Obamacare repeal is officially dead. On to the battle over Medicare for All.
Tuesday’s midterm victories by Democrats mean that Republicans no longer have a path to make major changes to the Affordable Care Act. It also sets up a debate between Democrats’ liberal and moderate wings over whether to embrace a broad expansion of insurance to all Americans as they prepare to challenge President Donald Trump for the presidency in 2020.
Once considered an outlier position, Medicare for All has gained substantial support among Democrats thanks to midterm primary victories by progressives who embraced.
In its broadest terms, the proposal would expand benefits in Medicare — which covers more than 50 million elderly or disabled Americans — and offer it to working age people. It would be a radical change to U.S. health care, potentially dismantling much of an existing system where people get health benefits through work. It would also shift trillions of dollars that the country currently spends on private insurance.
“Medicare for All has really been a slogan that has not been well-defined, and it was weaponized by the Republican party as some kind of an attempt to socialize the medical system,” said Dan Mendelson, founder of the consulting group Avalere Health.
“It’s really going to be important for anyone running for president to define what they mean by Medicare for All,” he said.
A presidential primary may ratchet up pressure on candidates to move left on health care. In the Senate, 2020 hopefuls including senators Cory Booker, Kirsten Gillibrand, Kamala Harris, and Elizabeth Warren have all co-sponsored a Medicare for All bill from Senator Bernie Sanders. Another supporter of a public insurance option is Rep. Beto O’Rourke, who lost a challenge Tuesday night to Republican Senator Ted Cruz in Texas, and who has emerged as one of the Democratic party’s young stars.
What individual politicians mean by Medicare for All may vary. Some early drafts of the Affordable Care Act included plans for a “public option” — a government-financed competitor to private insurers. That proposal didn’t make it into Obamacare in 2010, but Democrats who want to expand coverage without disrupting employer-based health plans could revive it.
Target for GOP
As Democrats fight out their future position, health care is likely to remain a line of attack for Republicans as well. Medicare for All has become a top target for Trump and his surrogates, who seem eager to paint it as socialism and a threat to current benefits for seniors.