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Republicans on single-payer: this is about Democrats “thinking about running for president”

Senators McCain, Graham, Cassidy and Johnson Discuss Health Care Reform
U.S. Sen. Bill Cassidy along with fellow Republican senators at a press conference on Obamacare repeal.
Photo by Justin Sullivan/Getty Images

As Democrats momentarily steal the health care limelight with Sen. Bernie Sanders’s much anticipated Medicaid-for-all health care bill, Republicans are watching idly from the sidelines with a shrug.

Democrats have grown increasingly energized with Sanders’s single-payer proposal he is planning to announce Wednesday. In the past weeks, at least one-quarter of Democratic senators have signed on as co-sponsors of the bill. Only two years ago, Sanders couldn’t find a single senator to support the idea.

It’s left Republicans, who have spent the greater part of this legislative year attempting and failing to find a replacement plan for the Affordable Care Act, with yet another challenge: a Democratic party that is increasingly close to declaring a monumental leftward shift in its health care ideals. The GOP won’t consider single-payer or embrace Obamacare and is having a difficult time coming up with a better solution to the American health care system.

To be sure, there is no chance a Medicare-for-all health care bill can pass in a Republican-led Congress and White House. And for now, that’s all congressional Republicans have to say about the single-payer fervor.

“I’m surprised they are talking about it because clearly it’s not going to move — it’s not going to pass,” Sen. James Lankford (R-OK) said. “Clearly they are just building momentum for when they get the White House back, when they get the House and Senate back.”

Republican Sens. Bill Cassidy (LA) and Lindsey Graham (SC) are also planning on announcing their health care bill on Wednesday — a repeal and replace of Obamacare, block granting existing Obamacare funding and capping federal health care spending and sending it down to the states to create their own health care programs. Among its few merits thus far is that it’s the last Republican proposal standing. It’s not clear there are enough Republicans backing the proposal, and the clock is ticking.

Wednesday will prove to be an important moment in the political dynamics between Democrats and Republicans, as the majority party inches closer to running out of time to enact a Republican-led health care policy, and Democrats coalesce around increasingly liberal policies aimed at energizing their base.

“I think it’s laughable,” Cassidy said of Sanders’s forthcoming bill. “I don’t think there is an energy behind single-payer except for people who don’t know anything about single-payer.”

As far as Republicans are concerned, this is just “political demagoguery.” They might be right, for now.

Congressional Republicans don’t have much to say about single-payer health care, except that it’s not going to happen.

“They ought to take a look at the scores,” Sen. Ron Johnson (R-WI), who recently signed on to the Graham-Cassidy proposal, said. “The Urban Institute said it cost $6.6 trillion more in health expenditures with single-payer. Vermont took a look at it and said eh, can’t do it. California did the same. It doesn’t work.”

“This is political demagoguery,” he added.

As far as Republicans are concerned, Democrats are taking advantage of a moment, Lankford said. After months of failed Republican attempts, the nation is looking for a health care fix to fall in love with, and Democrats are seizing the opportunity to energize their base.

“The issue for [some Democrats] is that with Obamacare we have government control, but we don’t have enough control,” Lankford said. “That’s coming out now to say, while we are talking about this, let’s go get the rest. I think they are building their base. They are saying activate, come help us win election and we will have a complete takeover of the health care system.”

There is no question that the push behind single-payer is political. Sanders and his co-sponsors will have a lot of policy questions to answer for. As the New York Times’s Margot Sanger-Katz pointed out, this push runs into a lot of the same obstacles Republicans’ “Obamacare repeal” campaign did: “Like ‘repeal and replace,’ ‘single-payer’ is a broadly popular slogan that papers over intraparty disagreements and wrenching policy choices,” Sanger-Katz writes.

In other words, when it comes to actual legislating, Democrats would have to iron out a lot of party differences to get close to passing a single-payer policy. But the minority party is banking on this being a popular message among the base — and Republicans are well aware.

“My guess is that this has a lot to do with the makeup of the Democrat caucus and the number of individual senators who are thinking about running for president,” Sen. Jerry Moran (R-KS) said of the Democrats’ energy.

Republicans’ Obamacare repeal dreams are dwindling fast

Meanwhile, the clock is running out for Republicans on Obamacare repeal.

After a recent ruling from the Senate parliamentarian, who dictates Senate’s procedural rules, Republicans only have until September 30 to pass a health care bill on a party-line vote in the Senate.

The last plan standing, the Graham-Cassidy-Heller-Johnson plan, has yet to be proposed or scored by the Congressional Budget Office, which evaluates bills for their cost and effects. It’s the only concrete idea left, and it doesn’t seem to have much support from GOP leadership. Asked whether he had started whipping votes, Majority Whip Sen. John Cornyn (R-TX) gave a solid “no”: “It hasn't even been released yet, much less scored," Cornyn said Tuesday.

Cassidy, who has been negotiating with senators and House representatives for the past months to get this idea off the ground would have to garner enough support for a vote in less than two weeks if he intends on relying only on Republicans. Democrats, he says, are not interested.

“Democrats are condemning our bill without having even read it,” Cassidy said. “I have gone to 10 different Democrats and asked them to cooperate and they all say they can’t for political reasons.”

The political energy behind single-payer is unlikely to help Cassidy get any bipartisan interest in a proposal that effectively repeals the Affordable Care Act. But if Cassidy can’t get his bill through by September 30, which is highly possible, then Republicans will have no choice but to work with Democrats if they are intent on passing an Obamacare fix.

It’s clear that single-payer, however, will not be raised in those discussions.

“There is still genuine concern about how to provide quality health care to Americans,” Moran said. “I don’t think the fact that there is a movement in some part of the Democratic Party means we can’t work together — it means not everybody will get what they want. Single-payer is not something that is going to pass Congress in the near future.”