By Samantha Young
January
2, 2019
WASHINGTON,
D.C. — Each of the seven California Democrats who flipped Republican
congressional seats in the midterm election campaigned for more
government-funded health care — with most of them calling for a complete
government takeover.
So when
they join the Golden State’s delegation this week, they will make it the
largest state bloc to support “Medicare-for-all” in the U.S. House of
Representatives. And Democrats, of course, will control the House.
Despite
this political shift, the reality is that there’s probably not going to be much
progressive health care legislation coming out of Congress in the next two
years — a point on which even Democratic lawmakers agree.
“We
need to do the things that are doable — that aren’t pie in the sky,” said U.S.
Sen. Dianne Feinstein, a Democrat and the dean of the California delegation.
Democrats
will hold 46 of the state’s 53 congressional seats in the House. It’s the
largest contingent of Democrats the state has ever sent to Congress, according
to membership rosters on the congressional History, Art & Archives website. All but
seven of them have publicly supported, at one time, some form of
government-financed health care — whether a sweeping Medicare-for-all program
that would provide health insurance to all Americans, or an optional “public
option” plan for those who want it.
California’s
Democratic junior senator, Kamala Harris, who is contemplating a presidential
bid, also supports Medicare-for-all, calling it “the moral and ethical thing
to do.”
But the
U.S. Senate will remain under Republican control, and Republican President
Donald Trump has lambasted the
idea of more government involvement in health care. Because of that political
reality, Feinstein and others have said, the state’s freshman lawmakers who are
eager to push forward on Medicare-for-all or a public option ought to refocus.
In a
midterm election where health care ranked as the No. 1 concern of many voters,
congressional newcomers Josh Harder, Katie Porter, Katie Hill, Harley Rouda and
Mike Levin won their elections after campaigning for Medicare-for-all, the
concept of one government-run health care program made popular by Sen. Bernie
Sanders (I-Vt.) during his 2016 presidential bid.
Meanwhile,
candidates Gil Cisneros and T.J. Cox promoted a public option, which would
allow consumers to voluntarily buy in to a government-financed health care
plan, such as Medicare or Medicaid.
None of
the seven freshmen Democrats agreed to an interview to discuss their ideas about
health care in the new Congress, nor would they provide a spokesperson. It’s
unclear whether they’ll make a big push for the progressive causes they pitched
on the campaign trail.
In a
twist, a mid-December ruling by
a Texas judge that declared the Affordable Care Act unconstitutional could
actually help Democrats. Instead of arguing for Medicare-for-all, they can now
pivot to protecting the law and its popular provisions, including protections
for people with preexisting conditions.
“A
conservative judge in Texas may have given new Democratic representatives in
California a lot more leeway on health care than they had a week ago,” said Dan
Schnur, a University of Southern California professor and former Republican
strategist. “There’s a lot of potential health care legislation that’s going to
be very popular in their districts.”
In the
weeks leading up to the election, Harder, who beat Republican incumbent Jeff Denham
in the Central Valley, was already tempering expectations about how effective
Democrats could be next year.
“I
think the reality is under a Trump presidency, it’s probably not going to be
passed in the next two years,” Harder said about Medicare-for-all. “But we need
to be making it very clear what we’re standing up for, and we’re standing up
for the fact that every individual needs to be covered.”
A day
after she won her congressional seat, Porter, who made Medicare-for-all an
integral part of her campaign, told supporters it
would have to wait.
“I
think until we pass campaign finance reform, doing anything on health care is
going to be a big challenge,” she said.
Part of
the challenge for Porter, along with the rest of her new colleagues, is that
they hail from swing districts. Each of them flipped Republican seats, and they
will need to adopt a more centrist tone if they want to stay in Congress,
political observers say.
“The
reality of advocating for single-payer and the actuality of what it means is
sobering,” said Lanhee Chen, director of domestic policy studies at Stanford University.
“If you’re vulnerable, on Day One, by the nature of demographics of your
district, I think it becomes harder to embrace.”
And
while California voters ushered in a new class of progressives, they also gave
a sixth term to Feinstein, who has openly warned against the cost and
feasibility of a Medicare-for-all system. And likely incoming House Speaker
Nancy Pelosi (D-San Francisco) has said she intends to focus on fixing
lingering issues with the federal health care law, not push ahead with Medicare-for-all.
Other
centrist Democrats say Congress ought to work out how to stabilize the health
care markets or allow Americans 55 and older to buy into Medicare, which is
currently open to those 65 and older. Feinstein, for example, also supports
giving Medicare the ability to negotiate the price of drugs.
“Let’s
build off of the gains we made in the Affordable Care Act,” said Rep. Ami Bera
(D-Elk Grove), “but let’s also address some of the things Republicans did to
undermine the ACA markets.”
Samantha
Young: syoung@kff.org,
@youngsamantha
https://californiahealthline.org/news/en-route-to-congress-california-democrats-hit-wall-on-medicare-for-all/?utm_campaign=KFF-2019-The-Latest&utm_source=hs_email&utm_medium=email&utm_content=68700082&_hsenc=p2ANqtz--iLvvFGBIJmNgtLSaFn7r079gR29LgddDiadLOgOmp71o_6QKSAI8BnZ-CgNYr8MiMpatfs27U2_wF4OLODUJ16r0MMA&_hsmi=68700082
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