Despite a large division in the Democratic party over the best health care solution ― single-payer or a continuation and possible expansion of something like Obamacare ― progressives in Congress appear to be in lockstep with House Speaker Nancy Pelosi’s priority of shoring up the ACA before tackling anything like Medicare for All.
“I’m happy to support any provision that strengthens the ACA and plug some of the gaps that we’re seeing, particularly as it’s under assault by the president,” Rep. Alexandria Ocasio-Cortez (D-N.Y.) told HuffPost on Wednesday. “I think it’s part of a longer-term vision, at least for me, towards guaranteeing ― truly guaranteeing ― health care for all Americans.”
Ocasio-Cortez said she understood prioritizing fixes to the Affordable Care Act. “Because we have a Republican Senate, a Republican president, and so the things that we have the ability to pass right now are pretty narrow,” she said, though she added she wanted hearings on Medicare for All and didn’t think single-payer solutions had been given enough attention from the Democratic caucus yet.
No less than Sen. Bernie Sanders (I-Vt.), whose 2016 primary campaign arguably mainstreamed Medicare for All among Democrats, also backed the idea of Congress shoring up the ACA rather than focusing all its energies on enacting single-payer.
“We must defend the ACA from Trump’s assault and protect people’s existing coverage. However, protecting the ACA will not fully solve the health care crisis. To finally guarantee health care as a right, we must take on the insurance industry and pass a Medicare for All bill,” Sanders wrote on Twitter Tuesday.
This coming together highlights that, whatever disagreements there are among Democrats on health care, they’re ultimately unified against GOP efforts to repeal Obamacare with no credible alternative.
Other progressives ― like the lead author of a Medicare for All bill released in February, Rep. Pramila Jayapal (D-Wash.) ― said Wednesday that it wasn’t “contradictory in any way” to support strengthening the ACA while still pushing for a transformation of the health care system to universal coverage.
“I told the speaker ― and I said in caucus yesterday ― we are completely united, as I’ve said for a while, on shoring up the ACA. Like, that cannot wait,” Jayapal said.
The Trump administration has now made clear that it wants to completely eviscerate the ACA, Jayapal continued. “So I think it’s very important for us to meet the immediate needs of the health care that’s been stripped away,” she said.
We’ve got to deal with the crisis at hand. The president just created a crisis. Rep. John Garamendi (D-Calif.)
The Trump administration’s Department of Justice reversed itself on Monday, saying it agrees with a federal judge in Texas that the entire ACA, not just one part of the law as it had previously contended, should be struck down. The result of such a ruling would take coverage away from tens of millions of people and completely disrupt the health care system.
“Right now, the ACA is under attack,” House Rules Committee Chairman Jim McGovern (D-Mass.) told HuffPost on Wednesday. “The president has launched an all-out war against the ACA, and if he succeeds in the courts, then 22 million people lose health insurance right off the bat. So we’re confronting an immediate threat, and I think it’s absolutely appropriate to do that.”
McGovern, who plans to hold the first hearing ever on Medicare for All in his committee, was also on board with addressing immediate concerns over the ACA before Democrats really push for a single-payer solution ― which McGovern supports.
“None of this is inconsistent,” he said. “It’s all about building to the point where we get to universal coverage.”
Another committee chairman who plans to hold a hearing on Medicare for All, House Budget Committee Chairman John Yarmuth (D-Ky.), agreed the first step for Democrats was to defend the ACA. “There’s tons of questions to answer before you could ever get to consideration of a bill in a committee,” Yarmuth said of the Medicare for All proposal. He said his committee was taking the first steps in just determining what questions need to be answered, but he absolutely thought Pelosi’s ACA fixes were needed immediately.
And that was the message from every progressive HuffPost spoke to on Wednesday. Democrat after Democrat said defending the ACA was the first priority, even as liberals argue that Obamacare is ultimately insufficient in providing coverage for everyone and containing costs.
Rep. John Garamendi (D-Calif.) said he was “not at all frustrated” with the priority the ACA had taken over Medicare for All.
“In fact, I’m very pleased. We’ve got to deal with the crisis at hand. The president just created a crisis,” he said.
And House Natural Resources Committee Chairman Raul Grijalva (D-Ariz.) said the DOJ’s decision to go after the ACA had changed the political and practical calculus for Democrats. “The Catch-22 both politically and in terms of the health care delivery ― Medicare for All, whatever you want to call it ― is that now you have to defend an ACA, the things that are in there, and protect it,” Grijalva said.
Jayapal added she wasn’t concerned there’d only be one bite at the apple for health care because she didn’t think Pelosi’s fixes would adequately address the tens of millions who are still uninsured or the majority of Americans who are still facing exorbitant health care costs compared to other countries.
Pelosi, who’s been hesitant to endorse a single-payer system, said Tuesday that Democrats were taking a “L.O.V.E.” approach to health care ― “Let Other Versions Exist” ― and Trump’s efforts to end the Affordable Care Act only seem to have brought them closer together.
“It’s like a football team,” liberal Rep. Ro Khanna (D-Calif.) said. “You got to have some folks who will catch the 40-yard pass. You got to have other folks who will get you the 2-yard run, the 3-yard run. A football team won’t win without all the types of players.”
Arthur Delaney contributed to this report.
CORRECTION: A previous version of this story indicated Jayapal’s Medicare for All bill had not yet been released.