‘Single payer’ hearing highlights differences among Democrats

By | May 22, 2019

A hearing Wednesday intended to focus on legislating a fully government-financed healthcare system exposed the differences Democrats have on healthcare.

The hearing, in the House Budget Committee, stood in contrast to another that occurred in the House Rules Committee in April, in which Democrats set aside their internal healthcare disputes to have an in-depth discussion about what government healthcare might look like and to explore the problems in the current healthcare system.

On Wednesday, they continued to focus their ire on Republicans for working to undo Obamacare, but several lawmakers took their allotted time of questioning to highlight alternatives they supported.

More than 100 House Democrats support the Medicare for All Act, long championed by Democratic presidential candidate Bernie Sanders, I-Vt., which would move everyone living in the U.S. onto a government plan.

But some of those co-sponsors have also backed other bills. The Medicare for America Act, which lead sponsor Rep. Rosa DeLauro, D-Conn., highlighted during her remarks, would automatically enroll the uninsured and people who buy their own coverage into a government plan, while letting employers offer public plans to their workers. Other bills would let more people enroll in Medicare or Medicaid.

“The shared goal is looking at the way we achieve universal coverage in the U.S.,” DeLauro said.

Democrats have worked to portray the party as united on the goal of providing medical coverage to everyone living in the U.S., but many remain divided on which policies to pursue if a Democrat wins the White House in 2020.

Rep. Seth Moulton, D-Mass., for instance, said he favored letting more people buy into a government plan in the same way that people had the option to use the Postal Service or private delivery services.

“Just like we have options for delivering packages, I think we should have options for delivering healthcare,” he said.

The hearing was intended to talk generally about what it would be like for the U.S. to transition to a fully government-financed healthcare system, often known as “single payer,” and analyzed a report the Congressional Budget Office published this month. The lawmakers questioned CBO officials about what kinds of services would be covered, how the system could be financed, and whether people would have improved access to medical services.

To many of the questions, the officials replied, “It depends.”

They stressed that much of how a government-financed healthcare system would turn out would depend on factors such as what the government chooses to pay healthcare providers, whether it charges patients anything for their care or tries to pay it all in taxes, and whether the payments will be enough to ensure that people won’t lose access to healthcare.

CBO Deputy Director Mark Hadley said allowing the government to fully fund the healthcare system could be “complicated, challenging, and potentially disruptive” and could “significantly increase government spending.” He said that people could potentially have access to more doctors and hospitals if the government became the only payer — doing away with health insurance networks — but alternatively that an increase in demand could lead to longer wait times and problems with access.

Republicans seized on many of these potential downsides, warning of reduced choice and decrying the issues faced in Obamacare as a warning sign of what other people would experience under a government healthcare plan.

“They’re admitting that Obamacare failed,” said Rep. Chris Stewart, R-Utah.

Rep. Pramila Jayapal, D-Wash., who introduced the Medicare for All Act, said during the hearing that she still expected the Budget Committee to hold another hearing on the topic, this time entirely focused on her bill.

“I can’t wait to have the hearing on my bill,” she said.

Throughout the hearing, going up against Republicans was the unifying factor for Democrats.

“Today’s naysayers don’t have any plan at all,” Rep. Lloyd Doggett, D-Texas, said. “They have had eight years to present an alternative to Obamacare, and what do we have? Republican nothingcare.”