What a Democratic House will mean for Medicare for All

They helped Democrats take back the House. Now grassroots activists are demanding lawmakers pass single-payer legislation.

UNITED STATES - JULY 19: Progressive Democrats of America holds a news conference to announce the launch of a Medicare for All Caucus at the Capitol on Thursday, July 19, 2018. (Photo By Bill Clark/CQ Roll Call)
UNITED STATES - JULY 19: Progressive Democrats of America holds a news conference to announce the launch of a Medicare for All Caucus at the Capitol on Thursday, July 19, 2018. (Photo By Bill Clark/CQ Roll Call)

Thousands of people dialed into a call Tuesday evening to strategize how Democrats can make unprecedented progress on Medicare for All. A week after the midterm elections handed House Democrats the majority, organizers with National Nurses United hosted a conference call with lawmakers, activists, and just about any #M4A enthusiast, outlining how single-payer legislation passes at least one chamber of Congress. By the end of the one-hour call, most unmuted to say “I believe that we will win” — which started off sounding like static noise given the volume of calls but ended on laughs.

“When we have that majority, we need to make sure that we put it to use,” said Rep. Pramila Jayapal (D-WA). 

Jayapal is calling for a committee hearing and vote on H.R. 676, or the Expanded & Improved Medicare For All Act, when Democrats take back the House. She’s asking every one of the 123 co-sponsors — really, every member of the Democratic caucus — to push for debate, as it’s not enough to say they just support legislation anymore. The Seattle representative and co-founder of the Medicare for All caucus is the new legislative lead on the House bill after former Rep. Keith Ellison (D-MN) left to become the Minnesota attorney general and Rep. John Conyers (D-MI) resigned after multiple sexual misconduct accusations.

“This is going to be an inside, outside strategy,” said Sen. Bernie Sanders (I-VT). “We are going to do our best on Capitol Hill but we need grassroots support.” 


Sanders emphasized the need for loud public support to counter the health sector’s influence, who’s bankrolling anti-M4A efforts. Already, a coalition of insurers, hospitals, and pharmaceutical companies have created the Partnership for America’s Health Care Future to lobby against Medicare for All legislation. Physicians for a National Health Program’s Adam Gaffney, who also joined the call, also warned of competing proposals on the Hill.

“It’s time to talk about where we are going and how we are going to get there,” said Bonnie Castillo, executive director of National Nurses United, an active get-out-the-vote group. “We cannot simply rely on the electoral process.”

“We are going to give Democrats the opportunity to stand up for the people,” added Nina Turner, of Our Revolution. (Over 70 candidates endorsed by Our Revolution won their races, and nine of them were elected to the House.) 

The grassroots movement will target 13 Democrats who haven’t supported H.R. 676 and are on key committees that need to hold a hearing before the bill moves to the House floor. They’ll also target Minority Leader Nancy Pelosi (D-CA), who hasn’t co-sponsored the measure and may be Speaker of the House. Organizers intend to flood representatives’ offices with phone calls, stage nonviolent direct actions, and build community engagement with constituent partners to pressure lawmakers. There’s already a big action planned for February; at least 70 percent of people on the call volunteered to participate, organizers told ThinkProgress. 


Healthcare-NOW Director Benjamin Day said his group already made progress with Rep. Joseph Kennedy (D-MA), who isn’t a M4A sponsor yet. Activists recently canvassed outside grocery stores in his district, asking constituents to phone his office. After more than 250 calls over a two-week period, Kennedy reportedly said he supports single payer but just has a few issues with the bill’s text and is going over it now. “Replicate [this] campaign in your district,” Day advised people on the call. 

Kennedy’s office, however, says their position hasn’t changed recently.

“For years, Congressman Kennedy has unequivocally supported universal access to health care and believes this must be a top priority in the new Democratic House,” said a Kennedy spokesperson in a statement to ThinkProgress. “However, he does not support the current version of HR 676 because — as drafted — it could limit women’s access to reproductive care and close regional hospitals his constituents depend on. As the legislation is updated in the months ahead, he will advocate for changes to address those concerns.”

His office says Kennedy’s position on this piece of legislation has been consistent for years and he made his concerns about the text known months ago.

People on the call were energized, as they saw the midterms as a successful referendum on Medicare for All. A Splinter News midterm election analysis found 57 percent of candidates who endorsed Medicare for All won; these candidates didn’t just endorse the concept but the policy — that is replacing the current private-public insurer patchwork with a single, largely government-run system. Moreover, Democratic candidates who ran in Republican-heavy districts and backed single-payer did better at the polls in 2018 than in 2016.

Democrats have plenty of competing priorities next year, including voting rights, climate change, and the federal minimum wage. That said, members can work on more than one policy; House Republicans passed a health bill, tax overhaul, opioid legislation — to name a few — when they controlled the House. And Democrats did run on health care. The question becomes, what will they do with it?

This post has been updated to include comment from Rep. Joseph Kennedy’s office.