Last Thursday, the Rhode Island state senate’s Health and Human Services Committee unanimously approved Governor Gina Raimondo’s nominee for health insurance commissioner: former insurance executive and Medicaid slasher Patrick Tigue. The full senate plans to vote on Friday. If the senators confirm him as expected, they will once again demonstrate their servility toward corporate interests and indifference to the suffering of working Rhode Islanders.

Physicians for a National Health Program wrote an exhaustive account of Tigue’s misdeeds. It is bad enough that Tigue is being appointed to regulate his own industry. (He was director of operations for commercial product development at Neighborhood Health Plan, and says he is an “accomplished executive” with a track record of “driving value [i.e., profit] in the health care system.”) Yet Tigue also had a stint as Rhode Island’s Medicaid director, during which time he oversaw cruel budget cuts and aggressively sought to purge working-class Rhode Islanders from the Medicaid rolls. Meanwhile, he was less eager to audit the private companies managing Medicaid. Under Tigue’s watch, the state signed contracts with “managed care organizations” that had already overcharged Rhode Island by more than $200 million in 2015.

We are lucky that the 2021 state budget does not cut Medicaid any further. No thanks are due to Governor Raimondo, who expected a “brutal” budget with “everything on the table,” and who for several months reduced funding to cities and towns without legislative approval. The General Assembly’s decision to reject austerity was at least in part due to pressure from grassroots organizations and a newly elected slate of progressive politicians, including Providence DSA members Senator Sam Bell and Representative-elect David Morales.

While the sitting legislators should be commended for preventing the most inhumane outcome, their willingness to rubber-stamp a terrible candidate like Tigue shows that they can’t be trusted to safeguard Rhode Islanders’ right to healthcare, even during a pandemic. Many nominal progressives in the General Assembly fear retaliation if they refuse to vote for establishment leaders and their appointees. They may be denied seats on committees or even receive petty punishments such as being assigned a windowless office. Nonprofits are likewise afraid to speak out lest they jeopardize their relationships with important state officials.

The only hope for preventing appointments like Tigue is a politically engaged public that holds politicians to account. The working class – the majority of Rhode Island – is being cheated and killed by a predatory for-profit healthcare system, yet working people have little role in shaping the decisions of government officials. Until ordinary Rhode Islanders have better avenues to participate in democracy and strong organizations to represent them, progress will stop at the doors of the State House.

Let the politicians know that you’re watching. Before Tigue’s confirmation, call your senator and tell them to vote “NO.” You can also send a quick letter using this link.