May 8, 2024 - Health

Missing from progressives' 2024 agenda: Medicare for All

Illustration of a person looking over the edge of a large cliff chasm shaped like a medical cross

Illustration: Annelise Capossela/Axios

Four years after Medicare for All dominated the Democratic presidential primary, some of the policy's most ardent backers are laying low this election season.

Why it matters: It's an acknowledgement there's no immediate path for a single-payer system long supported by progressives, and it spares Democrats from an intraparty squabble as President Biden puts his health care achievements at the center of his reelection campaign.

Driving the news: The Congressional Progressive Caucus notably excludes any mention of Medicare for All in its new policy agenda for 2025, which the group says it crafted with input from outside organizations supporting the idea.

  • The document, which aligns more closely with Biden's vision for incremental health reforms, is focused on what's "populist, popular and possible," said caucus chair Rep. Pramila Jayapal (D-Wash.).
  • A "Day One" agenda in a possible second Biden term, the group of House progressives says, should focus on expanding coverage in the 10 states refusing Medicaid expansion to low-income adults, lowering drug prices, and adding dental, vision and hearing to traditional Medicare — all ideas that Biden has supported.

Jayapal emphasized that progressive lawmakers haven't abandoned their vision for what would amount to a major reordering of America's health care system, but the group is playing the long game.

  • "What we know is this president, our president, isn't for Medicare for All," she told Axios. "We had that fight during the campaign. So what we have done is ... say, what are the most important things we want to do?"

Yes, but: Progressives are still trying to tug Biden further left on some health care issues, particularly on drug pricing and Medicare.

  • Their agenda would extend Medicare price negotiations to all drugs, reflecting progressives' concerns that the government's new dealmaking powers are too limited. Biden has recently called for expanding Medicare negotiations from as many as 20 drugs per year to at least 50.
  • It also supports lowering the Medicare eligibility age without mentioning a specific target.
  • Biden four years ago supported lowering the Medicare age from 65 to 60, seemingly in an attempt to offer an olive branch to Medicare for All supporters. He's since dropped the idea.
  • The lawmakers also called for publicly manufacturing certain generic drugs to ensure they're offered to consumers "at a fair price."

The intrigue: One top priority also missing from the progressives' agenda will be a big issue next year no matter who's president: extending enhanced Affordable Care Act subsidies set to expire in 2025.

  • Some speculate the subsidies could become a bargaining chip, since they expire at the same time as former President Trump's tax cuts.

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