health and primary care, and widespread use of geriatric care for VA’s many older patients. As health care reform advocates search for models of high quality, accessible and affordable health care, they don’t have to look to Canada or the U.K. or other European countries, they can find it in every state in the nation.

The nation’s only genuine health care system

Since 1811, when Congress directed the Navy to establish the Naval Home in Philadelphia, the United States has offered former service members health care services to deal with their military related injuries.

A month before the Civil War ended, on March 3, 1865, President Abraham Lincoln helped lay the foundation of what would become the Veteran’s Administration when he signed a law creating the National Asylum for Disabled Volunteer Soldiers to serve Union veterans. A day later, in his second Inaugural address, Lincoln famously pledged this care as both a literal and metaphorical means of healing the nation:

With malice toward none, with charity for all, with firmness in the right as God gives us to see the right, let us strive on to finish the work we are in, to bind up the nation’s wounds, to care for him who shall have borne the battle and for his widow and his orphan, to do all which may achieve and cherish a just and lasting peace among ourselves and with all nations.

By World War I, a variety of government agencies managed veterans’ health care and benefits. In 1930, President Herbert Hoover consolidated administration of veterans’ affairs into a single federal agency, the Veterans Administration. In 1988, President Ronald Reagan made that agency a cabinet level department, renaming it the Department of Veterans Affairs—still referred to as the VA. The Department includes the Veterans Health Administration (VHA) and Veterans Benefits Administration (VBA), which run the nation’s largest health care and benefits systems.

In 1994, the VA, still reeling from its failures to adequately care for veterans who suffered during the Vietnam War (as revealed in Ron Kovic’s 1976 memoir Born on the Fourth of July, later adapted as a movie in 1989 starring Tom Cruise) got a top to bottom makeover under the leadership of its new Under Secretary for Health Kenneth W. Kizer. Kizer, in what is known as the “Kizer revolution,” transformed a system that largely delivered hospital care of variable quality into the nation’s only comprehensive, fully integrated health care system.

While many largely market driven, increasingly corporate owned hospitals and clinics call themselves “health care systems,” they largely deliver fragmented medical treatment based on a fee-for-service, pay-as-you-go system. These “health care systems” are notorious for skimping on mental health care, and almost totally ignore social determinants of health like lack of housing, employment, occupational health and safety issues or legal problems. The VHA addresses all of these issues and more.

One common misconception about the VA is that anyone who has served in the military can access its health care system and benefits. That’s not true. Eligibility depends on a service member’s discharge status, their income, or their time in a combat zone, in our post-9/11 conflicts or whether they have a proven service-connected disability. More than half of America’s 17 million veterans probably qualify for VA health care; however, the system currently serves only nine million. An estimated 2.7 million, or about one third, of enrolled veterans live in rural areas.

The VA not only provides these veterans with a wide range of medical services—everything from primary care, to surgery, to geriatric care—it also has extensive mental and behavioral health programs. Major VA medical centers almost always include a full-service nursing home and residential rehabilitation treatment programs. The VA also has Blind Rehabilitation, Spinal Cord Injury and Polytrauma Treatment programs for veterans with serious vision loss, spinal cord injuries or who have suffered multiple traumatic injuries. The VA also addresses veteran homelessness, and employment and legal problems.

In 2014, the American Journal of Public Health lauded the VHA for its serious commitment, and action to achieve, health care equity, which it defines as providing timely, high quality, personalized, safe and effective health care regardless of geography, gender, race, age, culture or sexual orientation. This commitment to equity has supported rural veterans in particular, with the VA targeting programs and research initiatives focused on solving rural health disparities.

When it comes to serving rural veterans, who comprise about 25% of the total veteran population, the VA has made a serious and sustained commitment to meet their needs. VA has established almost 788 Community Based Outpatient Clinics (CBOCs) throughout the country, which means that most are within driving distance of a VA facility. Although some veterans who live in remote rural areas have to drive farther, most rural veterans are within a 44.5 mile range of a VA clinic. 

