The following editorial originally appeared in The Columbian of Vancouver.
“It’s health care, stupid.”
Adapting the 1992 mantra of then-candidate Bill Clinton — “it’s the economy, stupid” — would be a wise strategy for 2020 candidates from both political parties. Polls have consistently suggested that health care is a primary concern for voters, and the federal government has struggled to find workable solutions.
Democrats must recognize that “Medicare-for-All” is a pipe dream with middling public support. Republicans must recognize that years of attempting to repeal the Affordable Care Act — colloquially known as Obamacare — and empty promises of replacing it have led to skepticism from voters.
At stake is an industry that generated $3.5 trillion in spending during 2017 — about one-sixth of the United States economy. Meanwhile, Republican attempts to undermine the ACA have jeopardized the health insurance of 21 million Americans and coverage for 133 million with pre-existing conditions.
One of those stepping into the leadership void on health care is Sen. Patty Murray, D-Wash. As the ranking Democrat on the Senate Health, Education, Labor and Pensions Committee, Murray has helped shepherd a package of bills to the Senate floor, focusing on lowering the costs for care and for prescription drugs.
The action continues Murray’s effective work with committee chairman Lamar Alexander, R-Tenn. Their bipartisan collaboration in recent years has resulted in budget deals and the Every Child Succeeds Act to remake public education. But health care remains a polarizing issue.
Consider the recent debates among Democratic presidential candidates. Judging from those and from campaign rhetoric, one might think that the only solution to health care is the adoption of Medicare for All or a repeal of the Affordable Care Act.
The Lower Health Care Costs Act passed the Senate committee by a vote of 20-3, but two of the dissenting votes came from leading Democratic candidates Bernie Sanders, I-Vt., and Elizabeth Warren, D-Mass. They, apparently, have settled upon the universal health care as the only possible solution, rejecting piecemeal legislation that likely would be more palatable to voters.
Republicans in Congress, on the other hand, spent years criticizing Obamacare and promising a brilliant alternative. Yet when they had control of Congress and the White House for two years beginning in 2017, they failed to come up with actions to match their rhetoric.
There is no indication that has changed. The Trump administration continues to argue against the Affordable Care Act in court, and last week President Trump said his party is “going to come up with great health care if we win the House, the Senate and the presidency in 2020.” Given his party’s track record, voters should be suspicious of Trump’s promises. As Murray said, “The administration’s policies are undermining health care for tens of millions of people across the country.”
In truth, neither party has developed and effectively sold to the public a health care plan that will energize voters in 2020. The bipartisan Lower Health Care Costs Act would seek to end surprise medical billing, improve transparency of costs and increase the availability of affordable generic medications — representing a middle ground that avoids the radicalism of Medicare-for-All or scuttling Obamacare.
All of that will be essential as the parties position themselves for next year’s election. Because when voters cast their ballots, the most common determining factor is likely to be, “It’s health care, stupid.”