How Medicare for All Is Tearing Democrats Apart
Health Care

How Medicare for All Is Tearing Democrats Apart


Rep. Alexandria Ocasio-Cortez made headlines last week by suggesting in an interview with HuffPost that, given how difficult it would almost certainly be to secure the congressional votes needed to enact Medicare for All, a public option health care plan might be an acceptable fallback.

“A president can’t wave a magic wand and pass any legislation they want,” Ocasio-Cortez told HuffPost. “The worst-case scenario? We compromise deeply and we end up getting a public option. Is that a nightmare? I don’t think so.”

Ocasio-Cortez has been a key, high-profile supporter of and surrogate for Sen. Bernie Sanders in his campaign for the Democratic presidential nomination. She favors Medicare for All and stressed in her interview with HuffPost that getting a public option wasn’t the left’s ultimate goal. She later clarified that she believes the public option is worse than Medicare for All and that Democrats fight for Medicare for All first, but her comments roiled some on the left.

Sen. Bernie Sanders pushed back a bit Tuesday night.

“I love Representative Alexandria Ocasio-Cortez. She has done more in her first year in Congress to transform politics, to get young people involved, than any freshman member of Congress that I can remember,” Sanders told CNN at a Las Vegas town hall event. “But my view is that Medicare-for-all, the bill that we wrote, is in a sense already a compromise. It is a four-year transition period.”

Why it matters: Democrats are wrestling with questions about “purity tests” and just how ideologically flexible they can or should be as they both seek to defeat President Trump and stake out negotiating positions for future policy debates. But the ripples Ocasio-Cortez caused with her comments also highlight again just how divisive Medicare for All has been for Democrats, from party leaders to labor unions — and how risky the policy fight might be as an election issue.

A “civil war” among unions: The issue is likely to come up in Wednesday night’s Democratic presidential primary debate, after the Culinary Workers union last week criticized Medicare for All, which would eliminate the private insurance plans labor leaders have fought to secure for members over the years.

“‘Medicare for All’ is roiling labor unions across the country, threatening to divide a critical part of the Democratic base ahead of several major presidential primaries,” Politico’s Ian Kullgren and Alice Miranda Ollstein report. “On one side of the divide are more liberal unions like the American Federation of Teachers and the Service Employees International Union, which argue that leaving health benefits to the government could free unions to refocus collective bargaining on wages and working conditions. On the other side are more conservative unions like the International Association of Fire Fighters and New York’s Building & Construction Trades Council, which don’t trust the government to create a health plan as good as what their members enjoy now.”

The bottom line: The Washington Post’s Paul Waldman suggested last week that Sanders “would privately agree with AOC — even if he can’t say it publicly” for political and negotiating reasons. Sanders, Waldman wrote, “knows the unfortunate truth: There is precisely zero chance that a single-payer system of the kind Sanders proposes will pass Congress anytime soon. It wouldn’t even be close. … But it’s important that single-payer remain on the table as an option, not only because talking about it helps highlight everything that’s wrong with the current system, but also because it serves as a kind of cognitive and rhetorical anchor for everyone involved.”

For that reason, the battle over Medicare for All — as unlikely as it is to get enacted and as dangerous as it might be for Democrats — will keep going as the party’s protracted nomination battle plays out.