Leading establishment figures in the Democratic Party are coming around to Bernie Sanders’ proposal—once considered a left-wing moonshot—to create a massive, federally-funded health insurance system. The Hill reports:
Sen. Cory Booker is throwing his support behind a “Medicare for all” bill being introduced by Sen. Bernie Sanders (I-Vt.), becoming the latest Democrat floated as a 2020 contender to back the legislation.
“This is something that’s got to happen. ObamaCare was a first step in advancing this country, but I won’t rest until every American has a basic security that comes with having access to affordable health care,” Booker told the New Jersey outlet.
It seems certain at this point that the party’s 2020 nominee will campaign on something to the left of Hillary Clinton’s pro-Obamacare incrementalism; in all likelihood, that something will be a version of single-payer.
Meanwhile, the Republicans have proven unable to reverse president Obama’s landmark legislative accomplishment. The GOP proposal that is still making (increasingly lonely) rounds in the capitol, Cassidy-Graham, is more of a reform of Obamacare than a repeal.
In August, Peter Suderman wrote that “the future of health policy politics is Republicans defending something like Obamacare and Democrats pushing for something like single-payer.” With the Democrats marching left and the Republicans paralyzed, this seems increasingly likely to hold up.
The interesting thing about this new dynamic is that both the moderate wing of the GOP and the hardliners can claim vindication from it. Referencing Suderman’s prediction, David Frum, the Republican intellectual who in 2010 encouraged his party (in vain) to compromise with the Democrats on healthcare reform, remarked on Twitter that “my mistake was being 7 years ahead of the times.”
But the don’t-give-an-inch conservative hardliners could also argue that their views are being confirmed. They warned of a slippery slope from Obamacare, a relatively moderate bill, to “socialized medicine.” And, they might say, Bernie Sanders’ slow-moving triumph over the Democratic Party proves that they were right.
As the Overton window moves on healthcare, Republican moderates will become more convinced of the need to make only moderate reforms to the existing law to blunt the push for single-payer. And the right wing of the party will become more convinced of the need for total repeal to flatten the slippery slope. This stylistic debate—”fighter” vs. “squish”—also gets to the core of the Republican identity crisis on issues like immigration and religious liberty.
The Democrats are moving toward single-payer because they believe (probably rightly) that it will excite their base. But perhaps the even bigger advantage is that it drives a wedge into their opposition, exacerbating deep tensions and opening up old wounds.