Push for ‘Medicare for all’ worries centrist Dems

Centrist Democrats who helped their party win back the House majority with victories in key swing districts last fall are sounding the alarm that the liberal push for “Medicare for all” could haunt them as they try to defend their seats and keep control of the House. 

Instead, these moderates — many of whom will face tough reelection bids in 2020 — are pressing their party leaders to work with President Trump and Republicans to deliver to voters back home a bipartisan victory on lowering prescription drug prices and other health efforts rather than focus on an aspirational Medicare for all messaging bill.

{mosads}Already, Republican campaign operatives are trying to paint Democrats with a broad brush, linking vulnerable lawmakers in conservative-leaning districts with liberal colleagues pushing for a single-payer health care system. A new poll out Tuesday revealed that 64 percent of voters surveyed believed that Democrats back socialism. 

“We’ve got extremists who want to shoot the moon. Some policies would be wonderful, but you’re not going to get them out of the Senate and you’re not going to get them out of the White House,” said one House Democrat who represents a district won by Trump in 2016 and who wants the new Congress to tackle drug pricing first.

“It’s messaging versus action. I think we should go for action,” the lawmaker said. “And if we’re going to win as Democrats next time around, we better show that we can govern too. If we are just going to obstruct for the sake of it, that’s not going to help us keep the majority and certainly not going to win us the White House.”

Some freshmen Democrats who defeated incumbent Republicans last November also poured cold water on the Medicare for all bill, which Progressive Caucus Co-Chair Pramila Jayapal (D-Wash.) and Rep. Debbie Dingell (D-Mich.) plan to unveil on Wednesday with more than 100 co-sponsors. The idea has been championed by democratic socialists such as Rep. Alexandria Ocasio-Cortez (D-N.Y.) and Sen. Bernie Sanders (I-Vt.), who has launched another presidential bid.

“My strong preference is to do what can be done, which is something that can garner enough support to actually pass. We know that is not going to be a transformation of our health care system, although there are strong arguments for attempting that in the coming years,” Rep. Tom Malinowski (D-N.J.) told The Hill on Tuesday.

Malinowski, a former Obama administration official, aggressively campaigned last cycle on protecting the Affordable Care Act — a tactic which helped him unseat GOP Rep. Leonard Lance.

The New Jersey Democrat said he doesn’t care whether the House quickly turns to bipartisan efforts to lower drug prices, protect patients with pre-existing conditions or stabilize the ObamaCare marketplace, adding: “Any of those is a good place to start.”

Trump has repeatedly invoked cutting drug prices as one key area where he could work with Democrats, particularly in this new era of divided government. Health and Human Services Secretary Alex Azar, a former pharmaceutical company executive, has been meeting on Capitol Hill with party leaders and committee chairs on the issue.

At a Senate Finance Committee hearing on Tuesday, Republicans and Democrats alike grilled executives from seven major drug companies over the high cost of prescription drugs.

Meanwhile, another centrist freshman, Rep. Dean Phillips (D-Minn.), said he’s participated in behind-the-scenes talks on drug pricing among members of the bipartisan Problem Solvers Caucus, led by Reps. Josh Gottheimer (D-N.J.) and Tom Reed (R-N.Y.).

“My preference is a simple one, which is to work with our Republican friends across the aisle to identify shared desired outcomes and then work our way backward,” Phillips, who defeated GOP Rep. Erik Paulsen last fall, said in an interview. “I’m disappointed that we have a system here that doesn’t promote more of that kind of collaboration. We focus on tactics; therefore, we never reach the outcomes that we all want.”

{mosads}Asked if he’ll co-sponsor’s Jayapal’s legislation, Phillips replied, “I respect it. Our party is a big tent. Anybody who throws out ideas, I have respect for.”

