Ellison’s House colleagues gave their unanimous consent for him to replace Rep. John Conyers (D-Mich.) as chief sponsor of H.R. 676, the Expanded and Improved Medicare for All Act. (Conyers is retiring at the end of his term under a cloud of sexual misconduct allegations.)
The move makes Ellison the most prominent House spokesman for once-marginal legislation that has become a rallying point for progressives across the country. The bill, which Conyers introduced for decades with little support, now enjoys the backing of a majority of the House Democratic Caucus. A companion bill introduced by Sen. Bernie Sanders (I-Vt.) has the backing of more than one-third of the Senate Democratic Caucus, including virtually every rumored 2020 presidential candidate.
Ellison, a longtime backer of H.R. 676, attributed the uptick in congressional support to lawmakers hearing from constituents desperate for a more effective health care system.
“My motivation is just being in meetings, talking to people about their health care nightmare, and studying the array of options and coming up with this one as being the best one,” Ellison told HuffPost.
Ellison brings the imprimatur of a Democratic Party leader to legislation that has only recently edged its way into the mainstream. But he emphasized that he is pushing the bill in his capacity as a member of Congress. The DNC, he said, has not endorsed the idea of a single-payer health care system in which the federal government would be the sole insurer.
Ellison also said that his advocacy of “Medicare for all,” as single-payer proponents describe it, does not contradict his support for the Affordable Care Act, commonly known as Obamacare. When Sanders debuted his version of the bill in September, some centrist Democrats critical of single-payer argued that the push jeopardized efforts to protect the ACA.
“I am grateful to the Affordable Care Act. It has gotten us this far. It has improved the lives of millions of people,” Ellison said. “This is an advance of the progress that we’ve made, not a replacement of the progress that we’ve made.”
However, the shortcomings of the ACA ― which brought insurance to 20 million more Americans but still left 28 million people uninsured ― have helped fuel progressives’ enthusiasm for Medicare for all.
Single-payer advocates argue that the flaws in the ACA were the result of trying to accommodate the private insurance industry rather than build on the success of Medicare and Medicaid. As evidence, these activists and policy experts point to the relative success and political durability of the law’s Medicaid expansion, compared to the more troubled individual insurance marketplaces.
Public support for single-payer has steadily crept up over the years. Fifty-seven percent of Americans now back Medicare for all, according to a July 2017 poll conducted by the Kaiser Family Foundation.
But implementing Medicare for all would require moving tens of millions of Americans from their employer-provided coverage to a vastly expanded Medicare program. It is unclear how public support for the idea would fare under that kind of pressure.
Ensuring a smooth transition is one of many concerns that single-payer advocates must address, according to Ellison. Another is the resulting job losses in the insurance industry.
But he said, “I urge people not to get stuck on the details ― because you lose the forest for the trees in this debate all the time. You end up in a situation where because you can’t have everything, you can’t have anything.”
In the meantime, Ellison plans to be busy recruiting new members of Congress to support H.R. 676 and promoting its merits to the public.
Asked whether that included efforts to bring Republican colleagues along, Ellison replied, “We always hope.
“It would be great for business, right?” he said. “For Republicans who are thinking about helping business: What if you could take health care costs off of your bottom line as a business?”