By Jordain Carney, The Hill–
Democrats are heading toward a new phase in the battle over healthcare as they brace for a tough midterm.
With the GOP ObamaCare repeal push largely on ice, Democrats are shifting their focus from defending the Affordable Care Act to pitching their own healthcare ideas.
The long-shot proposals have little chance of passing with Republicans in control of both chambers of Congress and the White House.
But the competing measures could feed into the ongoing fight about the party’s future as Democrats search for a path out of the political wilderness.
Sen. Bernie Sanders (I-Vt.) is expected to unveil a “Medicare-for-All” bill next month, using the August break to build momentum for the forthcoming legislation.
“Establishing a Medicare for All single-payer program will improve the health of the American people and provide substantial financial savings for middle class families. It is the right thing to do. It is the moral thing to do,” Sanders wrote in a Guardian op-ed.
Echoing his upstart presidential campaign against Hillary Clinton, the Vermont senator is asking supporters to sign up as a “citizen co-sponsor” of the forthcoming legislation, arguing that it’s time “to wage a moral and political war against a dysfunctional healthcare system.”
Sanders put universal healthcare at the center of his bid for the Democratic nomination, and the idea has gained traction amid a progressive resurgence within the party.
Many of Sanders’s potential competitors in a 2020 presidential primary — including Democratic Sens. Kamala Harris (Calif.) and Cory Booker (N.J.) — have voiced some support for Medicare for All. Sen. Elizabeth Warren (D-Mass.) told The Wall Street Journal that “it’s time for the next step. And the next step is single-payer.”
Marissa Barrow, a spokeswoman for the Progressive Change Campaign Committee, said Democrats should embrace a “big and bold” agenda heading into the next election.
“We’re looking to make Medicare for all one of the big issues on the campaign trail,” she said. “We see it as an issue that could help unite the Democratic Party.”
But Sanders’s Senate colleagues who are running in red-state states have kept the proposal at arm’s length.
Democratic Sens. Joe Manchin (W.Va.), Joe Donnelly (Ind.), Jon Tester(Mont.) and Heidi Heitkamp (N.D.), as well as Independent Sen. Angus King (Maine), joined with Republicans to vote against a single payer amendment from GOP Sen. Steve Daines (Mont.) late last month.
Heitkamp said Congress needs “realistic solutions” and Daines’s maneuver — which was expected to fail — was a “political stunt.”
“We need realistic solutions to help fix our healthcare system. … The decision was made in 2010 to go with a market-based system — the question is how we improve the system we have,” Heitkamp said in a statement.
Sen. Claire McCaskill (D-Mo.), who like most Democrats voted “present” on the GOP amendment, also told constituents she would not support a single payer proposal.
“I’m going to disappoint a lot of you….I would say if a single-payer came up to a vote right now I would not vote for it,” McCaskill, who is up for re-election next year, told constituents during a town hall earlier this year.
McCaskill added she would support allowing individuals who only have one option on the ObamaCare exchanges to buy into Medicare or Medicaid instead.
Democrats face a tough Senate map in 2018, with ten senators running for reelection in states carried by Trump. The nonpartisan Cook Political Report shifted three of those races—West Virginia, Indiana and Missouri—to “toss up” and North Dakota from “likely D” to “lean D” this week.
A spokesman for Sanders said he didn’t yet have an estimate for how many members of the Democratic caucus would support the forthcoming legislation. One hundred and sixteen House Democrats are backing a separate House bill from Rep. John Conyers (D-Mich.) — the first time a majority of the caucus has supported the proposal.
Democratic leadership is trying to walk a fine line in the looming healthcare fight, as they balance the competing interests of different wings of the party.
Senate Minority Leader Chuck Schumer (D-N.Y.) has put a myriad of options, including single payer, “on the table.”
“We’re going to look at broader things — single payer is one of them,” he told ABC News. “Medicare for people above 55 is on the table. A buy-in to Medicare is on the table. A buy-in to Medicaid is on the table.”
Overall, 33 percent of Americans believe healthcare should be a “single payer” setup, according to a Pew Research Center poll from late June, compared to 52 percent of Democrats and 64 percent of liberals.
The poll also found that roughly 60 percent believe the government is responsible for making sure all Americans have health insurance.
The coming fight over healthcare is the latest example of a vocal progressive wing trying to flex its muscle and push the Democratic Party to the left in the wake of the 2016 election.
When Sanders introduced a bill to raise the federal minimum wage to $15—a key issue between himself and Clinton—thirty Democratic senators signed onto the bill, compared to five supporters for a similar bill in 2015.
But red-state incumbents aren’t the only Democrats worried about embracing single payer.
Sen. Dianne Feinstein (D-Calif.) received pushback at a town hall in San Francisco when she said told constituents that she wasn’t “there” on single payer.
Asked if he could support a single payer system, Sen. Tim Kaine (D-Va.), Clinton’s vice presidential pick, noted Sanders would be introducing a bill but he has “a different view about what we ought to do.”
“I want people to have more options, not fewer. …I would like to explore a circumstance under which there could be a public option, like a Medicare Part E for everybody that you’d have to buy into,” Kaine, who is also up for reelection, told ABC News earlier this month.
Democratic Sen. Debbie Stabenow (Mich.), Tammy Baldwin (Wis.) and Sherrod Brown (Ohio), who are each up for reelection in states carried by Trump, are offering legislation that let Americans between the ages of 55 and 64 buy into Medicare.
Barrow called the move a “positive step,” though the end game is either a single payer system or a state-by-state or federal Medicare option for everyone.
Sanders has also acknowledged that with Republicans in control of Congress, his bill is unlikely to pass. He outlined three steps to take in the meantime — passing legislation to get the public option in every state, lowering Medicaid eligibility to 55 and lowering the cost of prescription drugs.
But he is also prepared to take his argument for a broader single payer bill into Trump territory. He’ll hit the road with stops in Indiana, Ohio and Michigan to discuss healthcare and the economy, including a rally with Conyers where they’re expected to discuss Medicare for all.
Barrow added that PCCC is already reaching out Capitol Hill offices and will keep up their effort through 2018 and beyond to get Democrats to “wrap themselves in the flag of Medicare.”
“If you go into a red state… it’s a super, super popular program in red states, blue states and purple states,” she said. “It’s going to be a winning issue in 2018 especially in those red and purple states”
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