Democrats in the House disagree over the choice of the country's health system, but internal conflicts have eased and they can thank President Donald Trump.
The renewed attack by the Trump administration on Obamacare has so far eased tensions around the "Medicare for All" between the progressive wing of the Democratic Party and more moderate members and leaders.
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Even the most ardent defender of the single payer knows that this is not done overnight – and that in the meantime they have to gather around Obamacare, both because they want to prevent millions of people to lose their insurance and because the Affordable Care Act and its protection people with pre-existing conditions have become a the most powerful political messages of the Democrats.
"I have never seen a single Democrat who is not committed to supporting the ACA," said Representative Ro Khanna (D-Calif.), A prominent and dedicated Medicare for All supporter. "And nothing prevents us from saying that we are going to defend the law on affordable care, but we will also fight for health insurance for all."
Yet the democratic differences in the scope and speed of health coverage extension remain below the surface, and Republicans are eager to exploit them. The Senate, led by Republicans, is considering voting on Medicare for all for the sole purpose of dividing and embarrassing Democrats – as they have recently tried with the Green New Deal. And from the White House, the GOP is looking for every opportunity to portray the Democrats as reckless socialists in the run-up to the 2020 elections.
But the ACA, which was extremely controversial at the last House of Democrats in the House almost a decade ago, is now the main motto of party leaders hoping to keep the caucus going until 2020.
"We have to save what we have," said freshman representative Donna Shalala (D-Fla.), Health secretary to former president Bill Clinton and close to President Nancy Pelosi. "The message [from leadership] is: we have to regroup now. We are open to further discussions, but the first step is to defend the Affordable Care Act. "
The resumption of the legal battle, coupled with Trump's recent promises to repeal and replace the law after the 2020 elections, has been a gift for Democrats, who have spent much of the first three months of the elections. Year, impeded by internal struggles and the need to make concrete progress at the top of the party. health care priorities.
House Democrats voted 40 seats in November to protect pre-existing conditions and reduce prescription drug costs, a message that resonated in both the red and blue districts. But it has proved difficult to follow through on these policies.
Today, at around 100 days of power, the party has only very little effort to deploy, apart from the adoption of some defenseless resolutions condemning the agenda of Trump on health and a list of bills that even Democratic legislators admit to be "fruits at hand."
"Who has planned a 35-day stop? The recovery has been quite long, "said Representative Jan Schakowsky (D-Ill.), Echoing the frustrations generated by the caucus, that the protracted stalemate over funding at the border was hampering the Democrats' agenda. . "I think after this break you will see more action."
Democrats still have to agree on how to pay the hundreds of millions of dollars that their legislation could devote to ACA and the expansion of health insurance subsidies. And with regard to the price of drugs, Democrats remain divided over how aggressively they should tackle the problem and about collaboration with Trump, who described some personal steps that break with Republican orthodoxy.
Many progressive democrats want to force pharmaceutical companies to negotiate their prices with Medicare or face heavy penalties. Other policies are also on the agenda and Democratic leaders have begun talks with the White House, causing a new wave of grumbling among the House Liberals..
"We have certainly not kept our promise on pharmaceuticals yet," said Lloyd Doggett (D-Texas), author of an ambitious Medicare bargaining plan that was approved by bedroom. "I hope we can."
But Trump's surprise legal attack on Obamacare diverted the spotlight from the Democrats' struggles to return to the GOP's long-standing attempts to overturn the law, easing the pressure on the big Democrats who spent much of the year to try to maintain the cohesion of the caucus.
The Trump Department of Justice had originally argued that part of the lawsuit filed by Texas to dump the law; she recently gave her full support to the judge's ruling that the law as a whole is unconstitutional and should be removed. This decision is now on appeal and could reach the Supreme Court in the middle of the 2020 campaign. Yet Republicans have so far ignored the need to develop an emergency plan in case of fall of Obamacare.
"Since I've been here, Republicans have never agreed on a health care plan. Not once, "said Ways and Means President Richard Neal (D-Mass.), Who had to face intense pressure from activists not to hold hearings on Medicare for All. "If he wants to have this battle on health care, I'm in."
Representative Anna Eshoo (D-Calif.), Who chairs the health and trade subcommittee and heard similar criticisms from the left about her links with major drug donors and her district of origin, rich in biotechnology, seems visibly relieved of the opportunity to distract the public from the Republicans.
"Happy to start the day with a smile," she said about health care.
Democratic House leaders hope to regain their place in the health care sector after the parliamentary recess in April when the House votes for its first round of drug bills. And a package that broadens the benefits of Obamacare and reverses Trump's top health priorities could come in early this summer, giving vulnerable members of the legislature the opportunity to talk about the election campaign.
The centrist Democrats, frustrated by the publicity given to the party's liberal wing, rely on these actions to redirect their attention to a pragmatic agenda that exploits the strengths of the swing district moderates who toppled dozens of seats in 2018. promising to protect Obamacare.
"You have to love the activists: they are so passionate, they feel the need and it's great," said Rep. Ron Kind (D-Wis.). "But those of us in elected positions must also deal with the real world and achieve what is achievable for the moment."
However, new disagreements on policies and strategies will certainly occur in the coming months.
Senator Bernie Sanders (I-Vt.) Angered some Democrats just this week with the highly publicized launch of his revised single-payer bill, amidst House and Senate efforts to lure 39, attention to the price of drugs and trump Obamacare attacks of the administration.
"We were winning," complained a senior Democratic official at POLITICO the day of Sanders' announcement. "It's like when we were trying to save DACA [immigration protections for Dreamers] and some Democrats have begun to call for the abolition of ICE. "
The progressive wing of the House is also determined to continue pushing the party to the left, rallying its support for Medicare for All and encouraging activists to lobby. committee leaders to hold hearings – much to the frustration of the establishment democrats.
But just about every Democrat, from fervent Medicare for All supporters to centrist rotating districts who are wary of the single payer principle, has expressed support for Pelosi's efforts to defend Obamacare in federal court, strengthen its markets, and back Trump. The decrees of the administration aimed to weaken the law, even if they were not in agreement on where to go.
"Nancy is great in this area, allowing us to stay together," said Mark DeSaulnier (D-Calif.) Representative, Medicare for All Advocate. "In health, you can have both, but the question is when. And the first thing to do is not to hurt.