DEMS PROGRESSIVE SHIFT Begins Series Of ESTABLISHMENT CHALLENGES
Democrats’ embrace of sweeping progressive ideas like Medicare for All and the Green New Deal is about to get its first reality check on Capitol Hill — as both parties make huge bets about which message will sway voters in 2020.
For liberal Democrats, proposals to provide universal health care, combat climate change and create a fairer economy represent the kind of bold agenda they will need to unseat President Donald Trump, a candidate unafraid to make his own brash moves on trade and immigration. But Republicans are seizing on the same proposals to paint Democrats as socialist radicals, while trying to widen the ideological splits already emerging among Trump’s would-be challengers.
Senate Republicans plan to force a vote as early as next week, S.J. Res. 8, on progressives’ Green New Deal climate resolution, which has drawn support from almost all of the chamber’s declared and potential Democratic presidential hopefuls. House Democrats, meanwhile, are set to unveil legislation guaranteeing government-funded health care for all Americans — amid conflicting poll numbers about voters’ willingness to upend the existing health insurance market.
It’s the beginning of what promises to be a series of high-stakes tests that both parties insist will work to their advantage.
“The Republicans are misreading the moment,” said Sen. Brian Schatz (D-Hawaii), an outspoken liberal on issues like climate change. “We have never been more fired up.”
In fact, some progressives have invoked Trump’s upset 2016 win as an argument for taking a bold strategy into 2020 — evidence that Democrats should focus more on articulating popular core values and less on worrying about the practicalities. In the same way Trump fired up his base with pledges to build the wall and make America great again, progressives believe Democrats can piece together an even bigger coalition by branding themselves as the party of universal health care and economic equality.
“You could actually credit Donald Trump for this,” said Faiz Shakir, the new campaign manager for Sen. Bernie Sanders’ 2020 run. “The kind of not giving a crap what others think, or what his critics think, and just plowing ahead with a vision has made progressives hungrier for a version of, well, what would that look like [on the left]?”
But top Republicans say they see Democrats veering off a socialist cliff — citing the Green New Deal, H. Res. 109 (116), and S. Res. 59, co-authored by New York freshman Rep. Alexandria Ocasio-Cortez as a prime example.
“It’s entirely fantasy, it’s unrealistic. These are just talking points designed to appeal to the fringe of their party,” said Sen. John Cornyn (R-Texas). He added, “It’s ended up causing quite a headache for our colleagues across the aisle who’ve tried to explain exactly what they’re trying to do and how they’re trying to do it.”
The debate in Congress’ opening months follows more than two years of arguments by progressive activists that Democrats need to be more than just the anti-Trump party to succeed in 2020. They say transformative policies are also increasingly necessary to counter major crises like a changing climate and the growing power of the super-rich.
Even before Democrats finish drafting bills to create a single-payer health care system, the health care and insurance industries have assembled a small army of lobbyists to kill “Medicare for all,” an idea that is mocked publicly but is being greeted privately with increasing seriousness.
Doctors, hospitals, drug companies and insurers are intent on strangling Medicare for all before it advances from an aspirational slogan to a legislative agenda item. They have hired a top lieutenant in Hillary Clinton’s 2016 presidential campaign to spearhead the effort. And their tactics will show Democrats what they are up against as the party drifts to the left on health care.
They also demonstrate how entrenched the Democrats’ last big health care victory, the Affordable Care Act, has become in the nation’s health care system.
The lobbyists’ message is simple: The Affordable Care Act is working reasonably well and should be improved, not repealed by Republicans or replaced by Democrats with a big new public program. More than 155 million Americans have employer-sponsored health coverage. They like it, by and large, and should be allowed to keep it.
“We have a structure that frankly works for most Americans,” said Charles N. Kahn III, the president of the Federation of American Hospitals, which represents investor-owned hospitals. “Let’s make it work for all Americans. We reject the notion that we need to turn the whole apple cart over and start all over again.”
The Democrats’ proposals could radically change the way health care providers do business and could drastically shrink the role and the revenues of insurers, depending on how a single-payer system is devised.
The hospital federation and two powerful lobbies, America’s Health Insurance Plans and the Pharmaceutical Research and Manufacturers of America, created a coalition last June to pre-empt what they saw as an alarming groundswell of interest in proposals to expand the federal role in health care.
