Medicare For All vs Pay-Go?

In the piece Saturday about the Congressional Progressive Caucus idea of Pay-Go legislation rather than having opposed it as a rule, I neglected to mention how hard it would have been to go back and fight for the negotiated package the CPC had decided to prioritize-- the Medicare-For-All debate agreement perhaps being the most important part of it-- had the package been defeated. Writing for the Washington Post last week, Dave Weigel noted that previously Medicare-For-All proposals have been "typically sidelined, even when Democrats had power; in 2009 and 2010, when the House passed the Affordable Care Act, the “Medicare-for-All” package was not part of the discussion. [In 2017] for the first time, a majority of House Democrats co-sponsored HR 676."... [O]n Wednesday, Jayapal got Pelosi’s commitment to hearings in the Rules and Budget committees. The incoming chairmen of those committees, Reps. Jim McGovern (D-MA) and John Yarmuth (D-KY), support Medicare for All.

With Democrats locked out of power in the Senate and the White House, Jayapal said that supporters of universal health care were proceeding “one step at a time” and that getting the first real hearings on the bill-- for years, it has been aspirational, and not even subject to a Congressional Budget Office score-- would force a larger discussion.

  “This will ensure that Medicare for All is part of the 2020 Democratic presidential platforms,” said Jayapal.

...While Democratic leaders have pointed out that the spending rule is statutory and would remain active in the Senate no matter what the House does, a number of left-leaning Democrats have accused Pelosi of preemptively making it harder to pass major reforms. Jayapal, a co-chair of the Congressional Progressive Caucus who helped reshape the rule, said that those concerns were unfounded.

“The critical thing here is: Do we have a commitment to waive paygo on critical bills? I think we do,” she said. “I think we’ve not only got a commitment for that, but for hearings on those bills, and we’ve never had that before.”

Forget about conservatives for a moment-- we know they (now members of the GOP) will oppose Medicare-For-All the same way they have opposed all progressive initiatives starting with the Declaration of Independence. But Jayapal is far from unaware that she will have a tough battle with conservatives in her own party, the Republican wing of the Democratic Party-- Blue Dogs and New Dems.

Over the weekend, Pramila told me that "Even if we had been able to get the votes to vote the entire [Rules] package down, what would have happened is that we would have then gotten into a fight over everything else that we won in the package. Don’t think for a moment that they would have agreed to simply take out Pay-Go and not lose anything else in exchange. Conservatives and moderates would have fought like hell against taking Pay-Go out (and they comprise 60% of the caucus still, remember that) and then we would have been in the position of potentially losing some of the things we won. For what?"

We often think, proudly, about how there is finally a majority of Dems backing Medicare-For-All, but it's important to remember there are plenty of tenacious opponents from the Republican wing of the party, many who will fight as hard as a Republican in opposition. A few examples of Democrats who refused to sign on to HR 676, starting with all 7 of the officers of the New Dem Caucus:

• Derek Kilmer (New Dem-WA)
• Terri Sewell (New Dem-AL)
• Gerry Connelly (New Dem-VA)
• Ron Kind (New Dem-WI)
• Kathleen Rice (New Dem-NY)
• Scott Peters (New Dem-CA)
• Jim HImes (New Dem-CT)
• Suzan DelBene (New Dem-WA)
• Debbie Wasserman Schultz (New Dem-FL)
• Cheri Bustos (BlueDog-IL)
• Tony Cardenas (New Dem-CA)
• Joaquin Castro (New Dem-TX)
• Juan Vargas (New Dem-CA)
• Kurt Schrader (New Dem-OR)
• Jim Costa (Blue Dog-CA)
• Josh Gottheimer (Blue Dog-NJ)
• Val Demings (New Dem-FL)
• Henry Cuellar (Blue Dog-CA)
• Pete Aguilar (New Dem-CA)
• Charlie Crist (Blue Dog-FL)
• Raul Ruiz (New Dem-CA)
• Brad Schneider (Blue Dog-IL)
• Lisa Blunt Rochester (New Dem-DE)
• Seth Moulton (New Dem-MA)
• Stephanie Murphy (Blue Dog-FL)
• Julia Brownley (New Dem-CA)
• Ami Bera (New Dem-CA)
• Tom O'Halleran (Blue Dog-AZ)
• Sean Patrick Maloney (New Dem-NY)
• Ann Kuster (New Dem-NH)
• Denny Heck (New Dem-WA)
• Bill Keating (New Dem-MA)
• Bill Foster (New Dem-IL)

To make it completely clear what this meant, Pramila continued that "Getting a stated commitment from the Speaker of the House herself to hold hearings on Medicare for All was deeply tied into the Pay-Go battle. We did have a commitment from Rep. Jim McGovern-- who is a strong progressive and supporter of Medicare-for-All-- to waive the rule for MFA and progressive legislation but I thought we needed more than that. I wanted the Speaker’s public commitment to this as well-- which I was able to negotiate as part of this discussion. This is an enormous victory! There have never, ever been hearings in the House on Medicare for All. To get the Speaker’s commitment to support holding hearings in multiple committees in the House means that we will be able to have formal, televised hearings on my bill for the first time in history-- and that helps to build the momentum even more. And if the fear around Pay-Go is that it will stop progressive legislation from moving forward, then the antidote to that fear was to ensure that it does NOT do that."

So what was the point of those of us who were frantically calling our esteemed congress members and pleading with them to vote against the Pay-Go rule-- not to mention, the massive intellectual push from Paul Krugman, Stephanie Kelton and Robert Reich and from Bernie's camp (Warren Gunnels)? Was the stunning courageousness and savvy organizing demonstrated by Ro Khanna, Alexandria Ocasio-Cortez and Tulsi Gabbard all for naught? No, I don't think so-- although it will be really tragic if Pelosi holds it against them and refuses to put Khanna and Ocasio-Cortez on the Ways and Means Committee they would like to serve on. The good cop/bad cop strategy-- Pocan forever and ever and ever the good cop, of course-- that helped make space for the negotiations, gave the good cops some teeth and actually may be helping to make the Congressional Progressive Caucus more effective than I've given it credit for being in some time. So, there's that-- and like Gunnels pointed out after the vote: