Congressional Democrats aren’t just fighting to save the Affordable Care Act from Republicans hell bent on repealing it. They’re laying the groundwork to one-up President Obama’s signature law with a system in which the federal government covers health-care costs, regardless of income, job status, or health status.
That system would be single-payer health care, or “Medicare for All.” It’s all the rage among Democrats on Capitol Hill—and increasingly, among people across the United States.
A full 33 percent of people, regardless of party affiliation, support a “single national government program,” according to a June poll from the nonpartisan Pew Research Center. By party breakdown, 12 percent of Republicans and Republican-leaning independents support such a system, while 8 percent of conservatives, and 20 percent of moderate-to-liberal Republicans, along with 52 percent of Democrats and Democratic-leaning independents, 42 percent of conservative-to-moderate Democrats, and 64 percent of liberal Democrats, back single payer.
Support for the system appears to grow according to how it’s framed. Nonpartisan Kaiser Family Foundation polling from early in the 2016 presidential election season found that even “among Democrats, the term ‘Medicare-for-all’ generates a much more enthusiastic reaction than does ‘single-payer.’ With this discussion still mostly at the stage of broad concepts and messaging, language matters.”
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Whatever you call it, government-funded health care isn’t a new concept. But it’s gained traction as the U.S. public contends with steep coverage losses under GOP health-care alternatives and an administration that may not believe health care is a human right.
Rep. John Conyers (D-MI) introduced the Expanded & Improved Medicare for All Act (HR 676) in the U.S. House of Representatives just days after President Trump took office in January. Conyers’ bill counts the support of 113 Democrats—more than half of the 193 Democrats serving in the chamber.
Conyers has introduced “Medicare for All” bills since 2003, he told Rewire via email. But reports about the tens of millions who would lose insurance under the GOP’s “sadistic” Obamacare repeal efforts have “generated unprecedented interest in and momentum behind this movement.”
“We’ve made a lot of progress under Obamacare, but our goal is universal insurance and we’ve still got a long way to go,” Conyers said. “The only way we’ll get there is with a program that takes the profit motive out of health care and treats it as the essential, human right it is by covering everyone.”
Across the Capitol, former Democratic presidential candidate Sen. Bernie Sanders (I-VT) plans to introduce a version of Medicare for All in the U.S. Senate after the July 4 recess, spokesperson Josh Miller-Lewis told Rewire.
“It will look somewhat similar to the House bill, but I think be a bit more comprehensive,” Miller-Lewis said in a phone interview. The Senate version will include “more details about how to implement a single-payer system in the United States.”
Conyers said “we’ve got a bill that covers the key points. A progressive funding plan, delivery of care, and reducing costs.”
“The Sanders bill may differ a little on the details, but they’ve got far more commonalities than differences,” Conyers said. “The key is that they both expand Medicare to make every single American eligible.”
White House Press Secretary Sean Spicer recently dared Sanders and congressional Democrats to advance single-payer health care.
But the bravado may backfire on Spicer and the White House.
“There is an increasing understanding that this is not just the best way of getting people health care and the most cost-effective for families, it’s also what’s going to make us competitive,” Rep. Ro Khanna (D-CA) told Rewire in a phone interview.
Khanna said entrepreneurs and business leaders in Silicon Valley, which he represents, say that health-care costs, not higher wages, are the “biggest barrier” to economic competitiveness.
“If they are liberated from that, that’s going to create jobs, it’s going to create more startups, it’s going to help us compete and create jobs here at home,” he said.
“It is smart economic policy, and I think more and more people are figuring that out,” he continued. “This argument that it’s socialism is ridiculous.”
Vox’s Ezra Klein in June wrote that Senate Majority Leader Mitch McConnell (R-KY) “may prove the best friend ‘Medicare for all’ ever had.” Only 20 percent of voters are more likely to vote for a member of Congress who supports the U.S. House’s Obamacare repeal and replacement efforts, according to a May Quinnipiac University poll. Meanwhile, the repeal efforts are pushing Democrats to the left on health care.
“Obamacare was the test of the incrementalist theory, and, politically, at least, it’s failed,” Klein wrote. “Democrats built a law to appeal to moderate Republicans that incorporated key ideas from Mitt Romney’s Massachusetts reforms, and it nevertheless became the single most polarizing initiative of Obama’s presidency.”
Sen. Elizabeth Warren (D-MA) recently echoed that sentiment.
“President Obama tried to move us forward with health-care coverage by using a conservative model that came from one of the conservative think tanks that had been advanced by a Republican governor in Massachusetts,” she told the Wall Street Journal in a June interview. “Now it’s time for the next step. And the next step is single payer.”
As early as March, Warren offered an unequivocal “yes” to a constituent who asked her about whether Democrats should fight for a public option or single payer. But HuffPost characterized Warren’s remarks as “a shift to her position on the U.S. health care system.” That same month, Huffpost reported, she hinged her support for a single-payer system “on whether Democrats could find Republican lawmakers willing to help fix the Affordable Care Act passed under Obama.”
Another high-profile Democrat, Sen. Kirsten Gillibrand (NY), backs Medicare for All.
Warren’s and Gillibrand’s offices did not respond to requests as to whether the lawmakers will co-sponsor Sanders’ bill. Some progressives on the Senate side have expressed reticence toward Obamacare alternatives as they fight to stop Republicans’ repeal efforts, HuffPost reported.
Miller-Lewis, Sanders’ spokesperson, expects to “have more support than we’ve had in the past in the Senate.” He would not specify who else might sign on to the bill.
House Democrats say they’re hearing calls from their constituents and the public to act.
“Support for Medicare for All and other plans continues to grow as families realize that their health care must be protected and that the U.S. lags behind on many key health indicators,” Rep. Robin Kelly (D-IL), chair of the Congressional Black Caucus Health Braintrust, said in an email.
“The American people know that health care is a human right.”
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