November 16, 2018
House Democrats of the “Medicare for All” caucus are pushing for a vote on the legislation, but the issue could divide the party, with a number of key members looking to strengthen the Affordable Care Act before tackling broader reforms.
Aligning House and Senate Bills: Rep. Pramila Jayapal (D-WA), cofounder of the Medicare for All caucus, is rewriting the leading single payer bill in the House to more closely mirror Sen. Bernie Sanders' (I-VT) legislation, but some differences are likely to remain between the two bills.
Split in the Democrat caucus? Rep. Frank Pallone (D-NJ), likely chair of the Energy and Commerce Committee, has indicated he is not interested in holding hearings or a vote on the issue and pointed to smaller steps to shore up the ACA. However, Rep. Raúl Grijalva (D-AZ), co-chair of the Congressional Progressive Caucus, acknowledged that the Democratic base is expecting votes on these and other progressive issues.
Expanding Medicare coverage could be an interim step: Rep. John Larson (D-CT) said that allowing people 50 and over to buy into Medicare is a more “intelligent and incremental” way to address the issue.
Slow walking in California? While incoming Gov. Gavin Newsom (CA) campaigned in part on implementing single-payer in the state, he has recently questioned whether it could be achieved given the Trump administration’s opposition.
Outlook: Likely House speaker Rep. Nancy Pelosi (D-CA) and committee chairs may focus first on reducing drug prices, protecting coverage for pre-existing conditions, and funding state reinsurance programs before moving single-payer legislation next year. There may be hearings on the issue to set the stage for the 2020 campaign, but it remains to be seen whether Democrats can solve their differences before then.