Medicare for All, a popular campaign item touted by 2020 Democratic presidential candidates and now a bill in Congress, may struggle to gain traction in the House, as Democratic lawmakers appear more eager to make repairs to the struggling Obamacare law.
A group of Democrats last week introduced the Medicare for All Act of 2019, which would replace all private health insurance with a government-run system available to everyone.
“We mean a complete transformation of our healthcare system,” said lead sponsor Rep. Pramila Jayapal, D-Wash. “We mean a system where there are no private insurance companies to provide these core comprehensive benefits that will be covered through the government.”
The measure has 106 cosponsors so far, which is less than half of the House Democratic caucus.
Medicare for All has generated enthusiasm among progressive lawmakers and presidential candidates. Sen. Bernie Sanders, I-Vt., who has announced he will run for president again in 2020, has authored his own Medicare for All plan. Sens. Kamala Harris, D-Calif., Elizabeth Warren, D-Mass., and Cory Booker, D-N.J., who are also running for president, have signed on to the Sanders bill.
But many Democratic lawmakers, particularly those from swing and centrist districts, say they are wary of pushing for a complete overhaul of the healthcare system and are more eager to try to reform the Affordable Care Act, which was partially dismantled by the GOP and is struggling to keep down costs and enroll participants.
“If you eliminate private insurance, what does that mean?” Rep. John Yarmuth, D-Ky., the House Budget Committee chairman, said in an interview. “All of those things have budgetary implications. It would be wonderful but what does it cost and what does it mean in other areas?”
Speaker Nancy Pelosi, D-Calif., the lead architect of Obamacare and a staunch defender of the law, last week appeared skeptical of converting the nation’s healthcare system to a single-payer program like the one Jayapal proposes.
One problem, Pelosi said in a Feb. 27 Rolling Stone interview, is the high cost of a single-payer plan, which is projected to top $30 trillion over a decade. Pelosi also explained that the current Medicare program is not all-inclusive. Jayapal’s proposal would provide far more robust coverage and benefits.
“People have to understand this,” Pelosi said in the interview. “Medicare for All is not as good a benefit as the Affordable Care Act. It doesn’t have catastrophic [coverage], you have to go buy it. It doesn’t have dental. It’s not as good as the plans that you can buy under the Affordable Care Act. So I say to them, come in with your ideas, but understand that we’re either gonna have to improve Medicare, for all, including seniors, or else people are not gonna get what they think they’re gonna get. And by the way, how’s it gonna be paid for?”
Jayapal hasn’t come up with a proposal to cover the tremendous cost of single-payer healthcare in America. She told reporters last week those details would come later. Public hearings on the subject will be critical, she said. “I want people to understand what the cost of the healthcare system is right now,” Jayapal said.
She pointed to an estimate that 70 million people remain uninsured, and healthcare costs eat up 18 percent of the nation’s GDP while premiums are rising dramatically.
Jayapal faces opposition from about half of the Democratic caucus, which has a different plan than pushing for a single-payer system. The New Democratic Coalition, which touts itself as a centrist group made up of more than 100 Democrats, announced it will urge leaders to focus on improving and expanding Obamacare, not ditching it for a single-payer program.
The Democratic primary could give Jayapal’s proposal a boost, however, if it wins support from primary voters who gravitate to a candidate who backs a single-payer proposal.
Polls show strong support among Democratic voters and overall support among all voters, but the numbers plummet when respondents are told higher taxes are needed to pay for it.
Jayapal said public sentiment in the months ahead will determine whether her plan gets a vote this session of Congress. “It depends on how strong the movement is,” Jayapal said. “If I had to guess, I would say yes.”
