Just eight years ago, when the Affordable Care Act was being crafted in the Senate, this sort of moment seemed inconceivable, particularly to a group of centrist Democrats who actively worked to exclude a public option insurance plan in the bill.
Now out of office, these former lawmakers are more free to endorse bills without having to calculate the political risk attached. Which could explain why former senator Max Baucus (D-MT) said he supported the idea of Medicare for All last week, giving hope to single-payer advocates that there was, indeed, a sea change happening within the Democratic Party. Baucus, famously, led the process of crafting Obamacare in 2009 and 2010, during which time he pumped the brakes on efforts to include a public option insurance plan in the final package.
But in interviews with The Daily Beast, others who opposed, or were skeptical of, the public option did not share Baucus’ newfound support for single payer.
“Whether you call it a public option or you call it Medicare for All, what the advocates are really talking about is a governmentally controlled health care system,” former senator Joe Lieberman (I-CT) said in a phone interview with The Daily Beast. “Why is it happening now? I guess it’s a response to the failure of the Republicans to repeal Obamacare, which they kept yelling about.”
In late 2009, Lieberman, who was then serving as an independent from Connecticut, surprised his colleagues by ruling out a vote in favor of a version of the Affordable Care Act that included a provision allowing those over 55 to buy into Medicare. He had already joined with other Democrats to kill the public option. But because of his filibuster threat, the party’s fall-back option couldn’t be added to the bill.
Eight years later, the Democratic Party has had a significant lurch to the left, with its base growing enthralled by the prospect of a single-payer system. Lieberman, however, hasn’t moved an inch.
“To me the best thing to do is to fix Obamacare,” he told The Daily Beast. “For Democrats to respond to the Republican failure on health care by sort of offering a kind of a panacea for all your ills, this is like the wonder drug stuff that people used to sell at county fairs in America. It won’t work and it will really hurt the country financially.”
It’s not just Lieberman. Many other Democratic senators who were opposed to the public option in 2009 haven’t been convinced by Sanders’ pitch.
Former senator Ben Nelson (D-NE), who was a serious skeptic of Obamacare but inevitably ended up jumping on board after the public option was stricken, simply told The Daily Beast “no” when asked if he supported the concept of single-payer health care.
Former senator Kent Conrad (D-ND), who was among three Democratic senators in 2009 to vote against two public-option proposals while the bill was in the Senate Finance Committee, also had reservations.
“I think it is unlikely we will get single payer in the foreseeable future because the interests arrayed in opposition are too strong and the cost to the federal government is too high,” he told The Daily Beast.
Conrad, however, was not as caustic as Lieberman in his assessment of having a serious Medicare for All bill debated in the Senate. He suggested that it puts pressure on Republicans to devise an alternative fix, which they’ve yet to be united on.
“It moves the conversation more to the left, which you know puts pressure on Republicans to come up with an alternative,” Conrad said of Sanders’ bill. “And the alternative might be some variation on the status quo or some other alternative they so far have not been able to come up with.”
Sanders has framed the introduction of his bill as a kind of opening salvo in the nation’s debate on the future of health care. And the resistance from people like Lieberman frequently stems from concerns about costs, as Sanders’ bill would likely necessitate a tax hike worth trillions of dollars in order to provide Americans with a “universal Medicare card” for health care services.
Sanders’ office has released a preliminary look at possible options to pay for the legislation, including reforming the personal income tax system. Additionally, it addressed concerns about phasing out the current system, which is highly dependent on private plans from employers, with a four-year transition period in which workers will have the option of switching to the new Medicare for All system.
Lieberman cited that switch from employer plans as another personal problem he had with the bill, saying “by and large people are satisfied” with options provided in the workplace.
He equated the Sanders legislation with Republican efforts to repeal and replace Obamacare as being politically fruitless, even if they were ideological opposites.
“I think it is a mistake. No one thinks it’s plausible,” Lieberman said. “I fear that it puts Democrats on a quite different path than Republicans have been on with health care but with a similar ending.”
But of course, Lieberman doesn’t have a vote.