Democrats Plot a Smart Course Towards Universal Health Coverage

By now you might have seen some of the stories about Senate Democrats signing up to support the single-payer plan that Bernie Sanders will unveil today. As of yesterday afternoon, Sanders’s bill has garnered 11 public cosponsors:

In addition to Warren, Gillibrand, Booker, Harris, Merkley, and Whitehouse, Sens. Brian Schatz (D-HI), Mazie Hirono (D-HI), Ed Markey (D-MA), Tammy Baldwin (D-WI), and Richard Blumenthal (D-CT) have all announced their intention to co-sponsor the bill.

If you’re a regular reader here, one name on that list might stand out to you—Sen. Brian Schatz. That’s because he plans to author a bill that has been called “Medicaid for More.” It is also very likely that Sen. Chris Murphy, who is planning to introduce a bill to allow Medicare buy-in, will sign on as a co-sponsor as well. Both of them have discussed their proposals with Sen. Sanders.

Sen. Tammy Baldwin announced her support for Sanders’s bill in the Milwaukee Journal Sentinel. Take a look at what she wrote:

I always have believed that our goal must be universal health care coverage for everyone, and my support for Sen. Bernie Sanders’ Medicare for All legislation being introduced this week is a statement of that belief…

This reform will help us achieve universal coverage for everyone and is one of many paths we can take to expand coverage and lower health care costs.  Last month, I helped introduce the Medicare at 55 Act, which would provide an option for people between the ages of 55 and 64 to buy into Medicare. I am working with Sen. Brian Schatz (D-Hawaii) to soon introduce legislation to allow states to offer people a choice to buy into the Medicaid program. This would grant more Wisconsinites the opportunity to enroll in our popular BadgerCare program.  And Sen. Chris Murphy (D-Conn.) is working on a reform that would provide all Americans, individuals and companies with a public option to purchase Medicare.

What all of these proposals have in common is a commitment to the belief that every American deserves affordable health coverage.

I wouldn’t be surprised if a lot of the Senators who have announced support for Sanders’s bill will join Baldwin in also supporting the plans being proposed by Schatz and Murphy. Because those bills won’t be as large in scope or authored by a former presidential candidate, we’re not as likely to hear about that. But the sentiments involved have also been addressed by House Democrats who have co-sponsored Rep. Conyers’s single-payer bill.

House Democrats behind the bill say that despite co-signing it, they wouldn’t really want to immediately throw hundreds of millions of people off their insurance. HR 676 co-sponsor Rep. Ruben Gallego (AZ), for instance, told me that he favors slowly dropping the Medicare eligibility rate every few years — first from 65 to 55, then from 55 to 45, and all the way down until everyone qualifies. Rep. Peter Welch (VT), another co-sponsor, said doing so “will take time and we’ll have to be careful about how we do it.” A third, Rep. Raúl Grijalva (AZ), said much of the same thing.

“It’s something you’d have to phase in: You don’t have to do everything at once,” Gallego said in an interview. “There’s no rush to do it overnight.”

Here is what Minority Leader Pelosi had to say today:

“I don’t think [single payer] is a litmus test,” Pelosi said in an interview. “What we want is to have as many people as possible, everybody, covered, and I think that’s something that we all embrace.”

Pelosi said that she would like a variety of health-care ideas to be vetted and analyzed by budget scorekeepers but that she thinks none of them will succeed while the ACA is under attack from Republicans.

“Right now I’m protecting the Affordable Care Act,” Pelosi said. “None of these things, whether it’s Bernie’s or others, can really prevail unless we protect the Affordable Care Act.”

Sanders supporters and those who have advocated for single-payer should take heart: more and more Democrats are embracing the end-goal of some kind of single-payer system. But those who worry that a move too quickly in that direction could cause significant backlash against further health care reforms should also take heart: even the most liberal Democrats in Congress seem to recognize that, and are preparing to have a discussion on what the next steps should be.

Nancy LeTourneau

Nancy LeTourneau is a contributing writer for the Washington Monthly.