Rep. Jayapal will introduce her version of the Medicare for All bill soon.
Rep. Jayapal will introduce her version of the House's Medicare for All bill soon. Courtesy of Pramila Jayapal Campaign

This post was originally posted earlier Friday morning, but I'm re-upping it with new information from Rep. Pramila Jayapal.

Good news for people who would like to completely overhaul our country's murderous health care system.

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For the first time since the proposal's introduction in 2003, Democrats will hold hearings on Medicare for All (aka H.R. 676) this year, according to the Washington Post. On Wednesday, newly re-elected Speaker of the House Nancy Pelosi promised Congresswoman Pramila Jayapal that her version of the bill will get marked up in the Rules and Budget committees. Jayapal is the co-chair of the Congressional Progressive Caucus and the Medicare for All Caucus.

Jayapal uses some incrementalist language in the Post piece. She talks about moving "one step at a time" with the ultimate goal, at least this year, of forcing "a larger discussion" about single-payer legislation. She hopes the measure will be part of some "2020 Democratic presidential platforms," suggesting what everybody knows, which is that progressive politicians have no delusions of even trying to pass M4A until Democrats control the legislative and executive branches, hopefully sometime in the early part of the next decade.

Though all this cautioneering makes me cringe—especially considering the broad, transpartisan public support for the proposal—it doesn't make a lot of sense to try and pass the bill by next Friday. Democrats don't want to wind up like the Republicans in 2017, who proposed replacing the Affordable Care Act with something something high-risk pools, I don't know, go ask Susan Collins how Maine does it.

And right now, the Medicare for All bills aren't fleshed out enough to fully defend. They're messaging bills. Partly because Congress has never held hearings on them before, the bills don't have financing information nailed down, they don't have a CBO score, and there are plenty of other kinks that need working out. Last summer we got a preview of what a fight about Medicare for All would look like if Pelosi put it on the floor, and it looks bad.

Judging by her language in that article in the Post, Jayapal's new version of H.R. 676 will likely still operate mostly as a messaging bill. Giving the bill some hearings now, though, starts the process. It'll spur more studies, pieces of it will get assigned to other committees, and the bill will get bigger and more complicated and, hopefully, make more friends along the way.

Update, 2:47 p.m. Over the phone on Friday, Rep. Jayapal emphasized that her bill will not simply be a messaging bill. Though Sen. Bernie Sanders's Senate bill and former Rep. John Conyers's 676 bill inspired her new version, Jayapal said it'll be so different that they might not even use the same bill number. "It will be a real piece of structural legislation that outlines the path of how you transform our health care system. It will lay out exactly how this will work with real detail. It will be an implementable plan," she said. When asked about cost, Jayapal said "cost is determined in many ways, and we're developing our own ways of talking about that."

Noting my description of her language in the Post as "incrementalist," Jayapal insisted that securing these hearings is historic, and that they will allow Medicare for All supporters to continue to build the momentum they need to make it a reality. "We can all talk about it on the outside, but we haven't had any movement in Congress for 20 years," she said. And she's right about that. Sanders never got a hearing on the bill. Conyers never got a hearing on the bill. Jayapal did. And that's great!

Anyway, as I was saying, Jayapal's approach will also give the newly formed Medicare for All caucus time to educate the first-year class about the legislation, arming them with the information they'll need to combat Koch-funded white papers from libertarian think tanks.

Giving the bills hearings also shows the country that Democrats are considering the implementation of a single-payer system as a serious solution to addressing skyrocketing health care costs, rising drug prices, etc.

Some progressive activists and journalists have been worrying about the pay-as-you-go rule kneecapping Medicare for All before it even has a chance to climb out of the muck and breathe its first little subcommittee baby breaths, implying that Nancy Pelosi's commitment to hold hearings is a cynical move meant to appease progressives.

But I have read the Vox explainer on pay-go. I have read a progressive case for pay-go. I have scanned various pissy tweets on the subject. And I have determined that none of the current discussion around the rule/statute matters one bit. The entire conversation appears to be amplified by cynical both-sides journalists falling back on a "Dems in Disarray" narrative, and it is dumb.

Pay-go is dumb, too, but the rule won't affect Medicare for All because Medicare for All isn't going to pass in the next two years, and neither will the Green New Deal, and so who gives a fuck if Pelosi just wants to throw conservative Democrats a hollow bone they can use in a 2020 ad if they want to, or if the rule ends up forcing Democrats to think of how they might pay for stuff they want to pass before they propose it? I'm not mad at progressive lawmakers for knocking the policy as a way of making a rhetorical argument against the language of austerity, but the mere existence of pay-go didn't stop them from proposing Medicare for All and the Green New Deal in the first place, and the rule can be waived if they find enough support for those bills anyway. And as we've already discussed, it's probably best that neither bill passes the House this session even if either of them could. And so consternation about pay-go rules governing this session is just a bunch of wasted energy everyone could be spending on STOPPING THE GOVERNMENT FROM JAILING YOUTHS AND GASSING KIDS AT THE BORDER. GOD DAMN IT.

Also, is everyone reading all this shit about Yemen. Holy Fuck.

In any event, hearings on Medicare for All! Yay!