In a daily fusillade of digital advertising, videos and Twitter posts, the coalition, the Partnership for America’s Health Care Future, says that Medicare for all will require tax increases and give politicians and bureaucrats control of medical decisions now made by doctors and patients — arguments that echo those made to stop Medicare in the 1960s, Mrs. Clinton’s health plan in 1993 and the Affordable Care Act a decade ago.
The coalition will step up the tempo in the coming week as Democrats in the House and the Senate plan to introduce bills to establish a single-payer system.
The name of the coalition is intentionally nondescript, and its executive director, Lauren Crawford Shaver, who led Mrs. Clinton’s efforts in 2016 to put marginal states into play, is cagey when asked for details. She says only that the group is planning “a big nationwide effort” with grass-roots allies.
But its reach is undeniable. The coalition has picked up more than 25 members, including the American Medical Association, the American Hospital Association and the nation’s Blue Cross and Blue Shield plans.
And it has already sprung into action.
When Senator Bernie Sanders, the author of the Medicare for All Act, announced on Tuesday that he was again running for president, the coalition immediately attacked him as “a leading advocate for upending our nation’s health care system in favor of starting from scratch with Medicare for all.”
Mr. Sanders, independent of Vermont, fired back at the insurance and drug companies. “They make tens of billions of dollars a year in profits from this dysfunctional health care system and pay their C.E.O.s outrageous compensation packages,” Mr. Sanders said. “We’ve expected their opposition all along.”
When members of Congress unveiled legislation to let people age 50 to 64 buy into Medicare, the coalition conflated it with proposals to put all Americans into Medicare.
“This is a slippery slope to government-run health care for every American,” said David Merritt, an executive vice president of America’s Health Insurance Plans, a lobby for insurers.
The buy-in proposal for older Americans dates back to Bill Clinton’s presidency, and many of its advocates have put it forward as a moderate alternative to Medicare for all.
But the coalition said the proposal was wrong for America, “whether you call it Medicare for all, Medicare buy-in, single payer or a public option.”
The chief sponsor of the House buy-in bill, Representative Brian Higgins, Democrat of New York, said: “The critics lump our bill with the bigger Medicare-for-all proposal. That’s strategic, and I think it’s deliberate.”
Mr. Higgins said the option of Medicare at age 50 would create “a countervailing force to private insurance.”
Senate Majority Leader Mitch McConnell’s call for a vote on the Green New Deal is aimed purely at driving a wedge through the Democratic Party, forcing liberal senators and vulnerable centrists alike to weigh in on a proposal that envisions remaking the U.S. economy in just a decade. Already, moderate Democratic senators like Debbie Stabenow of Michigan and Joe Manchin of West Virginia have groused publicly about the plan as moving too far, too fast.
Republicans in the House, meanwhile, are pressing for a series of hearings on Medicare for All, certain that enthusiasm for single-payer health care will plummet as voters study the details and trade-offs.
“Democrats’ Medicare for All proposal would force over 150 million Americans to lose their employer or their union-sponsored insurance,” said Oregon Rep. Greg Walden, the top Republican on the House Energy and Commerce Committee. “You want to talk about sabotage? That’s what we should be having a hearing on.”
Democrats’ liberal wing vows to meet that challenge head on. And they’re expecting the party’s growing list of presidential candidates to stand with them through the long, bruising 2020 campaign.
Already, all six Democratic senators running for president have co-sponsored the Green New Deal, and five signed on last year to Medicare for All legislation. Sanders (I-Vt.) and Sen. Elizabeth Warren (D-Mass.) have sought to further separate themselves from the pack — Sanders is running as a democratic socialist in favor of free college and a break-up of the big banks, while Warren has rolled out plans for a wealth tax and universal child care.
In Congress, House progressives next week are rolling out a detailed road map to single-payer health care — even as party leaders urge a focus on the more immediate, incremental health issues that sparked their midterm electoral wave just months ago.
“What we’re proposing is really a transformation of the health care system to get out the pieces that are so embedded in it that it continues to make health care costs equivalent to 19 percent of GDP,” said Rep. Pramila Jayapal (D-Wash.), a Congressional Progressive Caucus leader who’s penning the Medicare for All bill. “The majority of the American public believes we should have what almost every other industrialized country in the world has.”
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