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Dems offer smaller step toward ‘Medicare for all'

House and Senate Democrats on Wednesday introduced a Medicare buy-in bill, legislation that they presented as an alternative to the single-payer proposals backed by the progressive wing of the party.

The new measure would allow people to purchase Medicare plans after turning 50, instead of waiting until 65. Supporters say it’s more politically palatable and easier to implement than “Medicare for all,” which would upend the entire health care system.

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“This is something that is not pie in the sky or aspirational,” said Rep. Joe CourtneyJoseph (Joe) D. CourtneyConnecticut Republican drops out of congressional race on primary day after arrest Navy recommends reinstating Crozier as captain of USS Theodore Roosevelt: report Overnight Defense: Aircraft carrier captain removed from duty after pleading for help with outbreak | Trump to expand use of defense law to build ventilators | Hospital ships receiving few patients MORE (D-Conn.), a co-sponsor of the buy-in bill. “This is a piece of legislation where you could turn the switch on overnight.”

The measure was introduced by Sens. Sherrod BrownSherrod Campbell BrownPlaintiff and defendant from Obergefell v. Hodges unite to oppose Barrett's confirmation Congress must repeal tax breaks for the wealthy passed in CARES Act Democratic senators unveil bill to ban discrimination in financial services industry MORE (D-Ohio), Debbie StabenowDeborah (Debbie) Ann StabenowHealthcare, retirement security seen as top issues for older voters, lawmakers say Dems to focus on issues, not character, at Barrett hearings Lobbying world MORE (D-Mich.) and Tammy BaldwinTammy Suzanne Baldwin Senate Democrats call for ramped up Capitol coronavirus testing Baldwin calls for Senate hearing on CDC response to meatpacking plant coronavirus outbreak Democrats demand answers from Labor Department on CDC recommendations for meatpacking plant MORE (Wis.) and Reps. Courtney, Brian HigginsBrian HigginsEighth person charged in alleged plot to kidnap Michigan Gov. Whitmer Biden slams Trump for promoting conspiracy theory about man shoved by police Trump claims 75-year-old man shoved by Buffalo police could be part of 'set up' MORE (D-N.Y.) and John Larson John Barry LarsonAnxious Democrats amp up pressure for vote on COVID-19 aid AARP endorses Democrats' measure to overturn Trump payroll tax deferral GAO clears way for Democrats to try to overturn Trump's payroll tax deferral MORE (D-Conn.).

Meanwhile, progressive House Democrats are preparing their Medicare for all bill, which would largely eliminate the private insurance industry and move everyone into a single-payer, government-run system.

“I have respect for people that are trying to find other ways to go forward,” said Rep. Pramila JayapalPramila JayapalOcasio-Cortez, progressives call on Senate not to confirm lobbyists or executives to future administration posts Pocan won't seek another term as Progressive Caucus co-chair Poll shows Biden leading Trump, tight House race in key Nebraska district MORE (D-Wash.), who plans to introduce Medicare for all legislation at the end of the month, followed by a hearing in the House Budget Committee in late March or April.

“But you know, I think what we’re proposing is really a transformation of the health care system to get out the pieces that are so embedded into it that continue to make health care costs equivalent to 19 percent of the GDP. We’ve got to get at those costs,” said Jayapal, a co-chair of the Congressional Progressive Caucus.

For some, Medicare buy-in is a reasonable step toward universal health care or Medicare for all.

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“I’ve always supported universal health care, but we are not there yet,” said Baldwin, who is also a co-sponsor of Sen. Bernie SandersBernie SandersSanders hits back at Trump's attack on 'socialized medicine' Trump's debate performance was too little, too late Final debate: War Admiral vs. Seabiscuit MORE’s (I-Vt.) Medicare for all bill.

“Medicare at 50 is a very bold step in the right direction,” she said.

The buy-in bill would leave the American health care system intact, while Medicare for all would largely do away with the private market where 50 percent of the population gets coverage through work.

But some Democrats are wary undoing the existing infrastructure, as highlighted by the response to presidential candidate Sen. Kamala HarrisKamala HarrisSanders hits back at Trump's attack on 'socialized medicine' Watch live: Biden participates in HBCU homecoming Jennifer Aniston: 'It's not funny to vote for Kanye' MORE’s (D-Calif.) comments last month about “eliminating” private insurance via Medicare for all.

