[Peace-discuss] Briahna Joy Gray, Current Affairs. The Case For Forcing A Floor Vote On Medicare For All

[David Johnson]

The Case For Forcing A Floor Vote On Medicare For All

By Briahna Joy Gray,
<https://www.currentaffairs.org/2020/12/the-case-for-forcing-a-floor-vote-on
-medicare-for-all> Current Affairs. 

December 17, 2020 

|  <https://popularresistance.org/strategize/> Strategize!

On November 27th, YouTube pundit and comedian Jimmy Dore
<https://www.youtube.com/watch?v=iIqw-mTX6ro> proposed a provocative plan to
advance the Medicare for All movement: refuse to re-elect Rep. Nancy Pelosi
D-CA as Speaker of the House until she brings Rep. Pramila Jayapal’s
Medicare for All bill H.R. 1384 to a floor vote. Because last month’s
elections whittled down the Democratic majority in the House, it would take
only a handful of Democrats to hold Pelosi’s speakership hostage. The
“Squad,” composed of Reps. Alexandria-Ocasio Cortez (D-NY), Ilhan Omar
(D-MN), and Rashida Tlaib (D-MI), could theoretically find sufficient
support from among the ranks of the nearly 100 members of the Progressive
Caucus. And if successful, progressives could force an unprecedented public
debate about the merits of an enormously popular policy that, because of the
COVID crisis, Americans have never needed more.

Without a majority of votes in the House, the only way to bring a bill out
of committee onto the floor where it can be publicly debated is if the
Speaker of the House agrees to do so. (When it comes to Medicare for All,
Pelosi never has.) And progressives worry that without a significant
pressure campaign, elected Democrats will never be made to answer for why
they stand well to the right of the public on the need for universal health
care. “Now is the time for progressives to exercise their power, play
hardball, and use their power for the benefit of their constituents,” Dore
argued.

Public interest in the scheme spiked on Friday night when Rep. Alexandria
Ocasio Cortez weighed in via a Twitter
<https://twitter.com/AOC/status/1337619367857713154?s=20> reply to Chargers
running back Justin Jackson, who has adopted Jimmy Dore’s call to action.
“If @AOC and the squad don’t do what @jimmy_dore has suggested and withhold
their vote for Pelosi for speakership until Med 4 All gets brought to the
floor for a vote
 they will be revealing themselves,” he wrote. “Power
concedes nothing without a demand.”

AOC disagreed with the proffered scheme on the basis that Jayapal’s Medicare
for All bill is unlikely to pass at this time. “So you issue threats, hold
your vote, and lose. Then what?” she asked. Instead of demanding a floor
vote, AOC countered that progressives could “use leverage to push for things
that can happen and change lives.” As an example, she offered a $15 minimum
wage in the first 100 days, and “elevating longtime progressive champions to
important positions in democratic leadership.”

But progressives pointed out that a $15 minimum wage is part of the
Democratic Party platform. “Biden already supports a $15 min wage,”
<https://twitter.com/aaronjmate/status/1337642286092578817?s=20> tweeted
journalist Aaron Maté. “It won’t take progressive leverage to hold
him/Pelosi to something Biden already supports. It’s the Senate that will
decide it.”

And unlike other progressive priorities such as student debt cancellation or
the provision of stimulus checks, initiating a floor vote is wholly within
Nancy Pelosi’s purview: it’s a power she can exercise unilaterally to
protect her position without relying on Biden to modify his policy
priorities to protect her. (
<https://www.cnn.com/2020/12/10/politics/joe-biden-audio-civil-rights-leader
s/index.html> Recently leaked audio of a contentious meeting between Biden
and the leadership of Civil Rights organizations exposed how unyielding
Biden can be to any agenda not his own.)

