Democratic party leaders’ plan for health care is to push for both everything and nothing at the same time.
On Sunday, George Stephanopoulos asked Senate Minority Leader Chuck Schumer on ABC’s This Week whether or not the Democratic agenda for health care was a plan to move to a single payer system.
“We’re going to look at broader things” the New York senator said. “Single-payer is one of them. Many things are on the table. Medicare for people above 55 is on the table. A buy-in to Medicare is on the table. Buy-in to Medicaid is on the table. On the broader issues, we will start examining them once we stabilize the system.”
All of the policies that Schumer lists are sound Democratic reforms that would move the American health care system toward expanded coverage. But none of them have any hope of becoming law unless Schumer and other Democratic leaders start laying out a clear and specific agenda for health care after the Trump era.
Instead, they’re doing everything they can to avoid it.
The morning after Schumer’s appearance on This Week, the Democratic leader released an op-ed in the New York Times laying out an outline for a Democratic agenda going forward. The words “health care” appear only once in a laundry list of industries that Democrats want increase anti-trust enforcement. Nowhere in the agenda is a unified plan for health care reform.
And even as more and more progressives and potential 2020 presidential contenders have voiced their support for single-payer health care, moderate Democrats continue to talk about the future of health care as an open-ended debate.
The lack of will to create a single health care policy agenda is deeply ironic as Democrats repeatedly point out that the GOP had years to come up with a plan while they were in the minority, and failed to do so.
Democrats would undoubtably argue that by putting forward a panoply of ideas to choose from, they have the workings of a real health care plan. But the same could have been said of Republicans during the Obama years. Both House Speaker Paul Ryan (R-Wis.) and then-Congressman Tom Price (R-Ga.) both introduced plans in the house to replace the Affordable Care Act. During those years, Republicans would write editorials and appear on cable news to extoll the virtues of conservative policies like expanding health savings accounts.
But when the time came to actually pass something, Republicans had not built enough broad support for either of those plans and had built a new, desperately unpopular, Frankenstein bill. Because no specific policy goals were agreed to other than “repealing and replacing Obamacare,” activists appear to have had success pressuring members of Congress to oppose different parts of the bill, though its future remains uncertain at this point.
Democrats do have the advantage of over Republicans here, in that they have a unified goal — increasing coverage — and are not trying to take health care away from millions of people. But just because their plans aren’t “mean” doesn’t mean they won’t face fierce outside opposition.
Powerful lobbying interests in both the health insurance and health care industries would likely oppose most of the provisions Schumer offered over the weekend. Those groups have considerable experience swooping in during the period when legislators are “exploring their options” and killing any support for the options they don’t particularly like.
During the 2009 health care debate, the American Medical Association, the nation’s largest association of physicians, played a key role in killing the public option for health insurance and there’s no reason to believe they would not do the same in future debates.
Today Democrats hold up groups like the AMA for their opposition to the GOP bill to show that doctors oppose the Republican plan. That alliance could prove to be disastrous for Democratic reform plans in the future if Democrats don’t establish what their alternative vision for America’s health care system is.
Working toward a unified health care agenda now could also help mediate the kind of divisions in the party that plagued the 2016 presidential primary. Candidates for the 2018 congressional races are likely to start facing questions about their positions on health care in the next few months, and a signal from the national party could go a long way in helping them appear united.
The question now becomes whether Democrats are willing to use their time in the minority to craft a health care agenda that works for every American.