Senator Bernie Sanders has rolled out a bill that would create a “single-payer”, government-run healthcare system in the US as Republicans engage in a last-ditch effort to dismantle Obamacare.
While President Donald Trump searches for a first major legislative win – whether on healthcare or tax reform – Republican and Democrat clashes over healthcare add another dimension to a full Congress schedule.
At a news conference promoting his legislation, Mr Sanders said, “The American people want to know what we’re going to do to fix a dysfunctional healthcare system, which costs us twice as much” per person as any other country.
A major part of Mr Sanders’ 2016 presidential campaign, single-payer healthcare – often referred to as “Medicare-for-all” – is a system in which the government, generally through taxes, covers basic healthcare costs for all residents regardless of income, occupation or health status. Many Republicans have baulked at this type of government involvement in the US’s healthcare regime.
“I think that the President, as well as the majority of the country, knows that the single-payer system that the Democrats are proposing is a horrible idea,” said White House press secretary Sarah Huckabee Sanders during a briefing. “I can’t think of anything worse than having government be more involved in your healthcare instead of less involved.”
While defending Obamacare – which still remains under attack by Republicans – Mr Sanders declared earlier this year that the way forward in the long-term was a “Medicare-for-all” system.
“This is where the country has got to go,” Mr Sanders told The Washington Post on Tuesday, having said he is working to propel the conversation forward about how healthcare in the US should be a right, not a privilege.
The Independent senator’s push for a single-payer system comes less than two months after Republican efforts to repeal Obamacare, otherwise known as the Affordable Care Act, failed on the Senate floor.
On the same day Mr Sanders unveiled his healthcare proposal, multiple Republican senators revealed their own answer to rising health insurance costs in the US.
“We refuse to quit, we have been working on a bill that should’ve been our first approach to repealing Obamacare, not our last,” said Republican Senator Lindsey Graham at a press conference on Wednesday. “If you want a single-payer system, this is your worst nightmare. Bernie, this ends your dream of a single-payer healthcare system for America.”
Mr Graham and his Republican colleague, Senator Bill Cassidy, are marketing their measure – known as the Cassidy-Graham bill – as a way of giving US states the flexibility to create the kind of healthcare system they want. If enacted, it is estimated that more than 30 million people could lose their health insurance over 10 years.
In a statement praising Mr Graham and Mr Cassidy’s efforts, the President – who has been pushing Republican leadership in Congress to again focus on healthcare reform – reiterated his belief that “inaction is not an option” on the issue.
“I sincerely hope that Senators Graham and Cassidy have found a way to address the Obamacare crisis,” Mr Trump said.
But it is still not believed that the Cassidy-Graham bill will garner enough support to pass. And with Republicans dominating both chambers of Congress, Mr Sanders’ “Medicare-for-all” measure has already been deemed dead-on-arrival.
As for Mr Trump, he stunned Republican leaders last week by striking a deal with top Democrats, House Minority Leader Nancy Pelosi and Senate Minority Leader Charles Schumer, on the US debt limit and federal spending for three months, and also spoke to them about how to resolve the fate of 800,000 young adults brought into the United States illegally as children, the so-called Dreamers.
Whether his push for bipartisanship is out of a sense of duty, or to punish the Republican leadership he has repeatedly admonished is open to debate. But, Trump was due to host Mr Schumer and Ms Pelosi on Wednesday evening to discuss the legislative agenda with a focus on the tax overhaul after meetings with bipartisan groups of legislators on Tuesday night and Wednesday afternoon.
“We should be able to come together to make government work for the people,” Mr Trump said as he met with eight Democratic and five Republican House members to try to find common ground on taxes as well as immigration and healthcare.
Asked what his message was to sceptical conservatives who worry he is cosying up to Democrats, Mr Trump said: “I’m a conservative, and I will tell you I’m not sceptical. And I think that if we can do things in a bipartisan manner, that’ll be great. Now it might not work out.”
However, Mr Trump said he wasn’t sure he would be able to get bipartisan support for one healthcare overhaul plan.
“We want to do something very, very powerful with respect to Obamacare,” Mr Trump said.
Mr Sanders had his own choice words to say to Republicans at his news conference on Wednesday: “Please don’t lecture us on healthcare... In the last few months, you, the Republican Party, have shown the American people what you stand for when you voted for legislation that would throw up to 32 million Americans off of the health insurance they have and at the same time give huge tax breaks to the rich and large corporations.”
“You, the Republican party, have no credibility on the issue of healthcare,” he added.
Under Mr Sanders’ proposal, Americans would receive a “Universal Medicare card” that would be a ticket to comprehensive healthcare services, including hospital stays, doctor visits, substance abuse treatment, dental, vision and reproductive care – including abortion.
The programme would be rolled out over four years, with the eligibility age dropping every year until every US resident is covered. Those aged 18 and under would automatically be eligible in the first year.
Even though more Democrats appear willing to embrace a shift away from the private health insurance market and toward a government-run programme, other members of the party have conveyed concerns about the costs and details associated with establishing a single-payer system in the US. The push for a single-payer system threatens to split the progressive and more centrist wings of the party on the issue.
During the presidential campaign, Hillary Clinton, who Mr Sanders challenged for the Democratic nomination, called the proposal “a theoretical debate about some better idea that will never, ever come to pass”.
“The last thing we need is to throw our country into a contentious debate about healthcare again. We are not England. We are not France,” Ms Clinton said during a presidential debate in February 2016.
An Urban Institute study of Mr Sanders’ single-payer proposal during the campaign said implementing the plan would increase federal expenditures by $32 trillion over 10 years.
While Mr Sanders has acknowledged the hefty price tag of his proposal, he left his news conference on Wednesday without clarifying how it would be paid for.
The bill has already received the backing of 16 other Democrats, including Elizabeth Warren of Massachusetts, Kamala Harris of California and Al Franken of Minnesota. However the two top Democrats in Congress, Ms Pelosi and Mr Schumer have not endorsed Mr Sanders’ plan.
In expressing his support, Mr Franken called the bill “aspirational”, adding that he is “hopeful that it can serve as a starting point for where we need to go as a country.”
“In the short term, however, I strongly believe we must pursue bipartisan policies that improve our current healthcare system for all Americans,” he said in a Facebook post.