Two-term Rep. Tom O’Halleran (D-Ariz.), who’s district Trump narrowly won in 2016, made clear he won’t sign on to Jayapal’s Medicare bill. Neither will Rep. Scott Peters (D-Calif.), a leader of the pro-trade New Democrat Coalition, nor freshman Rep. Abigail Spanberger (D-Va.), who beat Freedom Caucus Rep. Dave Brat (R) last year in a central Virginia district that Trump carried by 6 percentage points.

Spanberger is backing an expanded public option for health insurance, a less drastic approach than Medicare for all.

“I support the public option because I think it’s a great way for people to have access to a Medicare-like program without forcing them to do it,” Spanberger said in an interview just off the House floor. “I support the goal of universal coverage, but I think the public option is the workable way for getting people the coverage for what they should have.”

O’Halleran, a leader of the centrist Blue Dog Coalition, said he is unconcerned if the House GOP’s campaign arm tries to portray him as a socialist in the 2020 cycle.

“Whatever they want to do, they will do whether I vote for it or not,” O’Halleran said. “But we owe it to the people of America not to rush into it. Conceptually, making sure everybody has health care is a good idea, but there is not any consensus in the caucus yet on the direction.”

Told there are more than 100 co-sponsors on the Jayapal bill, O’Halleran said, “They are pretty short of a majority there.”

But not all vulnerable moderate Democrats are rejecting Medicare for all. Another Arizona Democrat, Rep. Ann Kirkpatrick, who succeeded Republican Martha McSally, told The Hill she’s signing on to the Jayapal bill after consulting with her daughter, who is a physician.

“I called her and asked, ‘Where are you on Medicare for all?’ And she said, ‘Absolutely, I support it,’ ” Kirkpatrick recalled. “She said everybody should be on Medicare, most of her patients are Medicare patients, it’s a good system, people like it, it works, and she gets a timely reimbursement.”

Dingell, who co-chairs the Medicare for All Caucus with Jayapal, argued that newly empowered Democrats don’t need to choose between going big or going small on health care this year; they can pursue multiple tracks simultaneously.

“We are the last industrialized nation in the world that does not have health care for every one of its citizens. … We’re paying a ridiculous amount of money in paper work. Doctors can’t pay attention to their patients because they are bogged down in bureaucracy. … The time is here,” said Dingell, who’s vowed to carry the torch of her late husband, former House Energy and Commerce Committee Chairman John Dingell (D-Mich.), an early advocate of a single-payer system.

“We need to make sure anyone with pre-existing conditions has access to health care. And we got to do something about prescription drugs,” she added. “But we need to work on Medicare for all too. It’s not either or; it’s all of this. If you don’t have a vision, you don’t know what you’re working for, and you’re never going to get it done.”

Speaker Nancy Pelosi (D-Calif.) has said repeatedly that, as an activist many years ago, she had fought for a single-payer approach to health coverage and would support that strategy if Congress were building a health care system from scratch today. But Pelosi also ushered ObamaCare through the lower chamber in 2009 and 2010, and she’s since focused her energy touting the benefits of the law she championed.

ObamaCare has grown steadily more popular since its passage, particularly in the face of Trump’s efforts to repeal it, and Democrats were the big winner of the health care debate in the 2018 midterms. With that in mind — and the ObamaCare framework in place — Democratic leaders appear willing to tolerate the Medicare for all debate, while keeping laser-focused on efforts to bolster the Affordable Care Act.

Pelosi is supporting the first-ever hearings for the Medicare for all plan, but they will be held in the Budget and the House Rules committees, not the main panels of jurisdiction. That suggests the bill likely won’t reach the floor during this session of Congress.

Rep. Hakeem Jeffries (N.Y.), the Democratic Caucus chairman, declined to take a position on single-payer on Tuesday, but said he supports having a “comprehensive” examination of how best to ensure “universal access to high-quality affordable health care for every single American.”

“That is the principle that unites the House Democratic Caucus,” Jeffries said.

“We have been clear, as part of our For the People agenda, that the starting point should be working to lower the high cost of life-saving prescription drugs.”

Mike Lillis contributed.