You Fight for the Bill You Want 

On Wednesday, Senator Bernie Sanders, backed by 15 Democratic senators, released his long-awaited Medicare for All legislation, which seeks to establish a national healthcare system.

The benefits in the bill are generous and comprehensive, including no copays for things like mental healthcare and prescription drugs. And while there is no real plan to pay for it yet, as Jeff Stein noted over at Vox, Sanders’ bill basically aims to start from the premise of getting everyone covered and work backwards from there. This is the fight ahead for Democrats: figuring out what needs to change to make truly universal coverage—something that is already a reality in most similarly wealthy nations around the world—possible in the United States. And they will have plenty of time to do that, since Sanders’ bill doesn’t stand a chance in hell of passing this Congress.

The bill also does another important thing: it makes comprehensive reproductive healthcare part of a preventative care package and eliminates funding restrictions on “any reproductive health service.”

This is a built-in repeal of the Hyde Amendment, which bans the use of federal dollars to pay for abortion services except in limited cases, and would ensure truly comprehensive abortion coverage to every single person who needs it. It is the most ambitious and potentially transformative approach we’ve seen on this issue to date. It rules so hard, man.

This is the language that turned organizations that were previously skeptical of Sanders, like NARAL Pro-Choice America, into enthusiastic backers of the bill.

But it is also a clear response to—and rejection of—the argument that universal coverage would necessarily mean a deeper entrenchment of anti-abortion politics. During and after the Democratic primary, I saw this argument cropping up a lot in the ~ Twitter discourse ~ as a reason to be suspicious of the left wing of the party agitating for single payer. That was, and remains, a fatalistic analysis. Politicians move where they are pushed. Sanders’ Medicare for All bill is a product of a reproductive justice movement and a growing Democratic consensus rejecting Hyde. If that’s where the energy stays, then politicians will walk the line.

There are of course reasons to be concerned about compromises Democrats may make in the future—like they did with the Affordable Care Act, like they did with Medicaid—that would ditch reproductive healthcare in order to bring on anti-abortion Democrats. There is also the fact that Democrats, by and large, have been and continue to be remarkably bad at talking about abortion rights. It’s clear there is more work ahead.

But that’s what these next months and years are for: building the coalition necessary to fight for a bill that protects abortion rights and reproductive healthcare as the fundamental rights that they are. That may mean primary challenges for Democrats who would sabotage the bill over its provisions around abortion coverage, or it may mean politically disciplining them into walking the evolving party line. All options are on the table right now.

Medicare for All will not pass this Congress. It may not pass in the next or the next or the next or the next. But you put out the legislation for the outcome you want, and the coalition you want to build. That’s what this bill does, and that’s what this time is for. The clock for the Democrats starts now.