The Senate Health Care Bill Must Be Defeated: Building a Movement for “Medicare for All”

Statement of the DSA National Political Committee, June 28, 2017

The Senate version of the American Health Care Act (AHCA) that the Republican leadership hopes to ram through without any hearings or substantive debate poses a grave threat to the well-being of all but the wealthy few. The bill is nothing less than an effort to take coverage away from tens of millions of low-to-moderate income families in order to provide a massive tax cut of $400 billion over the next ten years to the top five percent of income tax payers and to medical instrument and prescription drug companies. DSA urges its members to mobilize and press their Senators (of both parties) to vote against the Senate bill. The fight to defeat a Senate bill will continue through the summer, as the Republicans failed to pass the bill before the July 4th recess. (Longer term, DSA is committed to working on state and federal “Medicare for all” legislation; see below.)

This resistance can best be done through militant constituent visits to Senators’ home or DC offices alone or with other coalition partners, particularly when Senators return to their home districts during the July 4th recess.  At a minimum, constituent phone calls to Senators, especially those who have said the bill is too harsh and/or have hundreds of thousands of people in their states added to Medicaid are important. The key Republican swing votes are Ron Portman (R-OH), Shelley Moore Capito (R-WV), Susan Collins (R-ME), Lisa Murkowski (R-AK) and Dean Heller (R-NV). The list of Senate phone numbers and email addresses can be found here:

The Senate bill should be militantly opposed because it will gut Medicaid, a single-payer system that covers 74 million low-income, disabled and elderly Americans. The bill would cut $880 billion over 10 years from Medicaid, over one-quarter of the previous allocation. The 13 million working adults and children added by the 31 states that accepted the Affordable Care Act’s (ACA’s) federal funding of Medicaid coverage for working families earning $22 to $34,000 dollars will lose their coverage by 2023 (with major rollbacks in extent of coverage from 2020 on). In addition, given the large cuts to federal funding of the basic Medicaid program, an estimated additional 14 million more recipients will likely lose Medicaid coverage as states trim their rolls to deal with the lost federal revenue. States unwilling to radically increase their own contributions to Medicaid will be denying nursing home coverage and disability rehabilitation services to millions.

The bill also cuts $300 billion over ten years for premium subsidies for people who do not get insurance through employers and who must buy their own policies. And it eliminates federal subsidies for low-income families out-of-pocket expenses. Doing so would radically increase the already excessive premiums, co-pays and deductibles faced by many ACA beneficiaries. And by eliminating the individual mandate (which incentivizes younger and healthier individuals to buy insurance), insurance pools would increasingly be dominated by the elderly and sick.

But the above are not even the most inhumane parts of the legislation. States will now be free to deny mental health, reproductive services and other crucial medical services from minimal plan requirements. They also will be able to shift individuals with prior health problems into unaffordable “high risk” insurance pools. High risk pools were tried by 35 states before the ACA and almost all failed because of state underfunding.

DSA consistently argued that the ACA inefficiently expanded health insurance coverage by providing a huge federal subsidy to the private health care industry. We did support expanding Medicaid coverage to nearly 13 million working people and their children (another ten million would be added if the remaining 19 Republican states took the federal funds for Medicaid expansion). The Republican bill will begin to cut that program immediately after the 2020 presidential election (the date is not accidental) and eliminate it entirely by 2023.

DSA has always recognized that the Affordable Care Act would prove an inefficient, flawed and politically vulnerable means for expanding health care coverage, because it did so only by providing huge subsidies to an inefficient and profit-seeking private insurance system. Despite the federal subsidies, many moderate-to-low income families have insufficient coverage characterized by outrageously high deductibles and limited access to providers. Thus given the inefficiency and vulnerability of the ACA, DSA will also redouble our efforts to create state single-payer systems (that is, state-level  versions of “Medicare for All”) wherever possible, particularly in blue states such as California, New York, New Jersey, Minnesota, etc. We will also continue to join with other coalition partners to build a mass national movement for “Medicare for All,” a movement capable of electing to state legislatures and Congress those truly committed to “healthcare for all.”