“We’ve got an employment-based system that a lot of people depend on,” Larson said. “[Buy-in] would accommodate that. That’s what makes so much sense about this.”

Like-minded supporters argue it is the most popular approach out there and could lead to universal care further down the line.

A recent Kaiser Family Foundation poll found 77 percent of Americans support a Medicare buy-in approach for adults between the ages of 50 and 64.

“I think it’s good in and of itself because it would provide the protection of Medicare now, and it could be a pathway to something greater,” Higgins said. “The most important thing to keep in mind is the ACA has not been improved since inception. This is the next improvement of the Affordable Care Act.”

Any expansion of Medicare is unlikely while Republicans control the Senate and White House. But the looming 2020 elections have intensified the debate about health care among Democrats, especially since they credit the issue as a key reason why their party won back the House in the 2018 midterm elections.

Divisions over how best to move forward are already apparent among Democrats running, or considering a run, for president.

“We have some colleagues that are supporting this as a first step, and others who are saying, ‘I think this is what we ought to do and have a private marketplace addressing those between 27 and 49,’” Stabenow said. “There are differences of opinion, but the great news is this can be done now and has broad support.”

Almost every Senate Democrat running for president is a co-sponsor of the buy-in bill, including Cory BookerCory Anthony BookerDemocratic senators unveil bill to ban discrimination in financial services industry Obama endorses Espy in Mississippi Senate race Durbin says he will run for No. 2 spot if Dems win Senate majority MORE (N.J), Kirsten GillibrandKirsten GillibrandInternal Democratic poll: Desiree Tims gains on Mike Turner in Ohio House race Hillicon Valley: Facebook, Twitter's handling of New York Post article raises election night concerns | FCC to move forward with considering order targeting tech's liability shield | YouTube expands polices to tackle QAnon Democrats question Amazon over reported interference of workers' rights to organize MORE (N.Y.), Harris and Amy KlobucharAmy KlobucharStart focusing on veterans' health before they enlist Durbin says he will run for No. 2 spot if Dems win Senate majority Democrats seem unlikely to move against Feinstein MORE (Minn.).

Brown, who has said he is considering a White House bid, is also a co-sponsor.

But Brown and Klobuchar, moderate Midwest Democrats, say they aren’t ready to support Medicare for all, while their other colleagues running for president have signed on to the Sanders bill from 2017.

“Eventually we probably get to something like Medicare for all, but we start by expanding it and helping people now,” Brown said Tuesday at a Christian Science Monitor breakfast.

The introduction of various Medicare expansion bills could also create tension between the party and House Democratic leadership, which has tried to keep the caucus united on protecting ObamaCare from legal challenges and “sabotage” from the Trump administration.

As the Democrats introduced their buy-in bill Wednesday, the House Energy and Commerce Committee was holding a hearing on shoring up the ObamaCare marketplace.

The chairmen of the committees with primary jurisdiction over health care issues haven’t agreed to hold hearings on Medicare for all.

Higgins on Wednesday wouldn’t say whether he had a commitment from Speaker Nancy PelosiNancy PelosiOvernight Health Care: Following debate, Biden hammers Trump on coronavirus | Study: Universal mask-wearing could save 130,000 lives | Finger-pointing picks up in COVID-19 relief fight On The Money: Finger-pointing picks up in COVID-19 relief fight | Landlords, housing industry sue CDC to overturn eviction ban Finger-pointing picks up in COVID-19 relief fight MORE (D-Calif.) for a floor vote on his bill, but said they have spoken about “having the bill taken up in some way.”

Both buy-in and Medicare for all are fiercely opposed by outside interests that would stand to lose under both proposals.

“We can all agree that every American deserves access to affordable health coverage and high-quality care, but this proposal — whether you call it Medicare for all, Medicare buy-in, single-payer or a public option — moves us toward a one-size-fits-all health care system that is wrong for America,” said Lauren Crawford Shaver, executive director of the Partnership for America’s Health Care Future, a coalition of industry groups that launched last year to oppose expansion of Medicare.

Updated at 5:50 p.m.