The third presidential debate takes place today and if candidates discuss Medicare for All, you know what we’ll be reading tomorrow: a flurry of stories, tweets, and columns from the punditocracy predicting calamity for the Democrats if they nominate a candidate who endorses the bill.
David Axelrod was on Pod Save America last week warning that the eventual Democratic nominee will snatch defeat from the jaws of victory if they back Medicare for All. Rahm Emanuel, who infamously warned President Obama that he would be a one-term president if he signed the Affordable Care Act into law, did the same on MSNBC earlier this week.
But worrying that support for Medicare for All will turn off voters in the 2020 general election is silly when compared with what Trump is offering. Republicans spent 2017 trying to take health care away from Americans. In response, voters packed town halls and jammed switchboards on Capital Hill to demand that lawmakers leave the Affordable Care Act (ACA) alone. And it worked. Despite controlling the House, the Senate, and the White House, Republicans failed to repeal the ACA. In 2018, voters put an end to GOP health care “reform” efforts by putting Democrats in charge of the House.
Steve Greenhouse, author of the new book Beaten Down, Worked Up: The Past, Present, and Future of American Labor, accurately summed up the state of the health care debate in a recent interview: “There’s one party that’s trying to create a safety net for [Americans] on health and a whole other [party] trying to take away the health safety net from them.”
Democrats do not need to overthink this. In 2020, the health care message will be simple: We want to make sure you don’t have to launch a Kickstarter campaign to pay for chemotherapy. The other guy doesn’t even care that you’re sick.
The conventional wisdom from pundits that Medicare for All is too far left belies the fact— as Pete Buttigieg noted during the first Democratic debate—that Republicans are going to describe every idea put forward by the eventual Democratic nominee as socialism. Just look at how successful they were in propagandizing the ACA. The GOP took a business-friendly piece of legislation modelled after Mitt Romney’s 2006 Massachusetts health reform law and turned it into a communist plot.
Given that we know how it’s going to play out, warnings from pundits that Medicare for All “goes too far”—whatever that means—seem a bit off. Axelrod likes to remind people that he was in the White House when the ACA passed and that attempts to include a Medicare-esque public option in the bill failed because the idea wasn’t popular.
“It does seem if you’re running for president that you ought to take into consideration what the country wants,” Axelrod said on CNN after the first Democratic debate when nearly every candidate raised their hands in support of Medicare for All. “I was in the White House when we fought just to get the Affordable Care Act. Couldn’t get a public option. … Do we move forward with these idealized proposals that are going to beg opposition and make it easier for Donald Trump to make his case and win reelection?”
Make his case? First, what case is Trump making, exactly?
Second, what is Axelrod even talking about? In truth, during the 2009 health care debate, polls showed that there was enormous support for including a public option in the ACA. To understand how the popular proposal was eventually killed (hello Joe Lieberman), this piece by Health Affairs walks you through the policy, politics, and history of the public option, beginning with its introduction as a legislative idea in a 2001 California health reform bill. Meanwhile, there has been steady majority support in public opinion polling for a national health care plan since the spring of 2017, when Republicans put forward one bill after another that would have taken health care insurance from millions of Americans who now have it through the ACA.
Support for Medicare for All won’t kill the Democratic presidential nominee’s prospects in 2020. But making key political decisions from a place of fear will.
Susan Ryan-Vollmar, a communications consultant, was formerly editor-in-chief of Bay Windows and news editor of the Boston Phoenix.