Comprehensive health care coverage is the most pressing political issue of
the moment. Since the beginning of the pandemic,
<https://www.healthcaredive.com/news/more-than-14m-may-have-lost-health-cove
rage-after-historic-job-losses-stud/586564/> over 14 million Americans have
been kicked off their employer-based health insurance as they lost their
jobs to the shutdown. After a Democratic primary race in which nearly every
candidate fought to protect the private health care industry on the grounds
that voters deserved a “
<https://www.bostonglobe.com/metro/2019/11/10/health-care-buttigieg-promotes
-choice/r1kEoEygbjkISlaUsr2cvJ/story.html> choice,” millions of Americans
are now experiencing the cruel caprice of a system that links health care
access to one’s ability to work.

Perhaps unsurprisingly, support for Medicare for All has reached historic
highs during the pandemic. Even a Fox News
<https://www.commondreams.org/news/2020/11/06/centrist-house-democrats-attac
k-medicare-all-fox-news-poll-shows-72-voters-want> exit poll showed that 72
percent of Americans support a single payer system, and impressively, about
<https://thehill.com/hilltv/what-americas-thinking/494602-poll-69-percent-of
-voters-support-medicare-for-all> half of Republicans support Medicare for
All. But importantly for the purposes of the Dore proposition, a whopping
<https://thehill.com/hilltv/what-americas-thinking/494602-poll-69-percent-of
-voters-support-medicare-for-all> 88 percent of Democrats support the
policy. A floor vote on Jayapal’s bill could capitalize on the public’s
overwhelming approval for Medicare for All, and expose the chasm between the
policies Democratic voters want and the positions their elected
representatives are willing to take. It’s difficult to imagine a better
historical context for this fight.

Critics of the plan argue that demanding a floor vote for a bill that won’t
pass the House, much less the Senate, wastes progressives’ political
capital. “We already know who supports [Medicare for All],” argued Ryan Grim
of the Intercept, “and I can promise you it would get zero press coverage
because the press doesn’t cover bills that can’t pass both chambers.” But
recent history offers a counterpoint to Grim’s claim that the media won’t
cover a standoff over health care. Just a week ago, the passage of the House
bill decriminalizing marijuana was covered widely as “historic,”—perhaps
because, like Medicare for All, it’s an enormously popular policy with
bi-partisan support. (It’s also unlikely to pass the Senate.) And that was
without the added drama of the most powerful Democrat in the House being
bent over the proverbial barrel by a squad of progressive upstarts.

Moreover, the Squad has a unique ability to attract media attention.
Representatives Ocasio-Cortez, Katie Porter (D-CA), and other progressive
members of Congress are famously adept at making viral moments out of
congressional hearing testimony, and if they were to coordinate with the
activists and protesters who helped to organize the historically large mass
protests from this summer, it’s difficult to imagine they’d be ignored.
(Leveraging organized labor and the threat of a general strike would make
any effort to push Medicare for All impossible to brush off. And they should
do exactly that.)

Mass unemployment and the subsequent loss of employer-based coverage has
stripped corporate Democrats of one of their most potent arguments against
Medicare for All: that maintaining the for-profit health system offers
much-desired stability. And commitments to cover COVID-related costs have
exposed the hypocrisy inherent in defenses of our current system. The
<https://joebiden.com/covid-plan/> admission by party leadership that COVID
treatment should be
<https://twitter.com/KamalaHarris/status/1322378010192977921?s=20> free for
all is a slippery slope to universal coverage. After all, it’s not more
inhumane to deny COVID treatment to those who can’t pay for it than to deny
treatment to a cancer patient who can’t pay. (Cancer is a primary
<https://www.beckershospitalreview.com/finance/cancer-forces-42-of-patients-
to-exhaust-life-savings-in-2-years-study-finds.html> cause of bankruptcy in
America.) Should progressives force a floor vote, they’d be well positioned
to make a relatively unencumbered case for Medicare for All.

A floor vote and the debate that comes with it could spark a referendum on
our failing health care system at a moment when no other issue takes
credible priority. “Now is the time [progressives] have power,” Dore argued.
“In two years, the Democrats are going to get wiped out in the House. They
will lose their majority and their speakership. The only time the
progressives are going to have any power is right now at this moment,”
before the Speaker is elected in the first week of January. Dore’s
prediction that Democrats will lose seats during the 2022 midterms is far
from guaranteed, but given the party’s recent losses there is a certain
pragmatism to his urgency.

