As you’ve heard, the Trump administration has, in an act of supreme venality and bad faith, decided to fully embrace a lawsuit that seeks to overturn the Affordable Care Act based on a bonkers legal theory that has been dismissed by legal observers across the ideological spectrum. Paul Waldman already explained why this threatens to unleash Armageddon in our health-care system and gives Democrats a big issue against Trump and other Republicans in 2020.
But I’d like to point out another way in which the continued Trump/GOP quest to destroy the ACA poses a risk: It comes at a moment when there appears to be widespread public support for pushing our health system in a substantially more progressive direction.
A new Quinnpiac poll finds a majority of American voters support creating an option for all Americans to buy into Medicare:
Do you think that keeping the current health care system but allowing all adults the option of buying into Medicare is a good idea or a bad idea?
The poll also finds that the public is not as supportive of replacing the current health-care system with a single-payer one, or Medicare-for-all. Americans are almost exactly split on that question, 43 percent to 45 percent.
But what’s particularly interesting about Tuesday’s finding on giving everyone the option to buy into Medicare is the support it has among multiple voter groups.
Since Democrats won the House back in 2018, one big question has been whether the coalition that delivered them the majority could endure, going into the 2020 battle to oust President Trump. The 2018 win caused enormous numbers of college-educated and more affluent white voters, apparently disgusted with the Trump presidency, to flood into the Democratic coalition, helping Democrats win numerous moderate and even Trump-leaning House districts.
But since then, the ferment in Democratic politics has raised questions as to whether that will hold going into 2020. With emboldened progressive House members pushing policies like a Green New Deal and Medicare-for-all, the speculation among some political observers has been that this could alienate some of the more affluent suburban whites, who, it was said, gravitated to Democrats largely out of disgust with Trump personally and might not be too comfortable with overly progressive policies.
Yet the Quinnipiac poll challenges this assumption. It finds that college-educated whites support creating a Medicare option for everyone, or a Medicare buy-in, by 54 percent to 29 percent. Meanwhile, among core groups in the Democratic coalition, young voters support this by 64 percent to 23 percent, Latino voters by 50 percent to 27 percent, and African Americans by 46 percent to 34 percent. (Majorities of those groups also support Medicare-for-all, but majorities of college-educated whites do not.)
The point is that there’s no need to reflexively assume that a progressive policy such as this one would necessarily strain the Democratic coalition that looks as if it might be coalescing to defeat Trump. A Medicare buy-in seems to have appeal to all groups in this coalition. On top of that, non-college-educated whites also support a Medicare buy-in, by 51 percent to 31 percent, so this could potentially mean it wouldn’t compromise Democratic efforts to win back those voters. Other polls have found that various versions of a Medicare buy-in to be even more popular.
My point here is not to argue for a Medicare buy-in rather than Medicare-for-all but instead to note that there seems to be broad support for overhauling our health-care system in a generally more progressive direction.
Just consider the trajectory of the past few years. Obamacare was initially unpopular, and Republicans successfully ran against it. But when they finally had total control of everything, their repeal effort ignited a massive public backlash, and it crashed and burned. Democrats ran relentlessly on preserving Obamacare’s protections in 2018 and won the House, even as Republicans lost ground everywhere despite lying endlessly about how they would actually preserve protections, too. Now majorities support a Medicare buy-in option for everyone.
Yet Trump is, if anything, marching Republicans into an even more nihilistic repeal position, which only further reveals the GOP to have nothing on health care, ceding more of the reform field to Democrats, right when public sentiment seems fertile for more progressive reform. That seems awfully risky, doesn’t it?