Establishment Democrats Are
Undermining Medicare for All
The Democratic establishment — deep
in the pockets of the health industry — wanted to make sure any blue
wave election in 2018 would help sink, rather than support, the
growing movement for a single-payer health care system. The recent decline in
co-sponsors of the House Medicare for All legislation is, in part, a byproduct
of this strategy and a reminder of the great obstacles corporate Democrats have
put in front of the single-payer movement.
In 2018, there were 124
cosponsors for the Medicare for All bill in the House (then H.R. 676),
representing 66 percent of the Democratic Caucus. This was celebrated widely as
a high-water mark for the legislation. So was the release of Bernie
Sanders’s Medicare for All bill in the Senate, which also got a record 16 co-sponsors,
including prominent Democrats who are running for president.
Given that the Democrats
gained 35 seats in the 2018 midterm and Medicare for All has been polling
extremely high among Democratic voters — a survey
by Reuters from August 2018 showed around 85 percent of Democrats
supported the policy — many were hopeful that the number of cosponsors would
rise even higher in the current Congress.
Despite this hope, when Rep.
Pramila Jayapal introduced the new flagship Medicare for All bill (H.R. 1384),
the amount of co-sponsors decreased considerably to 106, down to 47
percent of the caucus. So why, if Democratic voters are moving left on health
care, is this not reflected in Congress? Where did all the co-sponsors go?
A Truthout analysis
shows the primary reasons for this decline are: 1) incumbents who once supported
Medicare for All who have defected, and 2) a largely disappointing freshman
class.
The most well-known faces of
the freshman class are progressives, such as Alexandria Ocasio-Cortez, thanks
to their ambitious proposals and popular support. This might give the
impression to the public that this is reflective of the whole class. The
majority of the newest House Democrats, however, were shaped strongly by the
Democratic Congressional Campaign Committee and the New Democratic Coalition.
About 71 percent (42 of 59) of freshman House members declined to co-sponsor
the legislation. Some freshman candidates who ran on the issue during the
campaign, like Harley
Rouda of California,
still declined to co-sponsor Jayapal’s bill.
In happier news for the movement,
three incumbent Democrats decided to co-sponsor Medicare for All for the first
time: Reps. Joseph Kennedy and William Keating of Massachusetts, and Susan Wild
of Pennsylvania. However, 29 of the Democrats who were previously co-sponsors
have defected this year. Why are Medicare for All’s congressional supporters
backing out?
Incumbent Democrats Turning
Away
It is much less courageous for
members of Congress to co-sponsor legislation that has no chance of passing. So
last year, as members of Congress quickly signed on to H.R. 676 some suspicious
names appeared on the list (like Joseph Crowley, who had never hinted at
support for the policy until he faced Alexandria Ocasio-Cortez in the primary).
In the minority, they could add their names while, behind closed doors, giving
viable explanations to donors: “Don’t worry, it has no chance of passing — I am
just getting re-elected.”
Now that Democrats control the
House, this calculus changes for many. Sure enough, 29
incumbents who previously co-sponsored H.R. 676 have failed to
co-sponsor the newer bill, which recently was made stronger to include
long-term care for elderly and disabled Americans. Among these defectors
are Reps. Elijah Cummings, Hakeem Jeffries and Marcy Kaptur.
“It’s another painful but
important lesson about the limits of politely pushing elected officials to the
left,” writes Alex
Panagiotopoulos, who analyzed the defections. “Just because they co-sponsor
or promise to support legislation doesn’t mean [they will] expend any political
capital to make it happen.”
Adam Gaffney, president of
Physicians for a National Health Program, told Truthout that the most
important thing is to keep pressuring candidates to support the legislation.
“The movement has been putting
pressure on Democrats [that] don’t support it, this kind of work must
continue,” he said. (Gaffney recently impressed many with his stirring
defense of Medicare for All on Fox Business News.)
Why the Freshman Class Is
Largely Unsupportive of Single-Payer
When people think of the
freshman class of Democrats, the most recognizable names tend to be Reps.
Ocasio-Cortez, Ilhan Omar and Rashida Tlaib. This makes sense, as they are
pushing popular policies — and are constantly attacked by Republicans.
These strong voices of
dissent, however, are in the minority in the new Congress. By and large, the freshman
class of House Democrats has refused to support single-payer in practice. Of
the 59 freshman Democrats elected to Congress this year, only 17 of them (a
woeful 29 percent) co-sponsored H.R.
1834.