Agitating for a floor vote also doesn’t foreclose making other demands at
the same time. On his blog the Daily Poster, journalist David Sirota
<https://www.dailyposter.com/p/heres-what-medicare-for-all-supporters>
offered a number of alternative strategies to advance Medicare for All,
including ousting Rep. Richard Neal (D-MA), a Medicare for All opponent,
from his position as Ways and Means Chair. This is the type of concession
AOC alluded to in her response to Jackson, and it’s a meaningful one. But
ousting Neal—an obscure figure to the average American voter—is unlikely to
generate the kind of movement energy that a Medicare for All floor vote
could potentially inspire.

The argument is both and, not either or. But crucially, technocratic
solutions must be wedded to the floor vote demand in order to spark the kind
of public excitement that can galvanize labor, social movements and voters.
Progressives are buzzing with excitement because Democrats might, for once,
do something bold; they might fight for something not because the
cost/benefit analysis demands it, but despite the potential political costs.
And the threat of ousting Nancy Pelosi—who 3/4 of Americans
<https://thehill.com/hilltv/what-americas-thinking/401175-poll-three-quarter
s-of-americans-say-nancy-pelosi-should-be> believe should step
down—practically guarantees breathless coverage from media figures on both
sides of the aisle.

In her response to Jackson, AOC argued that the “opportunity cost” was too
high to waste on a floor vote for a bill that wouldn’t ultimately pass. “The
Dem votes aren’t there yet,” she tweeted. Why risk negative press from a
failed vote if a clean victory is in sight? But a lengthy delay risks
wasting the leverage progressives get from a narrow house majority and the
exigency of the pandemic. Progressives want to force a vote now precisely
because they believe the chance they can secure the votes for Medicare for
All in the near future is remote.  If barely half of House Democrats are
willing to cosponsor Medicare for All even while it has the support of 88
percent of Democratic voters during a global pandemic, what are the odds the
holdouts will be more amenable once the vaccine is distributed and life
begins to normalize?

Importantly, even a failing floor vote would force Democrats to own their
opposition to a life-saving, popular policy, and it would expose those
Democratic House members who are thought to have cosponsored Medicare for
All to burnish their progressive bonafides without ever intending to vote
for the bill. For example,
<https://www.reuters.com/article/us-usa-election-inequality-poll/majority-of
-americans-favor-wealth-tax-on-very-rich-reuters-ipsos-poll-idUSKBN1Z9141>
Kamala Harris and
<https://khn.org/morning-breakout/booker-stands-by-medicare-for-all-plan-but
-adds-that-he-would-take-pragmatic-approach-as-president/> Cory Booker
cosponsored the Senate version of the bill but reversed their positions
during their presidential campaigns. Forcing a vote on H.R. 1384 would
pressure House Democrats to either support the bill or defend their “no”
votes as single-payer’s popularity spikes. (Recall how her Iraq war vote
dogged Hillary Clinton in both 2016 and 2008, or how both Biden and Bernie
Sanders’s votes for the 1994 Crime Bill continue to follow them.) “If
[Jayapal’s bill] loses, then we know who is on our side and who is not,”
Dore has argued. “Then we can put a marker down.”

“No” voters would also be forced to justify their position to primary
challengers in 2022. “Would love for Democrats to be on the record denying
their constituents healthcare during a pandemic,”
<https://twitter.com/J_ManPrime21/status/1337624234361700353?s=20> tweeted
Jackson. “Sounds like good politics for the progressive movement and our
goals.” Recall that although establishment Democrats attempted to blame
Medicare for All for last month’s congressional losses, no swing district
candidate who supported Medicare for All lost on November 3rd. Despite the
<https://jacobinmag.com/2020/11/medicare-for-all-democratic-party-down-ballo
t-2020-election> hand-wringing of pharma-backed corporate Democrats,
Medicare for All is a winning issue.

