On Wednesday, Sen. Bernie Sanders (I-Vt.) introduced a bill to socialize medicine with the goal of turning the United States into a single-payer health care nation in the name of “Medicare for All.” While many top contenders for the 2020 Democratic presidential nomination have cosponsored his legislation, Sanders’ quixotic push spells doom for red-state Democrats in 2018 — and may cast a pall on the party’s chances to defeat President Trump in three years.
“Health care in America must be a right, not a privilege,” Sen. Sanders declared. “Today, we begin the long and difficult struggle to end the international disgrace of the United States, our great nation, being the only major country on Earth not to guarantee health care to all of our people.”
Sanders’ suggestions may sound appealing, but they would mean higher taxes and less control over health care, along with a massive increase in the federal government’s control over the economy. This makes the single-payer issue extremely divisive in the Democratic Party, and a political powder-keg for the Left.
Even so, CNN’s Eric Bradner reported that Sanders’ health care plan “is already emerging as a litmus test for the Democratic base — much like Iraq was in 2008, when Barack Obama campaigned against Hillary Clinton’s vote in favor of the war and Clinton resisted saying she’d been wrong.”
With the notable exception of former Vice President Joe Biden — who has not announced his position on Sanders’ bill — the most likely Democratic prospects for 2020 have all supported the measure.
In a townhall last month, Sen. Kamala Harris (D-Calif.) announced, “I intend to co-sponsor the Medicare-for-all bill, because it’s just the right thing to do.” Sanders tweeted his thanks.
— Bernie Sanders (@SenSanders) August 30, 2017
Last week, Sen. Elizabeth Warren (D-Mass.) announced her support. “I believe it’s time to take a step back and ask: what is the best way to deliver high quality, low cost health care to all Americans?” Warren asked. “Everything should be on the table — and that’s why I’m co-sponsoring Bernie Sanders’ Medicare for All bill that will be introduced later this month.”
Sen. Corey Booker (D-N.J.) announced his support on Monday, declaring: “You should not be punished because you are working-class or poor and be denied health care.” He argued that while “Obamacare was a first step in advancing this country,” he “won’t rest until every American has a basic security that comes with having access to affordable health care.”
On Tuesday, Sen. Kirsten Gillibrand (D-N.Y.) jumped on the bandwagon, tweeting that she would “proudly join Senator Bernie Sanders to co-sponsor Medicare for All.”
Health care is a right, not a privilege. This week, I'll proudly join Senator @BernieSanders to co-sponsor Medicare for All.
— Kirsten Gillibrand (@SenGillibrand) September 12, 2017
Sen. Al Franken (D-Minn.) — who just last week compared a mainstream religious freedom law firm to the Cambodian dictator Pol Pot — joined these other potential 2020 challengers on Tuesday. Franken called the bill an “important marker,” but admitted that it likely would not pass. While the bill is “aspirational,” Franken said he was “hopeful that it can serve as a starting point for where we need to go as a country.”
For nearly every bold 2020 hopeful backing Sanders’ bill, however, there is a vulnerable Democrat hesitant to touch the issue.
Sen. Joe Manchin (D-W.Va.) said Tuesday he was “skeptical” of a single-payer health care system. “I am skeptical that single-payer is the right solution, but I believe that the Senate should carefully consider all of the options through regular order so we can fully understand the impacts of these ideas on both our people and our economy.”
Another vulnerable Democrat, Sen. Sharrod Brown (D-Ohio), proposed a separate bill to decrease the age of Medicare eligibility from 65 to 55. This plan echoed Hillary Clinton’s “Medicare for More” proposal. “This is the next major expansion,” Brown said. “I don’t fault anybody for going different places, but this is the most practical, sellable, sensible way to expand health insurance for people.”
“I’ve had enough trouble trying to save Obamacare,” Sen. Bill Nelson (D-Fla.) told The Tampa Bay Times. He said Sanders’ single-payer push is “way on down the road,” and suggested that attempts to “repeal and replace” Obamacare will not prove “very ascendant in next year’s election.”
Sen. Claire McCaskill (D-Mo.) told Politico that Congress should work to keep health care costs in check “before we would think about expanding that [Medicare] system to everyone.”
Another Democrat, Sen. Bob Casey (D-Pa.), argued for a public option for Medicare, and expressed hesitancy about Sanders’ bill.
Democrat leaders also expressed skepticism on Tuesday. Senate Majority Leader Chuck Schumer (D-N.Y.) said, “Democrats believe that health care is a right for all, and there are many different bills out there.” He refused to support Sanders’ proposal.
House Minority Leader Nancy Pelosi (D-Calif.) also distanced herself from the bill. “Right now I’m protecting the Affordable Care Act.”
Recent polling has suggested an increase in support for single-payer, especially among Democrats. In June, Pew Research reported that 33 percent of Americans favor “a single national government program” for health care, while 25 percent preferred a “mix of private and government programs” and 33 percent supported keeping Medicaid and Medicare.
A Quinnipiac poll last month found 51 percent of Americans described a “single-payer health care system” as a “good idea,” with 67 percent of Democrats supporting it and 62 percent of Republicans opposing it.
Nevertheless, a July poll by the Kaiser Family Foundation found that support for the idea is very malleable. While 55 percent favored a single-payer system at first, arguments against it swayed people surprisingly quickly.
When respondents were warned that the program would give the government too much control over health care, 21 percent changed their minds, bringing opposition up to 62 percent. When respondents were warned the program might lead to higher taxes, 19 percent switched sides and 60 percent opposed it.
These numbers are extremely important, because Sanders’ bill would increase the size and scope of the federal government and cost Americans a pretty penny. Unsurprisingly, Sanders has been skittish about nailing down a figure.
While the bill Sanders proposed Wednesday was not his original platform from the campaign, it is reasonable to consider that the new bill’s price tag would be similar, if a bit smaller, than the cost of his original proposal. That platform came with an estimated annual price tag of nearly $1.4 trillion, to be paid for by a proposed 2.2 percent income tax on all Americans, a 6.2 percent levy on employers — thus pushing down job availability — and a further round of tax increases for the wealthy.
Americans in red states, who voted for Donald Trump last year, would be unlikely to stomach this policy in the 2018 elections. If Republicans make the right arguments against single-payer, this might even be a powerful issue for 2020.
On Tuesday, MSNBC host Chuck Todd pointed out that “Sanders is driving a big wedge between the progressive left and the moderate left with his Medicare-for-all health care bill.” He noted that most senators who signed onto the bill are also eyeing a presidential run in 2020, and that none of them is likely to be vulnerable in 2018.
“Not a single Senate Democrat that’s facing a tough reelection in 2018 — including Sherrod Brown, who normally would be on board with something like Medicare-for-all — they haven’t signed on,” Todd noted.
Single-payer health care seems to carry the same divisiveness as the abortion “litmus test” pushed by liberals who would not see any pro-life Democrat in the party. The abortion test may prove particularly sticky, because the last time Democrats won the House, in 2006, they did so with quite a few pro-life candidates.
Bernie Sanders may be pushing the Democratic Party further left for 2020, but if the Democrats squander 2018 that may sabotage further electoral hopes. At the end of the day, Sanders’ “Medicare for All” plan requires winning seats in Congress — and ultimately, the presidency.
It seems Democrats staring down the 2018 election in red states are rather hesitant to offer their necks for a quixotic Vermontian vision. But if the party keeps pressing the issue, they may have no choice.