Despite support for a Medicare-for-All plan among Democratic voters, progressive activists have no choice but to keep their expectations in check. Even if Democratic policymakers were able to come together on such an ambitious overhaul of the existing system -- an incredibly difficult task, to be sure -- there's a Republican majority in the Senate and a Republican White House.
All of which means anything resembling a single-payer model will have to wait.
But in the meantime, proponents of the idea can start laying the policy groundwork for future reforms. The Washington Post reported overnight:
The new Democratic majority in the House will hold the first hearings on Medicare-for-All legislation, a longtime goal of the party's left, after Speaker Nancy Pelosi lent her support for the process. [...]Pelosi, who had been a co-sponsor, said throughout the 2018 campaign that Democrats were free to discuss many other health-care programs. She strongly suggested that a Democratic House would at least hold hearings on the far-reaching Jayapal bill; on Wednesday, [Rep. Pramila Jayapal (D-Wash.)] got Pelosi's commitment to hearings in the Rules and Budget committees.The incoming chairmen of those committees, Reps. Jim McGovern (D-Mass.) and John Yarmuth (D-Ky.), support Medicare for All, and Yarmuth had told reporters last year that he would like to use his committee for hearings on how single-payer health care could work.
Hmm. So if I understand this correctly, members of Congress are planning to hold something called "hearings," which will be open to the public, in which they'll closely examine a complex policy proposal in detail. As part of the process, lawmakers will invite subject-matter experts to offer testimony and answer questions, all in the hopes of better understanding the practical implications of an idea.
Or put another way, the U.S. House is preparing to do something we haven't seen much of since before the 2010 midterms.
All joking aside, I think this speaks to the asymmetry between the parties, especially when it comes to health care. When House Republicans crafted their "repeal and replace" bill, intended to tear down the Affordable Care Act, they refused to hold any substantive hearings on their legislation.
The GOP bill was written in secret, and passed without any meaningful scrutiny of the bill or its implications. The bill died in the Senate, but even there, nearly all of the Republicans in the upper chamber backed the bill without so much as a single committee debate.
It's too soon to say what'll become of Medicare-for-All proposals or what hearings on the idea will produce, but the fact that Democrats are taking scrutiny of the idea seriously, and are preparing to do the necessary and substantive legwork, suggests they're at least meeting the bare-minimum standards of how legislating in the United States is supposed to work.
It's a standard House Republicans too often failed to meet. The resulting dynamic highlights the difference between real governing and post-policy governing.