The desire to push Pelosi into allowing a vote and to have hearings in the
House on Medicare for All  is born out of a longstanding frustration with
the media, which historically shields Democrats from accountability to their
constituents when it comes to health care. Mainstream outlets rarely
challenge anti-Medicare for All Democrats on why they’re bearish on the
policy their constituents overwhelmingly support. And pundits on liberal
networks regularly adopt disproven
<https://twitter.com/briebriejoy/status/1312546015795384320?s=20> right-wing
talking points about the affordability of the program. Moreover, the
relationship between candidates who oppose Medicare for All and their
corporate-funded campaigns is rarely, if ever, examined, and voters are left
to assume that their representatives decline to support Medicare for All
because it’s not electorally viable, rather than because they’ve accepted
significant sums from the pharmaceutical and private insurance industries to
finance their campaigns.

As COVID raged last spring, President-elect Biden said that he would
<https://www.cnbc.com/2020/03/10/biden-says-he-wouldd-veto-medicare-for-all-
as-coronavirus-focuses-attention-on-health.html> veto Medicare for All even
if it were to pass the House and the Senate. He also received more money
<https://www.jacobinmag.com/2019/09/health-care-joe-biden-medicare-for-all>
from insurance and pharmaceutical industry employees than any other
candidate in the race, and his senior advisor is a
<https://prospect.org/power/steve-ricchetti-top-biden-campaign-aide-health-c
are-lobbyist/> former health care lobbyist. During the primary, he received
crucial ninth inning  <https://www.washingtonpost.com/> support from Rep.
Jim Clyburn of South Carolina, whose endorsement is considered to have been
critical to Biden’s victory after a string of disappointing primary
finishes. Clyburn is firmly against Medicare for All despite the fact that
Black voters support the policy
<https://www.wsj.com/articles/black-voters-back-medicare-for-all-not-so-much
-the-candidates-pushing-it-11575720002> more than any other ethnic group. He
is also the
<https://www.postandcourier.com/health/clyburn-has-taken-more-than-1-million
-in-pharma-money-in-a-decade-far-surpassing/article_62b10180-d956-11e8-9122-
4f50316f66fa.html> single highest recipient of  pharmaceutical money in
Congress. These connections are rarely made by the press.

According to the
<https://www.politico.com/news/agenda/2019/11/25/medicare-for-all-lobbying-0
72110> Center for Responsive Politics, health care companies spent just shy
of $568 million on lobbying in 2018—more than any other industry. And as
Bernie’s primary campaign ramped up in the first quarter of 2019, the number
of organizations hiring lobbyists to oppose Medicare for All increased by a
<https://www.citizen.org/article/fever-pitch-medicare-for-all-lobbying/>
factor of seven. Record numbers of Americans still support a single-payer
system, but positive polls alone aren’t enough to induce congressional
support for the policy as long as elected officials are paid to vote the
other way. The system needs a jolt. And Dore believes he’s identified the
necessary spark.

Ocasio-Cortez herself has
<https://www.independent.co.uk/news/world/americas/us-politics/aoc-democrat-
party-left-medicare-all-ocasio-cortez-a9294891.html> alluded to the value of
a floor vote on Medicare for All—regardless of whether it would pass.  “The
Democratic Party is not a left party,” she lamented this past January. “
We
can’t even get a floor vote on Medicare for All. Not even a floor vote that
gets voted down. We can’t even get a vote on it.”

At the end of the day, the moral case for action requires no strategic
justification. As Kyle Kulinski, co-founder of Justice Democrats—the
progressive PAC that backed AOC’s historic 2018 run—
<https://twitter.com/KyleKulinski/status/1337922765584801793?s=20> tweeted:
“If your politics comes from a place of principle then all the strategy talk
is pretty silly anyway. If you believe in something you fight for it & dot
every i & cross every t. If you lose ok but the act of doing everything in
your power to achieve it is the definition of morality.”

 

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