By Jack Runyan
The AHCA’s failure was a monumental defeat for the Trump & the Republican Party. This defeat arose from a combination of factors, such as the House Freedom Caucus failing to rally for any health care bill that seemed reminiscent of the ACA’s regulatory framework, as well as pressure on moderate Republicans to vote against the bill from constituents at town halls. Of course, a lot of the damage was self-inflicted: the reality is that Speaker Paul Ryan put forth a set of vastly unpopular policies (only 17% of Americans supported Trumpcare) and the party did not put much effort into organizing around these policies. It’s also fair to say that even President Trump’s effort was no where close to President Obama’s in securing the ACA’s passage.
For the moment, the ACA is safe. But Paul Ryan is not done with trying to undermine the state of health care in the United States. He is meeting with donors on Thursday and Friday with a rough plan of what his next push on health care would be like. So if elected Democrats consider the issue of the ACA resolved, they had better think again.
In fact, Democrats have a window to strike back on health care before Paul Ryan is able to organize another push against the ACA. This window is accompanied by a unique surge of energy for health care reform precipitated by the AHCA’s defeat, which some elected Democrats are recognizing. According to reports, Rep. Jim Langevin (D-RI) wants to look at single-payer as a solution, whereas Senator Sheldon Whitehouse (D-RI) indicated his support for a public option. Senator Brian Schatz (D-HI) tweeted out his support for looking into a single-payer system, and Senator Elizabeth Warren (D-MA) indicated her support for pushing for either a public option or single-payer, which is noteworthy since Senator Warren has not been a consistent single-payer advocate (contrary to popular belief). All of these statements occurred in the wake of the AHCA’s debate.
It would be unwise for elected Democrats to ignore this surge of energy in favor of stronger health care reform, particularly since another legislative assault on the ACA is looming. Democrats should unify around a major fix for the ACA immediately, which would accomplish a few major objectives. First, it would speak to those who have grievances with the ACA (e.g. people with high deductible plans), but who are generally people who support keeping the law in place. Second, it would put the Republicans on the defensive; a Democratic plan on health care is likely to poll much better than whatever Paul Ryan proposes. Thirdly, it would introduce a rallying issue for Democrats that will be key to taking back Congress (and state-level offices) in 2018. Finally, it would also make the prospect of saving the ACA much more likely: people pressuring GOP legislators at town halls or through phone calls could then clearly point to a Democratic plan on health care that is more popular.
What Democrats ultimately unify around remains to be seen (though I’ve made the case that Democrats should just run on Medicare for all). That said, the loudest advocate for single-payer in Congress right now is Senator Bernie Sanders, who plans to introduce legislation within a couple weeks congruent with his desire to see Medicare for all in the United States. How much cooperation he will be able to secure from his Democratic colleagues in this push remains to be seen; furthermore, there is a Medicare for all bill in the House sponsored by Rep. John Conyers (D-MI-13) with dozens of cosponsors (including the new deputy DNC chair, Rep. Keith Ellison). Whether the bill Senator Sanders puts forth resembles the framework of the House bill is unknown as well. Another policy choice for Democrats to rally around is a push for a public option and a Medicare buy-in for those individuals over 55 years old, which are policies incorporated in the 2016 Democratic platform.
Regardless of whether it is single-payer, a public option, or a Medicare buy-in, do any of these proposals stand a chance of passing a Republican-controlled Congress or a Trump White House? No, but that’s not the point. The point is to show the American people that Democrats are for a much more popular alternative than Paul Ryan’s on health care, which is important for long-term party-building and our electoral prospects in 2018. So Democrats shouldn’t wait for the next GOP assault on health care. They need to unify behind a comprehensive fix for the ACA and loudly encourage voters to rally around it. And if nothing else, such an act may enhance our chances of saving the ACA the next time Paul Ryan comes back with his next tax cut for the rich that’s masquerading as a health care plan.