MONTPELIER — With a re-election bid looming in 2018 and a potential second presidential run further on the horizon in 2020, Sen. Bernie Sanders is focusing his time, attention and campaign dollars on drumming up support for a complete overhaul of the nation’s health care system.
The 75-year-old independent senator is almost assured re-election to the Senate if and when he officially declares his candidacy. Whether he will launch a second bid for the White House is less clear. While the country attempts to catch its breath after the furious but failed effort to repeal the Affordable Care Act, Sanders is prepping a new national campaign to build support for a Medicare-for-all single payer health care system.
It’s the moment Sanders has been waiting for to achieve a policy goal he has coveted for decades. Americans have come to rely on former President Barack Obama’s signature domestic achievement, but they need more, Sanders told the Vermont Press Bureau in an interview.
“In my view, there is no question that the Affordable Care Act … has had some significant success — 20 million more Americans are now receiving health insurance, we have dealt with obscenities like pre-existing conditions,” Sanders said. “But, the truth remains that there are very, very serious problems today with the health care system, despite the gains of the Affordable Care Act, and those problems are high deductibles, high copayments and high premiums. And there are many people still without health insurance.”
“The American people saw some progress and feel reasonably good about the Affordable Care Act but they think more needs to be done,” he added.
Sanders said the “disastrous and inhumane” GOP proposals to repeal the ACA, pushed by President Donald Trump and Senate Majority Leader Mitch McConnell, R-Ky., are not the proper prescription for the country’s ailing health system. The proposals include cuts to Medicaid and defunding Planned Parenthood.
“All of those ideas are moving in exactly the wrong direction. They are outrageous and I did everything I could to defeat them,” he said. “The American people want an alternative.”
Sanders is stepping into the breach with an alternative — a Medicare-for-all single-payer health care system. It’s not an original concept, and certainly not a new proposal for Sanders. Since joining the House in 1991 where he served before his election to the Senate in 2006, Sanders has introduced or co-sponsored 12 bills seeking a single payer system.
“This is not a new idea for me. I’ve been an advocate for a Medicare-for-all single-payer system my whole career,” he said. “Right now, we are kind of dotting the Is and crossing the Ts.”
Aides say the legislation will be unveiled when senators return to Washington in September. It’s part of a gamed-out, three-part act, from the immediate goal of saving the ACA from Republican efforts to undermine it, to patching the system in the short-term and then finally implementing Sanders’ panacea.
“You look at the moment and you also look at the future. At the moment, what we had to do is defeat those disastrous proposals. Hopefully, that will not resurface,” Sanders said. “It really did in the past few months make me almost physically sick to think that there was a possibility that 23 million Americans could be thrown off of health insurance. It really did make me sick and it propelled me to work as hard as I could.”
With repeal efforts on the back-burner, at least for now, Sanders and other Democrats want to address “some serious and acute problems” with the ACA.
For Sanders, that means “seeing if it’s possible to put together a coalition in Congress who are prepared to take on the pharmaceutical industry and lower the cost of prescriptions.” It also means finding insurance solutions for parts of the country where people cannot obtain private insurance plans. For the latter short-term dilemma, Sanders said he hopes Congress will embrace lowering the age of Medicare eligibility to 55.
He is likely to find broad support within the Democratic caucus for his short-term proposals. Senate Minority Leader Chuck Schumer, D-N.Y., has voiced support for pursuing lowering the age of eligibility, and some Republicans have acknowledged the need to shore up the health care system.
Sanders’ ultimate goal, however, will require massive changes in Washington.
The unabashedly liberal senator is showing a bit of pragmatism as he pursues his opus. While he marches forward with his proposal, he is also acknowledging the very real hurdles entrenched in his path. With Trump occupying the White House and Republicans controlling both the House and Senate, achieving the liberal Holy Grail of policies won’t happen anytime soon.
“It’s not going to happen with that kind of political reality,” Sanders said. “If we are going to win this thing it has to be well-organized and well-thought-out. It has to be a national movement.”
Sanders said “the job right now is to energize millions of people across the country.” For Sanders, that means traveling the country, as he has continued to do since ending his presidential campaign in July 2016. It means getting doctors, nurses, unions and “ordinary working people” on board “who understand that health care is a right and not a commodity.”
There will be fierce opposition. Sanders said he expects insurance companies, drug companies, “the entire political and media establishment” and “parts of the Democratic Party” to mobilize against the proposal.
“This legislation is not going to be won overnight. I suspect at least tens and tens of millions of dollars will be spent against us,” he said. “What you’re going to need is a groundswell and a very, very strong grassroots movement, which is part of what I have called the political revolution.”
Sanders, and his Senate campaign committee, Friends of Bernie Sanders, are gearing up for the fight. As The Guardian recently reported, Sanders’ campaign has launched a six-figure ad campaign on Google and Facebook to promote Medicare-for-all. The campaign has also sent emails to millions of Sanders’ supporters seeking their input and promoting the plan.
Sanders and his aides have been working for months on both the policy and the strategy to pass it. Aides say the blueprints are straight from Sanders and rely on his political instincts. They are bolstered by a recent Quinnipiac Poll released earlier this month that found a slight majority of Americans — 51 to 38 percent — support the idea.
“There is growing support. Nobody will debate the fact — and this last poll makes that clear — there is more and more support, not only from Democrats and independents, but from Republicans as well,” Sanders said.
The plan is more popular among Democrats and independents, with 67 percent and 51 percent support, respectively. Republicans, meanwhile, are more skeptical, with 29 percent supporting it and 62 percent opposing it.
Sanders is also banking on Americans heeding his message that a Medicare-for-all system is “not a radical idea.” If Medicare works for seniors it can work for everyone, he said.
“It is a popular program. It has done what it was supposed to have done. It has extended the life of seniors, kept them healthier and kept them happier,” Sanders said.
The challenge for Sanders will be balancing the desire of single-payer supporters for immediate action with the existential political reality. Sanders is playing the long game but supporters may grow impatient. As Sanders embarks on his Medicare-for-all campaign, he will have to temper expectations while building more support.
“What has to be understood is that if we were to pass a Medicare-for-all bill, this would be the most significant piece of legislation, in my view, domestic piece of legislation, since the 1930s,” he said. “We will learn from all failures and try to develop that coalition that can finally give the people of the United States what every other major country has.”