Although House Speaker Paul Ryan’s plan to strip health care from 24 million people came up short, Congress and the Trump administration are planning a series of actions and legislation that would do much of the same. The question is not whether they will cut and privatize health care, but how deeply they will drive the knife.

But a bigger and more inspiring story is developing in the states. From Maine to Hawaii, people are not only resisting Republican attacks on health care, but are laying the foundation for a profound transformation of the American health care system.

By redefining health care as a human right, grassroots campaigns are challenging the core logic of the private insurance industry: that health care is a commodity that should be available only to those who can afford it.

Though calls to replace private insurance with universal, publicly financed coverage are not new, this political moment offers a unique opportunity. As health care access is attacked, people are turning out to town halls in droves, demanding more public involvement in health care, not less.

Polls show that a large majority of people recognize that government has an obligation to make sure everyone can get care. Bernie Sanders’ call for Medicare for all helped make him one of the most popular politicians in the country. And the insurance and drug industries have approval ratings even lower than Donald Trump. The public is way ahead of both parties.

But the insurance industry and its allies hold powerful control over the Republicans and Democrats and have so far successfully blocked every attempt at universal health care since the days of Harry Truman. To win, we need a mass people’s movement. But with Washington under the control of free-market ideologues, our path to power runs through the states.

In just about every state in the country, there is an active and organized grassroots campaign for universal health care, and state campaigns have already achieved significant success. The Campaign for New York Health has twice passed a bill for universal health care through the state assembly. And the Healthy California campaign has just introduced a bill in Sacramento that has powerful backing from the coalition’s 150 member organizations and their 4 million members.

Some of the most remarkable organizing is being led by the members of the Vermont Workers’ Center, Put People First Pennsylvania, and Southern Maine Workers’ Center, whose Healthcare Is a Human Right campaigns focus on the leadership of poor and working class people who are directly impacted by the injustices of the health care system.

We now have the chance of a lifetime, but if we’re going to win universal health care and refocus our economy on meeting human needs, we can’t afford to be passive, and we certainly can’t follow the lead of the Democratic Party. It’s time to turn down the Washington rhetoric, tune into our friends and neighbors, and get to work.

Ben Palmquist is a campaign manager with the National Economic and Social Rights Initiative and helps coordinate the Healthcare Is a Human Right Collaborative. He wrote this for Progressive Media Project, a source of liberal commentary on domestic and international issues affiliated with The Progressive magazine. Send email to pmproj@progressive.org.