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The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

Medicare for All Advocates and Incremental Reform Supporters Setting Democratic Agenda for Health Care Reforms

Many midterm polls indicated that the strongest issue favoring Democrats was health care reform. But how ready for congressional approval are the various Democratic proposals? In her aritlcle, “On ‘Medicare-for-All,’ Democrats Tread Lightly: It polls well. But Dems say the proposal isn’t ready for floor action,” Mary Ellen McIntire explores the question at Roll Call.

“Progressives in the House are calling for a vote on a single-payer “Medicare-for-all” bill in the next Congress,” writes McIntire, “but the expected chairmen who will set the agenda for next year say they have other health priorities.” Further,

A handful of potential presidential candidates expected to declare interest have already co-sponsored “Medicare-for-all” legislation, an issue that was also a flashpoint in Democratic primaries over the past year.

Most Democrats say the proposal, which polls show enjoys significant public support, hasn’t been fully fleshed out and isn’t ready for floor consideration. The drawbacks, like a major tax increase, the type of changes that would be needed to the Medicare program and the reality that millions of Americans would lose their current coverage plan, could become politically dangerous, they say.

Rep. Pramila Jayapal, founder of the Medicare-for-All Caucus sees it a little differently:

“We should continue to try to shore up health care as we have it, but we really have to be pushing to a complete transformation of our health care system and not just trying to do little fixes here or there because we’re still leaving out too many Americans who are literally cutting their pharmaceuticals into half because they can’t afford it, or getting off of health care because it’s not a choice to pay another $300 a month,” she said.

The debate is important for securing the public image of the Democrats as the only party which is serious about health care reform, while their GOP adversaries are still floundering without a coherent response to popular reforms of the Affordable Care Act, such as protection for those with prior conditions.

However, “Until they do a better job of selling this thing, I don’t want to see this become a litmus issue for 2020,” argues Jim Manley, a Democratic operative who worked for former Senate Majority Leader Harry Reid. Texas Democratic Rep. Lloyd Doggett adds, “We’ve not fully explored cost, transition, the effect of on people who have — such as many union workers — strong policies now…There’s so many aspects of it, so I wouldn’t envision that there would be any early vote.”

Rep. Jayapal counters that “We have to change our notion of what wins in swing districts.” McIntire notes that “Progressive Change Campaign Committee co-founder Adam Green said lawmakers should vote on a “Medicare-for-all” bill next year even if it would fail…Let’s pass things that will pass the House but are almost certain to die in the Senate so there’s a bright north star the sky for 2020 voters signaling what Democrats would do if given more power.”

Meanwhile, other Democrats are already moving forward with both piecemeal and comprehensive proposals that poll well, McIntire explains:

In the Senate, Democrats have offered at least six bills ranging from a Medicare buy-in proposal from Sen. Debbie Stabenow of Michigan to a “Medicare-for-all” single-payer plan from independent Sen. Bernie Sanders. Several senators seen as likely presidential candidates have either offered their own plan or signed on to one or more proposals.

Take Sen. Cory Booker, who is expected to enter the primary fray. He has co-sponsored six bills that would expand on the health law. Sen. Kamala Harris has signed on to five, while Sen. Kirsten Gillibrand co-sponsored four of the measures.

So, it’s likely that both the ‘Medicare for all’ proponents and the advocates for more incremental reforms are going to push health reform legislation in the next congress, despite the likelihood that all such Democratic proposals will be blocked in the Senate. If the two camps work together, they can reinforce each other’s efforts — and strengthen the Democratic brand regarding the top concern of American voters.

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