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Medicare for All absent from progressives' agenda

May 6, 2024

Rep. Pramila Jayapal at a January news conference. Photo: Julia Nikhinson/Bloomberg via Getty Images

The Congressional Progressive Caucus' latest agenda is noteworthy mostly for what's not there: any mention of Medicare for All.

Why it matters: It's an acknowledgement that a single-payer health system is unachievable at the national level in the current political climate after being a cornerstone of progressive campaigns and congressional speeches for more than two decades.

  • Instead, the group is focusing on incremental changes like closing the Medicaid coverage gap, lowering drug prices and expanding traditional Medicare to include dental, vision and hearing.
  • That more closely aligns the group with President Biden, who vowed to veto Medicare for All over its cost.

What they're saying: "Medicare for All is central to progressives' agenda but it's certainly going absolutely nowhere right now given Biden's opposition," said Larry Levitt, executive vice president for health policy at KFF.

  • "This is a health care agenda that's in the realm of possibility if Democrats controlled the White House and Congress."

Progressive Caucus Chair Pramila Jayapal characterized the group's recently released 2025 wish list as a "day one" agenda focused on what's "populist, popular and possible."

  • "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?"
  • She emphasized that the CPC hasn't given up on the goal of a single-payer health care system, but that the group is playing the long game.
  • Indeed, Sanders, in his re-election video posted Monday, touted universal health care without laying out a timetable.

Flashback: Just before Biden took office, at the end of 2020, the CPC released a 2021 progressive agenda with goals to "ensure health care for everyone" and "work towards Medicare for All."

  • It endorsed policies that would have expanded Medicare to anyone who lost their job during COVID-19, as well as all children up to age 25.
  • But many progressive priorities got axed in negotiations over the Inflation Reduction Act over cost concerns, prompting the group to narrow its short-term ambitions.

Zoom in: The new agenda doesn't include any wording on Medicare for All, instead endorsing going farther on several other Biden administration policies.

  • It would expand Medicare drug price negotiation to all drugs, and calls for publicly manufacturing certain generic drugs.
  • It also supports lowering the Medicare eligibility age (though a specific age isn't mentioned) and expanding Medicare to include dental, vision and hearing.
  • The group also wants to crack down on private equity in health care, increase funding for all public health care systems and to remove medical bills from Americans' credit reports.

The intrigue: One top priority also missing from the agenda will be a big issue in the next Congress: extending the enhanced ACA subsidies which expire in 2025.

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

The bottom line: Medicare for All isn't gone forever.

  • Most Democrats don't want to cut the population of people who depend on the government for health coverage.
  • But, steps like growing Medicaid coverage in holdout states that resisted Obamacare's expansion are a step-wise approach to a more universal health care system.
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