The Democratic Party is having a family feud over how to win back the White House. And no issue exemplifies the internal debate about whether to tack further left or move toward the middle better than healthcare and new Medicare for All proposals.
Some so-called Medicare for All measures floating around the Capitol nibble around the edges, like one popular version that merely extends the current federal health care system for the nation’s retirees down to 50 or 55-year-olds. But on Wednesday, a large block of progressives, led by Rep. Pramila Jayapal, from Washington, unveiled a Medicare for All bill that’s as simple as its name: It would eventually put all Americans — from infants all the way up to grandpas — under Medicare.
“Americans are literally dying because they can’t afford insulin or the cancer treatment they need,” Rep. Jayapal told a cheering crowd of more than 100 people outside the Capitol on Wednesday after unveiling the new Medicare for All proposal.
The bill has 107 Democratic sponsors, including 17 members of the freshman class. That’s down from the 124 co-sponsors of a similar version of the bill proposed last year, but Jayapal said the number of supporters will only grow in the coming days, weeks, and months.
“I am confident we will just continue to increase that number,” she said.
Progressive’s Medicare for All plan, however, doesn’t include a way to pay for its sweeping coverage, like free dental, vision, medical, and long-term care while also promising zero copays. That’s lead many more moderate Democrats to think of the legislation as more of catchphrase than a realistic proposal.
Democratic Sen. Joe Manchin, from West Virginia, for one, said lawmakers should work on making the current health system solvent instead of promising a new federal entitlement to all Americans.
“We can’t even pay for Medicare for some that we’re supposed to be paying for. It’s going to go broke, and they’re scared to death,” Manchin told VICE News in the basement of the Capitol.
Even House Speaker Nancy Pelosi has raised questions about the price tag. “Single-payer is just about who pays. It’s not about what the benefits are. That is, administratively, the simplest thing to do, but to convert to it? Thirty trillion dollars. Now, how do you pay for that?” she recently told Rolling Stone.
Other more moderate Democrats are also asking their progressive colleagues to show them the details of how they plan to pay for these proposals, especially because health care spending is already skyrocketing.
“If it means people have to pay a 20 percent copay like Medicare that’s not good, because most people on Medicaid — all people — pay zero. So I think we’ve got to figure it out first,” Democratic Rep. Kurt Schrader, from Oregon, told VICE News at the Capitol.
"We can’t even pay for Medicare for some that we’re supposed to be paying for. It’s going to go broke, and they’re scared to death."
Shrader’s a member of the more centrist New Democrat Coalition, a group of 101 lawmakers who on Wednesday sent party leaders a letter asking them to focus on shoring up so-called Obamacare, which would take GOP support in the Senate to accomplish. Working with Republicans in Trump’s Washington is anathema to many Democrats, but Schrader said that’s their aim.
“That’s exactly our focus. We’re trying to get something done, not making any big statement. Just trying to fix what’s out there,” he said.
But progressives brush aside the criticisms that single payer health care is unrealistic or too expensive.
“Somehow or another every major country on earth has managed to do it at significantly less cost than the United States of America,” Vermont Independent Sen. Bernie Sanders, one of a growing number of 2020 presidential candidates in Congress, told VICE News while walking next to the trams under the Capitol.
Sanders previously spearheaded Medicare for All plans in 2016 when he first ran for president. And he still believes the nation needs to flip its current free-market thinking around health care on its head.
“The drug companies and the insurance companies make billions of dollars in profit every single year, and they pay their CEO’s exurbanite compensation packages, and they will fight,” he said. “They will spend unlimited sums of money to make sure we continue a dysfunctional, expensive system, but at the end of the day, we will win this fight.”
The changing tide
President Donald Trump has already derisively labeled the Democrats pushing proposals like Medicare for All, or even the Green New Deal, as radical socialists. That rhetoric worked for the GOP back in 2010 when the term helped whip up tea party fervor the GOP effectively used to wrest control of Congress from Democrats under former President Barack Obama.
In 2016, many in the Democratic Party seemed to try to do anything they could to avoid being labeled “socialists,” and party leaders at the Democratic National Committee helped tilt the primary to Hillary Clinton. But she lost the 2016 election, in part, by failing to appeal to working class voters in states like Pennsylvania, Wisconsin, and Michigan.
After that historic blunder, many prominent Democrats called for the party to move to the middle to appeal to Independents and blue collar workers. Now, some moderates, like Sen. Manchin, maintain the Democratic Party has already lost working class voters. He fears the hard pivot left from several in the party is only further alienating those crucial voters who have been the backbone of the party for decades.
“Hell, in West Virginia they left us anyway. The national Democratic Party doesn’t have a working person in West Virginia voting for them — that I know of, or not many. It’s a shame,” a visibly frustrated Manchin said. “They get them back by doing common sense things, not the crazy stuff they’re throwing out where everybody wants to go as far as they can to the left.”
But Democrats from those states say the tides have turned since Clinton’s shocking loss, partly because of the Trump administration and Republicans’ methodical attempts to undo the Affordable Care Act (ACA), whether through court challenges or repealing the individual health insurance mandate, the required tax penalty against people without health coverage.
That shift in thinking on the ACA, coupled with Democrats success in recapturing control of the House in November, has left supporters of the new Medicare for All proposal feeling like they now have a winning issue. But they know they still need to work on connecting the legislation to people’s current struggles by pointing to issues like soaring premiums, expensive deductibles, and high drug costs.
“I think we’ve got to talk about it correctly,” Democratic Rep. Debbie Dingell, from Michigan, told VICE News after the press conference rolling out the proposal. “They’re trying to label it, and we need to talk about what it means to working men and women.”
Other Democrats agree the party needs to unify its messaging on health care soon, otherwise Trump will be able to win that battle in crucial states on an issue that’s essential to all Americans. But they’re not too happy the party’s loudest — or at least most publicized — voices on the topic are those Democrats calling for the most revolutionary changes to America’s health care system.
Still, Democrats want to find common ground as a party on how to merge the desire for universal health coverage with calls for the federal government to pick up the tab for that pricey bill.
“I don’t want to be critical, but I think we can do a better job,” Democratic Sen. Jon Tester, from Montana, told VICE News at the Capitol. “We’ve got to have a plan, and I’m not sure we’ve got one right now.”
Cover image: Speaker of the House Nancy Pelosi, D-Calif., meets with reporters on Capitol Hill in Washington, Thursday, Feb. 28, 2019. (AP Photo/J. Scott Applewhite)