According to the Washington Post, House Speaker Nancy Pelosi is still unsure about the universal single-payer healthcare plan known colloquially as Medicare for All.
“I’m agnostic. Show me how you think you can get there,” Pelosi told the Post. “We all share the value of health care for all Americans—quality, affordable health care for all Americans. What is the path to that? I think it’s the Affordable Care Act, and if that leads to Medicare for All, that may be the path.”
Medicare for All, once a far-fetched fantasy proposed in the Senate by Sen. Bernie Sanders, has now become a litmus test for progressive 2020 candidates. In the House, 100 legislators have signed on to a single-payer proposal, while Sanders’ version is still building support in the Senate.
But Pelosi, who was instrumental in passing the Affordable Care Act during the Obama administration, still has doubts.
“When most people say they’re for Medicare-for-all, I think they mean health care for all. Let’s see what that means. A lot of people love having their employer-based insurance and the Affordable Care Act gave them better benefits,” Pelosi told the Post.
This, to us, sounds false. Most people, we believe, when they say “Medicare for All,” mean free at the point of service healthcare paid for by the government (the “single-payer”) through taxes. And though many Americans who have employer-based insurance may be grateful to have any kind of healthcare, we’ve never once heard someone say they love it. Many Americans with employer-provided healthcare have extremely high deductibles, and still end up in dire straits when they’re hit with medical expenses.
Some of Pelosi’s concerns are legitimate. Among the 2020 contenders, what it means to implement Medicare for All is up for debate. Beto O’Rourke has proposed something called “Medicare for America,” which would allow many more people to enroll in Medicare, without extending it to all Americans, and while maintaining employer-sponsored coverage. Kamala Harris, meanwhile, briefly aligned herself with a Sanders-style plan that would eliminate private health insurance, before quickly walking it back.
Another point brought up by Pelosi that is worth discussing is how Medicare would need to be changed in order to work for everyone. Clearly, as Medicare is currently geared towards certain populations, it would need to be adapted to accommodate all Americans.
“Medicare is not as good a health benefit as the Affordable Care Act,” Pelosi said. “So, if you are to do Medicare-for-all you have to improve the package—and when you improve the package, you have to have more money.”
Progressive Rep. Ro Khanna told the Post he doesn’t feel Pelosi is against the plan, but rather asking reasonable, important questions. Pelosi is “absolutely right” that Medicare as it is will need to be improved, Khanna said. He added that he saw her comments as a “challenge.”
“I believe we will meet the high bar that Nancy Pelosi has set,” Khanna told the Post. “We can make the case.”
But there’s been reporting that her team is deeply skeptical of Medicare for All. Earlier this week, it was reported that Pelosi’s top healthcare aide, Wendell Primus, “dismissed Medicare for All during the private session as an unhelpful distraction.” He was accused of digging for any research he could find that would prove the plan couldn’t work.
“Wendell is not a member of Congress; Wendell is probably the most progressive staff person on Capitol Hill,” Pelosi told the Post. She added that Primus left the Clinton administration “because they passed the so-called welfare reform bill, which I voted against.”