The Biggest Obstacle to Medicare for All Is Other Democrats

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Democratic Rep. Pramila Jayapal unveiled her Medicare for All bill in the House today which, according to her office, comes with more than 100 co-sponsors. The bill would overhaul the broken U.S. healthcare system and guarantee coverage of something that every other developed nation has to all Americans within two years. But before she even introduced the bill, the Hill had a piece out centered around the Democrats who are “worried” about single-payer.


The story starts off with an unnamed centrist lobbing a bomb at the left:

“We’ve got extremists who want to shoot the moon. Some policies would be wonderful, but you’re not going to get them out of the Senate and you’re not going to get them out of the White House,” said one House Democrat who represents a district won by Trump in 2016 and who wants the new Congress to tackle drug pricing first.

“Extremists”! Whatever happened to party unity, huh?

I could go on about how the true intent of the bill is to put down a marker of what the ostensibly center-left party in this country should fight for in 2020 and beyond, but at this point, that has to be obvious. Painting Jayapal’s effort instead as a real effort to get something through the Senate and the White House in this session is pure disingenuousness.

The unnamed Democrat continued:

“It’s messaging versus action. I think we should go for action,” the lawmaker said. “And if we’re going to win as Democrats next time around, we better show that we can govern too. If we are just going to obstruct for the sake of it, that’s not going to help us keep the majority and certainly not going to win us the White House.”


One thing is for sure: obstruction certainly didn’t help Republicans keep a House majority for eight years and then win the White House in 2016.

Other Democrats who spoke to the Hill, such as freshman Reps. Tom Mailinowski and Dean Phillips, said they prefer to work on something that could pass both the House and the GOP-led Senate, and get signed into law by President Donald Trump. “My preference is a simple one,” Phillips told the Hill, “which is to work with our Republican friends across the aisle to identify shared desired outcomes and then work our way backward.”


This approach essentially ignores the past decade of healthcare discourse in the United States, and the many, many Republican attempts—by both moderates and conservatives—to repeal the Affordable Care Act. There are no “modest improvements” to the ACA, such as the public option or a bill that would actually stabilize the marketplace, which will pass a GOP Senate and get signed into law by Donald Trump. The Republican Party wants the Affordable Care Act gone; why would they help fix it?

The one issue where collaboration with Republicans might work is lowering the cost of prescription drugs. But the support of left-wing Democrats for lower drug costs has never been in question; Jayapal herself introduced a bill to do exactly that in early 2017. You can advocate for short-term gains (where you can actually get them) and articulate a long-term vision at the same time.


There were some unexpected positives, such as the support of Rep. Ann Kirkpatrick—a New Democrat in her second stint in the House—which reportedly came after she talked to her daughter, a physician. “I called her and asked, ‘Where are you on Medicare for all?’ And she said, ‘Absolutely, I support it,’ ” Kirkpatrick told the Hill. “She said everybody should be on Medicare, most of her patients are Medicare patients, it’s a good system, people like it, it works, and she gets a timely reimbursement.”

With luck, more Democrats like Kirkpatrick will continue to come around as it becomes more and more obvious that Americans prefer a healthcare system with guaranteed coverage to one with “choice” which results in GoFundMe pages where people beg for donations in order to pay for insulin. But depressingly, the outlook of her fellow Democrats on single-payer is more proof that on top of batting the healthcare industry and the full force of the Republican Party on Medicare for All, lefty Democrats are going to have to fight colleagues in their own party tooth and nail in order to get a healthcare system that works for everyone.