But we knew this was coming two years ago. - EB
https://www.politico.com/story/2018/12/10/establishment-democrats-progressive-medicare-1052215
The united front that helped Democrats save Obamacare just a year ago is falling apart over single-payer health care.
Deep-pocketed hospital, insurance and other lobbies are plotting to crush progressives’ hopes of expanding the government's role in health care once they take control of the House. The private-sector interests, backed in some cases by key Obama administration and Hillary Clinton campaign alumni, are now focused on beating back another prospective health care overhaul, including plans that would allow people under 65 to buy into Medicare.
This sets up a potentially brutal battle between establishment Democrats who want to preserve Obamacare and a new wave of progressive House Democrats who ran on single-payer health care.
"We know the insurance companies and the pharma companies are all putting tens of millions of dollars into trying to defeat us," said Rep. Pramila Jayapal (D-Wash.), who co-chairs the Medicare for All Congressional Caucus. "Which I take as a badge of honor — that they’re so concerned about a good policy that they're going to put so much money into trying to defeat it."
The rift could come into full view in the opening weeks of the new Congress, as the party long bound by a need to defend the Affordable Care Act tries to embrace a new health care vision it can carry into the 2020 presidential campaign.
House Democratic leaders already are emphasizing the need to align behind a more pragmatic agenda focused largely on shoring up Obamacare, without peering too far into the future.
“We want to continue promoting the idea of accessibility and improving the Affordable Care Act,” said incoming Ways and Means Committee Chairman Richard Neal (D-Mass.). “That should be the primary goal that we have.”
It's a sentiment shared by the major lobbies that fought alongside Democrats against Obamacare repeal and now want to reap the benefits. These interest groups contend that, after a decade of upheaval in health care, the public would prefer simple fixes that strengthen the ACA over a headlong rush into another dramatic overhaul of the system.
But House progressives, buoyed by voter enthusiasm and a surge of single-payer support among the party's base, have other ideas. Among their high-profile agenda items is "Medicare for All" legislation, an idea until recently on the fringes of policy debates that polling shows captivated voters during the 2018 election cycle, despite potentially staggering costs.
"It's more of a mainstream position than it's ever been before," said Adam Green, co-founder of the Progressive Change Campaign Committee, which maintains close ties to House progressives. "There's this hugely rapid advancement toward Medicare for All — single-payer — as not just an eventual North Star goal, but as something that's increasingly possible."
But major lobbies that fought shoulder-to-shoulder with Democrats last year are working now to derail such liberal ideas in order to preserve the status quo.
More than a dozen groups intend to press their point next year through The Partnership for America’s Health Care Future, a vehicle to combat an expanded government role in health care.
America's Health Insurance Plans and the BlueCross BlueShield Association helped found the coalition alongside the Federation of American Hospitals, the big drug lobby PhRMA and the American Medical Association.
Since then, it's added another 13 organizations — most representing companies with much to lose under a system that shrinks or in some cases eliminates private health care.
Medicare for All legislation would effectively eliminate private health coverage. And talk of greater government influence over health care has alarmed providers that contend Medicare and Medicaid currently pay only a fraction of what it costs to care for beneficiaries.
The Partnership, some of whose members began discussions within weeks of Senate Republicans’ failed Obamacare repeal vote in July 2017, is planning to launch a campaign featuring ads, polling and white papers playing up the private sector's role and warning against further disruptions to the health system, people involved with the group said. Avalere, a consulting firm Democrats often leaned on to highlight the dangers of GOP repeal bills, is producing research for the coalition.
Avalere founder Dan Mendelson — a former Clinton White House official — declined to comment on the firm's work, citing a policy of not talking about its clients.
The Partnership has also received support from Lauren Crawford Shaver, a veteran of the Obama administration’s Health and Human Services Department and Hillary Clinton’s 2016 campaign, who is running its operations out of the lobbying shop Forbes Tate Partners.
“We believe all Americans deserve access to affordable, high-quality health care. But a one-size-fits-all, government-controlled system like Medicare for All isn’t the answer,” Shaver said, predicting it would restrict choice and innovation and put “decisions regarding our health care in the hands of politicians in Washington.”
