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. CourtneyNavy 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 Aircraft carrier captain removed from duty after pleading for help with coronavirus outbreak 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 BrownSenate Dems request briefing on Russian bounty wire transfers On The Money: Mnuchin, Powell differ over how soon economy will recover | Millions fear eviction without more aid from Congress | IRS chief pledges to work on tax code's role in racial wealth disparities IRS chief pledges to work with Congress on examining tax code's role in racial wealth disparities MORE (D-Ohio), Debbie StabenowDeborah (Debbie) Ann StabenowACLU calls on Congress to approve COVID-19 testing for immigrants Senators press IRS chief on stimulus check pitfalls Democrats warn Biden against releasing SCOTUS list MORE (D-Mich.) and Tammy BaldwinTammy Suzanne BaldwinBiden strikes populist tone in blistering rebuke of Trump, Wall Street Biden campaign adds staff in three battleground states Clinton, Buttigieg among Democrats set to hold virtual events for Biden MORE (Wis.) and Reps. Courtney, Brian HigginsBrian HigginsBiden 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' NY, NJ lawmakers call for more aid to help fight coronavirus MORE (D-N.Y.) and John Larson John Barry LarsonCongress must act now to fix a Social Security COVID-19 glitch and expand, not cut, benefits Encouraging research and development can drive America's recovery House pays tribute to late Congressman Sam Johnson on the floor 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 JayapalDemocrats fear US already lost COVID-19 battle Progressive lawmakers call for conditions on Israel aid Hillicon Valley: Democrats introduce bill banning federal government use of facial recognition tech | House lawmakers roll out legislation to establish national cyber director | Top federal IT official to step down 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 SandersOVERNIGHT ENERGY: EPA declines to tighten smog standards amid pressure from green groups | Democrats split on Trump plan to use development funds for nuclear projects| Russian mining giant reports another fuel spill in Arctic Biden lets Trump be Trump Democrats split on Trump plan to use development funds for nuclear projects 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 Devi HarrisHillicon Valley: Facebook considers political ad ban | Senators raise concerns over civil rights audit | Amazon reverses on telling workers to delete TikTok Senators raise concerns over Facebook's civil rights audit Biden's marijuana plan is out of step with public opinion 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 BookerIn politics, as in baseball, it ain't over till it's over Democrats blast Trump for commuting Roger Stone: 'The most corrupt president in history' Koch-backed group urges Senate to oppose 'bailouts' of states in new ads MORE (N.J), Kirsten GillibrandKirsten GillibrandDemocrats seek to tie GOP candidates to Trump, DeVos Democratic lawmakers call for expanding, enshrining LGBTQ rights The Hill's 12:30 Report: Fauci 'aspirationally hopeful' of a vaccine by winter MORE (N.Y.), Harris and Amy KlobucharAmy KlobucharThe Hill's Coronavirus Report: Fauci says focus should be on pausing reopenings rather than reverting to shutdowns; WHO director pleads for international unity in pandemic response State election officials warn budget cuts could lead to November chaos Biden strikes populist tone in blistering rebuke of Trump, Wall Street 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 Pelosi70 progressive groups call for next Foreign Affairs chair to reflect 'progressive realism' House to vote next week on ridding Capitol of Confederate statues Eye on gavel, Wasserman Schultz proposes panel on racial inequality in spending 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.