House Democrats avoided exposing their party’s divisions over healthcare on Tuesday during a hearing for the Medicare for All Act, a bill that would do away with private insurance and move everyone living in the U.S. onto a government plan.
Rep. Jim McGovern of Massachusetts, chairman of the House Rules Committee and co-sponsor of the Medicare for All Act, said at the conclusion of the hearing that he was pleased that “a serious topic was treated in a very serious manner” and that his colleagues were surprised the discussion had been “civilized and in-depth.”
House Speaker Nancy Pelosi, D-Calif., has been walking a delicate line within her caucus as 109 members support the Medicare for All Act and as it is backed by Democratic presidential candidates. Though she has questioned how such a plan would be paid for, she has also said that she’s willing to have the matter debated in public so that voters might view their options.
Still, such an approach carries political risk because Republicans are eager to cast the entire Democratic Party as willing to gut the current system in favor of what they call a “government takeover of healthcare.”
The Medicare for All Act long had the backing of Democratic presidential candidate Bernie Sanders, but the version discussed Tuesday comes from Rep. Pramila Jayapal, D-Wash., and Debbie Dingell, D-Mich. It is far more expansive than the current Medicare program, and would finance healthcare with taxes rather than premiums, copays, deductibles, and coverage that employers offer.
House Democratic leaders have ceded more ground to the “Medicare for all” movement over time. Republicans pointed out that holding the hearing on Tuesday showed that the proposal was not being taken seriously by leadership, as the crafting of healthcare policy would typically fall to the Energy and Commerce Committee and the Ways and Means Committee. By Tuesday afternoon, however, the Ways and Means Committee agreed that it would also hear the bill.
Much of the focus remained on the Medicare for All Act Tuesday as a group of Democrats postponed a call that had been scheduled on a competing bill known as Medicare for America that would make government plans optional, with the eventual goal of enrolling most people into the provision.
Democrats have tried to show they are unified on the idea of everyone in their party supporting “universal healthcare,” even if they disagree on the various paths to getting there. The most liberal members of the party, however, say that gradual shifts are insufficient to repair a deeply broken system.
The disagreements have played out behind the scenes and in the media. Complaints surfaced last week in the Huffington Post that those invited to testify Tuesday were not enthusiastic enough about the Medicare for All Act. Democrats have denied they were trying to present the plan in a lukewarm fashion, and it was later announced that Ady Barkan, a 35-year-old father and prominent healthcare activist with the fatal Lou Gehrig’s disease, would also appear at the hearing.
Barkan’s illness, which gradually paralyzes the body, prevented him from speaking, so he delivered an emotional testimony with the help of a machine, setting the tone of the debate.
“Some people argue that although ‘Medicare for all’ is a great idea, we need to move slowly to get there,” he said. “But I needed ‘Medicare for all’ yesterday. Millions of people need it today. The time to pass this law is now.”
Similar testimony came from Farzon Nahvi, an emergency department doctor in New York City supportive of government healthcare, who shared how his patients often forgo care because they fear they cannot afford it.
“I feel like I’m practicing with one hand tied behind my back,” Nahvi said. He said that often he wonders whether he has sentenced patients to loads in debt even when he is able to convince them to undergo the treatment they need.
It was difficult to assess from the line of questioning which Democrats co-sponsored the Medicare for All Act and which ones favored alterations to the current system. Instead, their clashes with Republicans were amplified.
As Republicans and conservative experts aimed to bring the conversation back to the price tag of a fully government-financed healthcare system, estimated at between $32 trillion and $38.8 trillion over a decade, those in favor of such a system instead aimed to frame the debate as one of morality and political will.
Democrats said that people would be able to see any healthcare provider they wanted under the new plan — an assertion the healthcare industry vehemently denies, given that they would receive lower reimbursement rates for their services under the bill than under the current system. That was the point conservatives aimed to hammer in committee.
Grace Marie Turner, president of the conservative Galen Institute that studies healthcare, said the bill would mean many hospitals “simply could not keep their doors open.” She warned that providers would have to ration their services even as the demand for healthcare increases.
“‘Medicare for all’ would require all Americans to pay more in taxes, wait longer for care, and receive potentially worse care,” said Rep. Tom Cole of Oklahoma, the top Republican on the committee.
