Twenty-six House Democrats who signed on to a previous version of the Medicare for All Act have dropped off from the latest bill released Wednesday, as leaders are steering members to focus on shoring up Obamacare instead.
Democrats picked up 40 House seats in November, but the number of lawmakers backing the Medicare for All Act so far has fallen to 107. That is fewer than the 124 co-sponsors the Medicare for All Act finished with in the 115th Congress.
Three who have fallen off are high-ranking: Rep. Jim Clyburn, D-S.C., the House Majority Whip; Rep. Anna Eshoo, D-Calif., chairwoman of the Energy and Commerce’s Health Subcommittee; and Rep. John Yarmuth, D-Ky., chairman of the House Budget Committee.
The split shows an ideological tension in the Democratic Party between those seeking to set an ambitious agenda that lays the groundwork for a liberal candidate to topple President Trump in 2020, and another faction that wants to rack up pragmatic victories for constituents. It’s possible, as well, that individual lawmakers have backed off the idea of a fully government-financed healthcare system in favor of keeping private insurers in the game.
[Related: Medicare for All may struggle to gain traction]
In interviews, Democrats insisted they were on the same page on pursuing universal healthcare, saying the priority should be to shore up Obamacare. They vowed that, after working to protect Obamacare, then they would consider other options that would boost insurance rates and reduce the cost of coverage. They are not unilaterally committed to the government becoming the only payer for healthcare.
“We are not going to enact ‘Medicare for All,'” Yarmuth said, alluding to the political realities of facing a GOP-controlled Senate and White House. “We’ll have a pretty good extensive debate on the variables in doing an expanded Medicare solution, and we are going to start that process in the Budget Committee.”
Yarmuth has asked the Congressional Budget Office to write a report about the different issues the committee will need to consider in crafting a government-financed healthcare system. But the Budget Committee is looking at other bills that would expand Medicare, including legislation letting people buy into Medicare at a younger age.
“I though it would be best for me to either not co-sponsor any of them or co-sponsor all of them,” Yarmuth said of the Medicare options on the table. “We have at least four different approaches introduced by members of the Budget Committee.”
Eshoo, similarly, said that she is seeking to remain neutral toward the proposals in her role as the Health Subcommittee chairwoman, which she said was commonplace.
“I want everyone that comes before the committee, anyone that has introduced a bill … some manifestation of universal healthcare, that they get a fair shake,” she said.
Meanwhile, the chairman of the Energy and Commerce Committee, Rep. Frank Pallone, D-N.J., who hasn’t backed either version of the Medicare for All Act, has said that he wants to work first on fixing Obamacare.
That’s the approach the healthcare industry is pushing for, and another large portion of the caucus wants to do the same. At least 101 House Democrats came out on Wednesday, just hours after the Medicare for All Act was introduced by Rep. Pramila Jayapal, D-Calif., to push for what they billed as a more realistic goal of pouring billions of dollars into Obamacare to help lower premiums. Some of them were even co-sponsors of the Medicare for All Act.
There are various reasons the number of Medicare for All Act backers have dropped. Eleven of the former supporters are no longer in Congress, but several were replaced by representatives who ended up co-sponsoring the latest version. Members who replaced Democratic Reps. Jim Crowley of New York, Jared Polis of Colorado, and Michael Capuano of Massachusetts — meaning Reps. Alexandria Ocasio-Cortez, Joe Neguse, and Ayanna Pressley, respectively — have co-sponsored the bill. So far, at least 15 freshmen have signed on.
Sifting through the changing support for the legislation presents a few complications. For instance, Rep. John Conyers, D-Mich., was the original sponsor of the last version, but retired following sexual harassment allegations. Rep. Brenda Jones took his place for five weeks and became a co-sponsor, but lost the election. Both are counted among the 124 supporters from the previous Congress. Now, the representative who unseated Jones, Rep. Rashida Tlaib, is a co-sponsor.
The latest version of the bill has more original co-sponsors than the former version, which had 51, and some members indicated they might again become co-sponsors later, such as Rep. Doris Matsui, D-Calif.
“I really want to shore up the Affordable Care Act first,” she said, using the formal name for Obamacare. “That’s my first priority.”
She also indicated she was open to expanding Medicare in other ways as a step after that.
“I must say this: I’m for universal healthcare,” she said. “There are many ways to get there … I’m looking for every step along the way.”
Rep. Debbie Dingell, D-Mich., co-chairwoman of the Medicare for All Caucus, said she is working on getting more co-sponsors. Even she indicated fixing Obamacare was the priority.
“What I want to do right now is get pre-existing conditions taken care of,” she said. “We have got to do something to lower drug prices right now. People are hurting. It’s not either or. You’ve gotta have a vision. I’ve got a vision and we have to fix stuff now. You do both.”
Undercutting the argument that Obamacare can be tackled first, however, is that Republicans don’t view it as an area of bipartisanship. The plan outlined by the centrist New Democrat Coalition on Wednesday is similar to an Obamacare stabilization package that failed last year in the Senate after Democrats objected to its anti-abortion language.
Democrats have been unable to say how they would work around that impasse in pursuing the policy again. Sen. Lamar Alexander, R-Tenn., chairman of the Health, Education, Labor, and Pensions Committee, said at an Atlantic event that he was moving on from Obamacare. Pallone, who heard the remarks, said he “hadn’t given up.” He went on to say Medicare for All would be too costly, but noted he has long supported a public option, which is a government plan people could buy into to compete against private insurance.
The latest version of the Medicare for All Act is more extensive than the last. It covers long-term care in addition to prescription drugs, hospital stays, and doctor visits, all without co-pays. The program, which is more generous than the current Medicare program, would be fully enacted within two years.
For Rep. Zoe Lofgren, D-Calif., who co-sponsored only the former version, it’s the timeline that’s the rub.
“I’m for ‘Medicare for All,'” she said. “But I think that bill is not the best way to achieve the goal. I think the two-year time frame is unrealistic.”
