March 25, 2019 | Press Releases

Memo: Why Medicare for all is not the path for Democrats on health care


To: Interested Parties
From: Lauren Crawford Shaver, Partnership for America’s Health Care Future
Re: Why Medicare for all is not the path for Democrats on health care
Date: March 26, 2019

As 2020 presidential hopefuls continue to struggle with the implications of Medicare for all-style proposals and what they truly mean between policy and impacts on patients, The Washington Post reports that “House Speaker Nancy Pelosi says Democrats will roll out legislation[today] focused on lowering health-care costs and protecting people with pre-existing conditions – an effort timed to coincide with the ninth anniversary of the Affordable Care Act … Pelosi has repeatedly indicated her wish is to improve Obamacare over trying to pass a sweeping Medicare-for-all-type bill, which more liberal members of her caucus have been pushing for.”

While the details of this legislative proposal have yet to be known or debated, it isn’t difficult to understand why Speaker Pelosi and most Democratic Members of the House favor this approach over embracing calls by some to push ahead with a disruptive, costly and unpopular Medicare for all-style proposal.

Marking the ACA’s ninth anniversary last week, the Partnership for America’s Health Care Future took stock of today’s health care including coverage extended to 20 million more Americans and noted that we have the opportunity to cover millions more using the tools available to us under our current system.  Those facts, the Partnership argued, stand as “a strong rebuke” to those who claim we should throw our health care system away and start from scratch with a Medicare for all-style proposal, including so-called “buy-in” or a “public option” proposals that are simply stepping stones to a one-size-fits-all government-run system.

This helps explain why most voters – including most Democratic voters –  want our elected leaders in Congress to focus on protecting and improving upon what works in America’s health care system, not on disruptive, costly Medicare for all-style proposals, according to a recent poll by the Kaiser Family Foundation.  In fact, the same poll found that – from eliminating the choice and control Americans enjoy through market-based coverage, to subjecting patients to treatment delays and a lower quality of care, to the fact that such proposals would force families to pay more, including through higher taxes – Americans do not support Medicare for all-style proposals once they learn the facts.

At the ballot box last fall, the Democratic House candidates who delivered the party their majority did not run on a platform of Medicare for all.  In fact, not a single one of the 11 Democratic candidates who won in House districts where a majority of voters supported Republican presidential candidates in the past decade ran on support for Medicare for all, and 74 percent of all House Democrats who won seats in Republican-leaning districts did not run on support Medicare for all.  Instead, Democrats netted 40 U.S. House seats largely on an agenda of protecting Americans with pre-existing conditions and other policies aimed at preserving and strengthening our current health care system.

As one Democratic strategist put it to The New York Times“Most of the freshmen who helped take back the House got elected on: ‘We’re going to protect your health insurance even if you have a pre-existing condition,’ not ‘We’re going to take this whole system and throw it out the window.’”

So it’s no wonder that there is little momentum behind Medicare for all legislation recently introduced in the House.  A CNN analysis found that despite Democrats now holding 40 more seats in the House, the bill has fewer co-sponsors than similar legislation in the 115thCongress and “has attracted very little support from House members beyond the most reliably Democratic districts.”  Upon introduction, it garnered only two new non-freshman cosponsors; only a quarter of freshman Democrats cosponsored the bill; 83 percent of Democrats who flipped red districts in 2018 did not cosponsor the legislation; and 93 percent of cosponsors of the bill represent districts that Democrats controlled before the 2018 midterms.  Meanwhile, The Washington Post reports that “the major [House] health committees are staying away from the legislation and leadership hasn’t said they will hold a vote on it.”

It’s also no wonder that Medicare for all has come under increasing fire from Democratic leaders in recent weeks.  The Washington Examiner notes that in the wake of Speaker Nancy Pelosi’s blunt criticism of Medicare for all, “Democrats who aren’t on board with the plan are becoming more vocal about why.  Rep. Cheri Bustos, D-Ill., the chairwoman of the Democratic Congressional Campaign Committee, told The Hill that the former bill’s estimated price tag of $32 trillion in extra government spending over a decade was ‘a little scary.’  Rep. Frank Pallone, D-N.J., who chairs the Energy and Commerce Committee, also has drawn attention to the cost.”

These leaders understand that with our health care system now working for more Americans than ever before, this is no time to put patients at risk with Medicare for all-style proposals.  Rather than scrapping America’s health care system in favor of a one-size-fits-all government-run program, our elected leaders should embrace the progress made, protect and build upon what’s working, and continue working together to extend quality, affordable health care to millions more Americans using the tools available within our existing health care system.


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