Close Close

Life Health > Health Insurance > Health Insurance

Democrats Coalesce Around Health Care

Your article was successfully shared with the contacts you provided.

Big news on the health care policy front: Democrats appear to be converging on an actual agenda if they win in 2020.

Sen. Elizabeth Warren introduced new legislation on Wednesday that policy guru Charles Gaba calls “ACA 2.0.” The Huffington Post’s Daniel Marans has details here.

This is, as Gaba describes it, more than just patching up Obamacare to make up for the damage done by Congress, states and design flaws in the original bill. It’s an upgraded version of the Affordable Care Act. At the same time, it’s nowhere close to the various single-payer or “Medicare for all” proposals that liberals have been spending a lot of time talking about over the last two years.

(Related: Trump NHS Tweet Angers Brits Fearing U.S.-Style Health Care)

What’s interesting is that Warren is the senator carrying this bill, and its co-sponsors include Bernie Sanders, Kamala Harris and Kirsten Gillibrand. This vehicle has total buy-in from the senators most likely to run on the more liberal side of the Democratic Party in the 2020 presidential nomination contest. There’s also, by the way, a fairly similar House companion bill that was introduced recently.

All of which tells us two things. The first is that the more liberal wing of the Democratic Party is revealing a strong pragmatic streak when it comes to health care. None of these senators is giving up on single-payer as an aspiration. But they apparently recognize that “Medicare for all” is a long-run goal, and that they have a serious responsibility to also have a short-term, achievable and significant plan to improve on the post-Donald Trump, post-Paul Ryan status quo.

As I’ve long argued, the problem with the House Freedom Caucus and similar conservatives isn’t that they’re “too” conservative; it’s that they reject compromise and would rather prove themselves True Conservatives than actually achieve anything. It’s very good news for all of us that — at least so far — the new generation of very liberal Democrats doesn’t seem to be even remotely like that.

Secondly, we may be seeing an emerging consensus on health care that most of the Democratic Party can get behind — which would mean it has a pretty good chance of passing in some form if Democrats do have a unified government in 2021. Of course, it’s early, and a more modest alternative could wind up emerging. But it’s quite possible that relatively moderate liberals won’t come up with their own proposal but buy into this one or just begin with this and cut it back some.

One way or another, Democrats who care about health care are going to push presidential candidates to back aggressive legislation. In 2008, the leading candidates quickly signed on to the same basic concept that eventually became the Affordable Care Act. This time, we’ll almost certainly have some candidates who push strongly for a single-payer system, and others who say the best path is repairing Obamacare and then working for incremental change. But it’s quite possible that the split will matter less than consensus around something like what Warren has introduced.

— For more columns from Bloomberg View, visit


Jonathan Bernstein is a Bloomberg View columnist. He taught political science at the University of Texas at San Antonio and DePauw University and wrote A Plain Blog About Politics.