Some Democrats Want Medicare for All. Others Aren’t So Sure
Shortly after her primary victory in New York, Democratic Socialist Alexandria Ocasio- Cortez declared her goal of giving Medicare to all Americans. Some fellow Democrats like Ken Harbaugh aren’t convinced.
The Navy veteran, who is challenging Rep. Bob Gibbs (R., Ohio), says the party should focus on bolstering the Affordable Care Act, not starting from scratch with Medicare for All. “We need a much quicker fix, which is shoring up the ACA,” he said. As Democrats enter the final sprint in a campaign where health care is a dominant issue and a House takeover seems achievable, they are split on whether to promise coverage for everyone, which would fuel an already revved-up liberal base, or target centrist voters by campaigning on the more modest goal of fixing the Obamaera health law.
No issue is more important to voters than health care, polls suggest, and this internal tension carries risk. It has opened up Democrats to attacks from Republicans, pitted party members against each other, and could alienate rural and red-state Democrats. Robert Blendon, a health-policy professor at Harvard University, said Democrats should unite around the simpler promise of protecting people with pre-existing medical conditions.
“They’re missing the boat,” Mr. Blendon said. “The message of Democrats should be that ‘unless we get the House and Senate, they’re going to take preexisting conditions away.’ But there’s no coherent message in the ads.”
The growing popularity of Medicare for All surprised even some supporters. The idea was widely dismissed two years ago when Sen. Bernie Sanders (I., Vt.) couldn’t get any co-sponsors for a single-payer bill. Now that legislation has 15 co-sponsors, and 70 Democrats in Congress have launched a “Medicare for All Caucus.” Rep. Pramila Jayapal (D., Wash.) recently announced a Medicare For All PAC to support candidates who back the idea.
In a recent Reuters-Ipsos poll, 70 % of people said they favor Medicare for All, but, reflecting the importance of labeling, 41 % said they support single payer.
Under Medicare for All, a government agency would provide essential health care to every American. That would upend the current health-care system and erase employer-sponsored coverage, which is how roughly 155 million Americans now get insurance.
Still, there is no clear Democratic consensus. Some party members are instead embracing proposals such as letting people buy into Medicare that fall short of a true single-payer system.
Seventy percent of swingdistrict Democratic candidates who won their primaries as of late July support Medicare for All or single payer, according to Real Clear Politics. Former President Obama, who shied away from it as president, recently called it a “good new idea.” The support can be traced in large part to Republicans’ failed effort to topple the ACA in 2017. Polls showed that public approval for the ACA peaked during the most frenzied days of the repeal push.
That buoyed single-payer proponents, who concluded Americans were ready for the government to play a bigger role in health care. “The move to expand and protect health care has become the most powerful force in American politics today,” said Jonathan Schleifer, executive director of the Fairness Project, which supports ballot initiatives to expand Medicaid. “If the past year has taught us anything, it’s that Americans want more health care, not less.” Many centrist Democrats disagree. They long expected to hold the political edge over Republicans on health care in 2018 for the first time in years, with a straightforward message of protecting the ACA from the GOP and expanding it.
Now they fear the Medicare for All slogan, with its promise of sweeping government action, will alienate voters they need. “If we lock ourselves into one way of getting affordable health care, we’re never going to get there,” said Democrat Angie Craig, who is challenging Rep. Jason Lewis (R., Minn). “My neighbors, my district, can’t wait for some grand plan.”
The Democratic rift hasn’t been lost on Republicans like House Majority Leader Kevin McCarthy (R., Calif.), who told a crowd in Ohio this summer: “If any of you have had health care provided by your employment, or if you’re on Medicare now, [Democrats] are pretty much going to end it as we know it. They want one government- run system.”
Last week, Health and Human Services Secretary Alex Azar derided Medicare for All as a misnomer that will take away consumer choice and cost $32 trillion over 10 years, referencing a controversial study published this summer by the Mercatus Center. Democrats say the study also showed savings because U.S. health-care spending would drop by $2 trillion over that period.
Kristina Peterson contributed to this article
Sen. Bernie Sanders speaks during a health-care rally on Sept. 22, 2017 in San Francisco. Mr. Sanders has introduced a Medicare for All bill.