This was not by chance. It can
be traced to the Democratic
National Campaign Committee (DCCC) and the corporatist New
Democratic Coalition in the House (and its affiliated NewDemPAC). Long
before the 2018 midterms were underway, Democratic Party power brokers and
fundraisers were militant in trying to keep prospective members of Congress in
line going into the 2018 election. This included pleading with new candidates
not to support single-payer or, as The Intercept reported with
corroborating audio, trying
to bully progressives out of the races altogether, depriving voters of
a chance to weigh in. Establishment Democrats’ goal was, as Politico reported,
to “neutralize
the threat” of single-payer.
“Democratic voters want single
payer health care. But don’t expect to hear Democratic candidates talk about
it,” the report said. “To avoid divisive intraparty fights that drive candidates
left — only to be attacked by Republicans for favoring socialized medicine — the
Democratic Congressional Campaign Committee warned aspirants last year about
the political liabilities of endorsing ‘single-payer.’”
Until the Bernie
Sanders campaign in 2016, single-payer was not recognized by most media and
politicians as a mainstream proposal (despite its popularity among the public).
Sanders energized the
movement, putting powerful Democrats and industry stakeholders on guard.
Surely, the leadership of the
New Democratic Coalition and similarly minded organizations chalk this up to another
victory for the “vital center.” They, like House Speaker Nancy
Pelosi, argue the voters aren’t “ready” for single-payer, despite its
massive popularity. This is a rather dubious interpretation, however, given
that the DCCC deprived
many voters of a chance to vote for a single-payer candidate in their
district. Candidates were hand-picked by party officials in many instances, as
the Hoyer tape proved.
When seeking candidates in
2018, the DCCC embraced
the centrist/corporate Third Way agenda. The New Democratic Coalition,
which preaches free markets and is funded largely by Wall Street, endorsed 27
candidates in the 2018 primary. The DCCC, the primary fundraising institution
for the House, endorsed
25 of these 27 candidatesvia its Red
to Blue list. This provided money, support, opposition
research and more, giving these candidates a huge advantage in the
primaries. As a result, candidates supporting single-payer found themselves
being thwarted, attacked and outspent by their own party leaders, who were
defying the wishes of most of their base.
“The Democratic Congressional
Campaign Committee unleashed
a scorched-earth campaign against [House candidate Laura Moser of
Texas],” reported Vox, “releasing
an opposition memo highlighting past statements Moser made seemingly
denigrating her home state.”
Moser, a single-payer
supporter, lost to the DCCC’s choice, Lizzy Fletcher, in the primary. Fletcher
won the seat and failed
to co-sponsor the new Medicare for All bill.
By contrast, the DCCC did not
support any of the same House candidates endorsed by the Bernie Sanders-founded
organization, Our Revolution, which endorses candidates with a range of
progressive views on single-payer and beyond.
The New Democratic Coalition
saw 16 of its endorsed candidates win in 2018. Of these 16 candidates, only
three co-sponsored the Medicare for All bill in the House. Had the DCCC not
gone so far out of its way to oppose single-payer supporters, the outcome may
have been quite different. Had they embraced single-payer, the amount of
co-sponsors could have risen considerably.
“The problem we have is
actually with the Democrats,” said Jessica Early, a nurse practitioner and
health care justice organizer, in a 2017
interview with Truthout. “We know how Republicans are going to vote on
this issue. The obstacle we face is getting Democrats who will support us into
office.”
Can New Democrats Derail
Single-Payer?
The term “New
Democrats” refers to an ideological and strategic movement that argues the
U.S. is fundamentally a center-right country and the Democrats must embrace
this — and corporate donors — to win elections. During the 1990s it was the
most powerful wing of the party: Bill and Hillary Clinton, John Kerry, Joe
Lieberman and most of the party’s top names were on board. The New Democrats boasted
about helping pass the Welfare Reform Act of 1996, which added work requirements
to cash and food assistance and was supported mostly by Republicans in
Congress. The organization was
also hostile to candidates who tried to run as progressives, such as Howard
Dean and Ned Lamont in 2004 and 2006 respectively.
This kind of thinking has, for
the most part, fallen out of favor: There is virtually no grassroots support for
“centrist” moderation. It is a doctrinal assumption,
however, made by much of the dominant media, that proposals like single-payer
will hurt Democrats in the general election, or in districts that President
Trump won in 2016. Third Way, which is run largely by hedge fund managers,
advanced this theory in its Winning on Health
Care memo in 2016.
“A national debate over single
payer is what Republicans want since it would turn health care from a winning
Democratic issue into a losing one,” Third Way pleaded.
Many advocates, however, say a
national debate over single-payer is exactly what the Democrats – and the
United States more generally – need to be having.
“This is a winning issue for
the American people and for the Democrats,” Gaffney said. “Now we have to get
it done.”
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