Congressman John Yarmuth | Photo via campaign website

By Lesley Clark | For the Lexington Herald-Leader

WASHINGTON — The increasingly powerful Democratic left sees a huge opening this year to promote Medicare for all in Congress. But they need to persuade Rep. John Yarmuth, and that’s going to be tough.

The Kentucky Democrat chairs the House Budget Committee and supports a limited version of the heath care overhauls that are dubbed Medicare for all. But as budget chairman, his job is to keep a close eye on federal spending, and Medicare for all, even in a limited form, could be seen as a budget-buster.

Yarmuth’s fellow budget committee member, Rep. Pramila Jayapal, D-Washington, a co-chair of the House’s Progressive Caucus, is among the lawmakers championing a sweeping Medicare for all bill that’s expected to be unveiled Wednesday.

Yarmuth plans committee hearings, but they could disappoint progressives who want a sweeping program delivered speedily.

Yarmuth says Democrats are “nowhere remotely close to being able to say there is a Democratic plan.” His committee plans to help narrow the options by looking at several variations of universal health coverage.

On the budget committee alone, three Democrats have their own plans. Yarmuth, who considers himself a progressive Democrat, has co-sponsored a House Medicare for All act since he was first elected in 2006. But he is skeptical of plans such as those proposed by Democratic presidential candidate Sen. Bernie Sanders, Ind.-Vermont. Sanders wants universal health care on demand with no consumer contribution and no role for private insurance companies.

“I’m not sure anybody thinks that can be done,” Yarmuth said. The House bill that Yarmuth has co-sponsored in each Congress retains private insurance plans.

Still, several potential Democratic 2020 contenders have embraced Sanders’ proposal. Sen. Kirsten Gillibrand, D-New York, who co-sponsored Sanders’ 2017 Medicare for all bill, has said she supports the plan where the federal government would pick up the entire tab. Sen. Elizabeth Warren, D-Massachusetts, also endorsed the measure.

Yarmuth, who has asked the Congressional Budget Office to look at the details of creating a single-payer plan, says his job “is to try to deal with it from the impact of the federal budget … and then let the policymakers and the candidates take it from there.”

A July study by George Mason University’s Mercatus Center estimated that Sanders’ bill would add more than $32 trillion in government spending over 10 years. He has disputed those figures, saying his plan would decrease total health spending.

Republicans, who are looking to paint Democrats as embracing socialized medicine, are eager for the hearings to start.

“We think it’s a flawed proposal, we think it will explode an already horrific situation with regard to the debt,” said Rep. Steve Womack, R-Arkansas, the top Republican on the budget committee.

Womack hopes to use the hearings as political ammunition against Democrats.

“We have to tell the American people what the truth is, “ Womack said. “It’s one thing to suggest a program that most everybody can say, ‘Yeah, in a perfect world we’d like to try this.’ It’s a whole other thing to find support when it’s going to have a cost to it that we can’t afford.”

Yarmuth and other Democrats have gravitated to a more moderate and they say politically pragmatic position, expanding Medicare but keeping private health insurance providers.

That includes Sen. Amy Klobuchar, D-Minnesota, a presidential candidate, who suggested during a Feb. 18 CNN town hall that Medicare for all “could be a possibility in the future,” a worthy goal but not immediately attainable.

“What we’re going to try to do is provide information for the public as a backdrop for the debate as to what the financial implications are,” Yarmuth said. “We want to pose the question: ‘Can the country afford it?’ “

Jayapal successfully pressed House Speaker Nancy Pelosi to approve hearings for the legislation before the budget and House Rules committees, but two key House health panels have yet to commit to holding hearings.

Jayapal maintains the hearings show significant momentum for a cause that has been a goal for many in the party since Harry Truman in 1945 proposed a “universal” national health insurance program.

“This allows us to put forward our arguments about why this is important and why the American people deserve it. It’s not just some pie in the sky,” Jayapal said.

She said she’s not worried that the budget committee will arm Republicans with more talking points about the cost associated with the plans because Republicans will talk about health care costs, regardless of what plan is being offered.

“Our job is to talk about the costs of not having health care,” Jayapal said. “Republicans want to say ‘Oh my gosh, everyone is going to pay so much more.’ But the average family is already paying enormous amounts in premiums and deductibles. We have to understand this is costing people not just a lot of money, but the anxiety and stress that comes from not having access to health care.”

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