Democratic Left Playing a Long Game to Get ‘Medicare for All’

Bloomberg Dec 26, 2018 (excerpts)

 …Their aim for now is to shift the health care debate. By making single-payer health care -- a model under which all Americans would get their insurance from a single government plan -- the progressive position, advocates argue that gives Democrats representing conservative areas of the country political cover to support more modest proposals to expand the government’s role in health insurance.

“Everybody understands we’re not going to get Medicare for All enacted in January. But it’s a marker about where we want to land, which is to say we want everybody to have health care,” Democratic Senator Brian Schatz of Hawaii said in an interview. “This is about moving the so-called Overton window.”

Moving that Overton window -- the spectrum of ideas the public will accept -- captures the progressive strategy for making the government’s Medicare program available for everyone, not just those over 65. Schatz, for instance, is a co-sponsor of Senator Bernie Sanders’ Medicare for All legislation, but has also offered a less comprehensive alternative which would give states the authority to let people who aren’t otherwise eligible buy into the Medicaid program targeted to aiding low-income individuals.

The maneuvering on health policy comes as the Affordable Care Act, which expanded insurance coverage to millions of Americans, is under a Republican-led court challenge. While the law, popularly known as Obamacare, remains in effect, the court case may drag into the 2020 campaigns for the White House and Congress. In the meantime, there’s a wide range of potential proposals between the status quo and a government-run single-payer system that are gaining support among Democrats.

“We will be having a conversation about many ideas on how we can lower the costs of health care,” said Representative Ben Ray Luján of New Mexico. The Democratic-led House will discuss the Medicaid buy-in that he co-sponsored with Schatz, as well as Medicare for All and “other initiatives members have, as opposed to Republicans who were only intent on repealing the Affordable Care Act,” he said….

While Republicans have struggled to coalesce around a health care alternative, they found unity in attacking Medicare for All against Democrats in 2018 House races, calling it a radical and costly government takeover of health care. Democratic candidates running in swing districts generally distanced themselves from the idea.

But the Kaiser Family Foundation found in March that 59 percent of Americans favor “Medicare for All,” a figure that’s grown in recent years, while 38 percent oppose it. Support fell to 53 percent, though, when it was dubbed a “single-payer plan.” Meanwhile, 72 percent favor a “Medicaid buy-in for everyone” and 75 percent favor an optional “Medicare for All” proposal that also lets people who already have coverage keep their plans.

The obstacles are enormous. Major changes to health care are politically treacherous as Americans, about half of whom get insurance from an employer, fear their coverage will be reduced. Opposition from industry and conservatives would make plenty of Democrats wary of such a disruptive change….

The Sanders proposal is estimated to raise federal spending by $32 trillion....

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