Medicare For All activists are pressuring Dems to back a single-payer system over recently proposed, lighter alternatives. [Photo courtesy of National Nurses United]

Within the next couple weeks, Rep. Pramila Jayapal (D-WA) and Sen. Bernie Sanders (D-VT) will introduce Medicare-For All proposals in the U.S. House and Senate, and some Democrats are already walking back their commitment for the initiative.

Last Monday, 2020 presidential hopeful Sen. Cory Booker (D-NJ) — who often champions the phrase “health care is a human right” — did not fully embrace Sen. Sanders bill when asked about it by CBS News. “A lot of people use that term and there’s differentiation about what they actually believe,” Sen. Booker said.

Six other Democratic bills relating to Medicare are currently under revision, but only Jayapal’s and Sanders’ can truly be categorized as “Medicare For All.” Theirs are the only bills which call to phase out private health insurance altogether in favor of government-backed system that extends premium free health care coverage to all U.S. residents.

“Enough is enough,” Sen. Sanders tweeted on January 14. “We are going to end the disgrace of health care being a privilege for the wealthy. We must pass Medicare for all and make healthcare a right.”

In contrast, other Democratic politicians who have touted the “health care is a human right” line often rely on vague market-driven qualifiers like “affordability” and “accessibility” when pressed for details on their health care platform.

Take Booker for example. He’s sponsored Sanders’ bill, but he’s also sponsored all six of the other lighter alternatives and hasn’t publicly prioritized one over the other. Those bills range in scope from Sen. Debbie Stabenow’s (D-MI) plan of expanding Medicare to people aged 55 and older, to Sen. Brian Schatz’s (D-HI) plan of a hybrid system where people can choose to “buy-in” to Medicare or keep their private or employer-provided insurance. Democrats like Sens. Sherrod Brown (D-Ohio) and Amy Klobuchar (D-Minn.) are supporting these less inclusive proposals over Sanders’ single-payer model.

Sen. Elizabeth Warren (D-Mass), another presidential hopeful who has put health care reform at the top of her agenda, also supports single-payer, but hasn’t ruled out backing the watered-down alternatives. “There are different ways we can get there. But the key has to be always keep the center of the bulls-eye in mind. And that is affordable health care for every American,” Warren told a Bloomberg reporter on Jan. 30.

And then there’s Democratic Speaker of the House Nancy Pelosi, who has aspirationally backed the idea of Medicare For All in the past, but hasn’t joined Jayapal’s Medicare-For-All Congressional Caucus or backed her proposal. Instead, she has reportedly been meeting with executives from private insurance company Blue Cross Blue Shield, reassuring them that Democrats were not focused on single-payer health care and were more determined to lower the cost of prescription drugs, according to a Feb 5 report in The Intercept. (Last month, Pelosi announced that Democrats in the House would consider Jayapal’s far-reaching bill in a series of special hearings in the Rules and Budget committee, so hey, baby steps.)


Progressive supporters of a single-payer system worry that Democrats using the Medicare-For-All slogan while simultaneously backing bills that require people to “buy in” to Medicare are muddying the initiatives original intent.

“There is a major scramble and counter-offensive happening among the Democratic Party establishment to ensure that leading 2020 candidates back off from single-payer, Medicare for All,” tweeted Waleed Shahid, a communications director for Justice Democrats. “They will try to redefine it as a buy-in. Don’t let them.”

Dr. Phillip Caper, the founder of the Maine chapter of the nonprofit Physicians for a National Health Program, told the Phoenix that his group does not support “incremental proposals that just kick the can down the road once again,” like Sen. Schatz’s bill for a buy-in plan, because it doesn’t fulfill their principles of public financing, inclusivity for all U.S. residents, and rigorous cost containment.

“We believe the current system is fundamentally flawed, as a result of over 40 years of free-market ideology inappropriately applied to healthcare in Maine and throughout the nation,” Dr. Caper said. “The system must be fundamentally reformed and patches to it have not and will not result in an economically or politically sustainable system.”

Bonnie Castillo, a nurse and executive director of the National Nurses Union, an advocacy group which represents 150,000 nurses nationwide, agrees. She said that the some of the Democrats' “Medicare-lite” plans will only “exacerbate the ongoing health care crisis for tens of millions of Americans.”

“Medicare for some plans still leave us tethered to a market-driven model of health and are a placebo that will only prolong the pain and delay the care we need,” said Castillo in a written statement. “What we should have learned from other industrialized nations is that it is possible to achieve genuine universal, guaranteed care for all their residents at lower cost and with equal or better health outcomes that in our broken and dysfunction, profit focused system.”

Throughout February, Medicare-for-All activists plan to gather in 130 “barnstorms” across the country, to put pressure on their representatives in Congress to back a single-payer plan and not settle for less. 

University of Southern Maine social work student Phoebe Shields organized one of these events in coordination with the Maine People’s Alliance last Tuesday in an attempt convince Maine Rep. Jared Golden to back Jayapal’s bill.

“The bottom line is that there should be a single-payer national health plan where no one is left out. That should be the goal,” said Shields. “Terms like 'affordability' and 'increasing access' do not necessarily address the issue at hand, and actually continues to give the power to insurance companies. That is why it is so important to maintain this vision of a single-payer system, to keep power with the people.”

The Phoenix couldn’t reach Rep. Jared Golden or Sen. Susan Collins for comment, and both have been publicly silent on the issue of single-payer so far. We did reach a spokesperson for Sen. Angus King, but he declined to comment on Jayapal’s bill because it hasn’t been formally introduced — that spokesperson also “didn’t want to get into particulars” when asked whether or not Sen. King believes that health care is a matter of consumer choice in the free market or a public good the government should guarantee.

Rep. Chellie Pingree is the only one of Maine’s congressional delegates to back Medicare For All — as she’s consistently done in the past — and is a co-sponsor of Jayapal’s bill. Pingree remains confident that the upcoming hearings and debate within the Democratic party on what the size and scope of Medicare will be productive.

"It’s clear that exorbitant out-of-pocket costs, confusing red tape, and the Trump administration’s attacks on consumer protections have driven unprecedented grassroots support for a universal health care program,” said Rep. Pingree in a statement to the Phoenix. “As with any major legislative initiative, members of Congress will bring their own perspectives, questions, and concerns. That’s what the hearings process is for — ironing out differences and building consensus. With Democrats now in the House majority, I’m eager to see the process finally move forward and to ensure that Mainers are part of the conversation."

Despite some Democratic apprehension to back a single-payer plan and affirm that health care should be a human right, support for Medicare-For-All is popular — 85 percent of Democrats and 52 percent of Republicans back it, according to a Reuters survey conducted last summer.

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