Veterans benefit not only from a network of rural VHA clinics but also from well-established pathways to VHA facilities in metropolitan areas where they can receive more specialized care. In the cases of truly long travel, the VA often helps defray transportation and lodging costs and ensures coordination of care once veterans return to their local communities. A system of Fisher Houses also provides lodging for family members of veterans getting longer term treatment. In 2006, Congress also mandated that VHA create an an Office of Rural Health to study the needs and obstacles to access of rural veterans. The ORH also has developed regional Veterans Rural Health Resource Centers to delve more deeply into how to address the health care challenges of rural veterans.

VHA’s other missions include teaching, research and emergency preparedness. The VHA’s more than 12,000 hospitals and clinics are a key training ground for many of the nation’s future doctors, nurses and other clinicians. More than 1,800, or nearly 90%, of educational institutions partner with the VHA in this $900 million-a-year program. More than 70% of the nation’s physicians have received training in the VHA.

The VA also trains many other kinds of health care professionals. It’s the single largest employer of psychologists in the United States. According to the American Psychological Association (APA), “one in five doctoral interns in psychology is training at the VA. VA also hosts more than 50 percent of APA-accredited postdoctoral training programs in psychology.”  In 2022, the American Association of Medical Colleges told Congress that the VHA played a role in medical education, training and research that is “irreplaceable.”

The VHA is also the nation’s largest research institution. Only the National Institutes of Health funds more research than the VHA. The VHA developed barcoding for medication administration, the first implantable cardiac pacemaker, the nicotine patch and the first Shingles vaccine. It has assembled the largest collection of brain tissue in the world in its Biorepository Brain Bank, established the connection between concussions in football and later development of Chronic Traumatic Encephalopathy, and its Million Veteran Program has assembled the largest genomic data bank in the world, allowing more than 600 researchers across VHA’s 80-plus projects to better understand and treat anxiety, heart disease, kidney disease, cancer, Parkinson’s Disease and other ailments.

The VHA is also mandated to address veteran homelessness. Its pioneering homeless programs, which include prevention services (Supportive Services for Veteran Families), outreach services (Health Care for Homeless Veterans and the National Call Center for Homeless Veterans), temporary housing and permanent housing services (Supportive Services for Veteran Families), have helped significantly reduce veteran homelessness as well as create models that have been emulated across the country to reduce a growing national epidemic. According to data from the Department of Housing and Urban Development, veteran homelessness hit a record low in January 2024 since measurement began in 2009.

Finally, the VHA serves as backup to the civilian health care system in times of war, terrorist attacks, natural disasters and other emergencies—from pandemics and mass shootings to hurricanes, tornados and wildfires. The VHA’s medical center in Puerto Rico, for instance, was the only functioning hospital on the island during and after Hurricane Maria. And it was open to non-veterans. At the height of the Covid-19 pandemic, VHA facilities cared for non-veteran patients in hot spots like New York, New Jersey and Louisiana. The VHA also has a memorandum of understanding with the Department of Defense to serve as a backup in times of war or terrorist attack.

Study after study has confirmed that the care VHA delivers to veterans not only equal to but very often superior to the care delivered by the private sector. Surveys of veterans also document that veterans highly approve of their dedicated health care system and want to see it improved and even expanded.

Unfortunately, neither the messages veterans are sending or those published in prestigious scientific journals have convinced Republican—and even too many Democratic—lawmakers to fully fund and staff the VHA. Over the past decade, a powerful movement funded by billionaire industrialists like the Koch Brothers and other dark money allies like Elon Musk—supported by the hospital, medical equipment and pharmaceutical industries—have launched a movement to privatize the VHA and even attack the benefits administered by the VBA.

Should this movement succeed, it will create serious problems not only for veterans but for all Americans. As I will explain in the next article, it will exacerbate an already catastrophic shortage of health care in rural America.

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