New Speaker Pelosi, House Democrats, plan to hold hearings on Medicare for All. Meanwhile, California and NYC move ahead with their own programs for universal health care which don’t require Capitol Hill, White House approval.

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The News:

Newly minted House Speaker Nancy Pelosi (D-CA) supports holding hearings on “Medicare for All,” her spokesman said last week, marking a major step forward for supporters of a single-payer health system. Some Democrats have been talking about holding hearings on the issue, but Pelosi’s backing is seen as a boost for those efforts. Pelosi had said last year only that Medicare for All would “have to be evaluated” and is “on the table.”

Rep. Pramila Jayapal (D-WA), the main sponsor of Medicare for All in the House, said Thursday (January 10, 2019) that hearings would likely start in the Rules and Budget committees. That would leave out the main committees with jurisdiction over the issue: Energy and Commerce and Ways and Means. The chairmen of those committees have not given their backing to Medicare for All, while the chairmen of Rules and Budget have. Pelosi’s support for hearings, which was first reported Dec. 3 by The Washington Post, is a plus for the movement, but it’s unclear whether she would support further steps such as holding a vote on Medicare for All legislation.

Jayapal has been working to update the Medicare for All legislation and said she hopes to have draft text available “in the next week or two.” She said she is hoping to eventually have hearings in the Energy and Commerce Committee, and has spoken to its chairman, Rep. Frank Pallone Jr. (D-NJ), but he has yet to give a commitment to hold hearings.

“He hasn’t committed that to me but I have the Speaker’s commitment that she will help me to do this,” Jayapal said. “And I spoke to Pallone and Pallone is not opposed, he just hasn’t said yes yet.”

Pallone threw cold water on the idea in November, but that was before Pelosi’s support for hearings.

“I’ve always been an advocate for Medicare for all or single-payer, but I just don’t think that the votes would be there for that, so I think our priority has to be stabilizing the Affordable Care Act, preventing the sabotage that the Trump administration has initiated,” Pallone said in November.

Some lawmakers are awaiting the details of the new version. Rep. Joe Kennedy III (D-MA) told The Hill in November that he was “hopeful” he could support the new version if issues with last year’s bill were worked out. Rep. John Yarmuth (D-KY), the chairman of the Budget Committee, said last year that he planned to hold hearings on Medicare for All.

“Chairman Yarmuth plans to hold a hearing this Congress on the various approaches to expanding coverage and making health care more affordable, which would include different Medicare for All options,” spokesman Sam Lau said Thursday (January 10, 2019).

Rep. Richard Neal (D-MA), the Ways and Means chairman, has been more open to the idea, saying in December that Medicare for All deserved “a conversation.”

Steve’s Take:

Yawn. Medicare for All. Sounds great, but on another front, Senate Majority Leader Mitch McConnell (R-AL) has repeatedly said he will not take up any House-sponsored legislation to re-open the government that does not fund a southern border Wall up to President Trump’s $5-plus billion requirement. If McConnell doesn’t have 60 votes and is assured Trump will sign off, forget it. Not going to happen.

Which is to say, the spirited move by Democrats in the House to achieve Medicare for All via traditional Congressional legislation is likewise DOA in the Senate. McConnell has made that abundantly clear. Attempts to draft and enact Medicare for All on Capitol Hill is therefore pointless, it seems to me, unless Democratic legislators are only seeking another political talking point to rile up the progressive, anti-Trump viewers of MSNBC pundits like Chris Hayes and Rachel Maddow.

That’s show business in Donald Trump’s world, where he plays the role of President, delivering Fox News-scripted talking points to reporters from the White House lawn. You have seen this, right. And yet it’s always the same scene. On his way to the presidential helicopter, whisking him away to who knows where.

But this week, the focus on health care shifted from the do-nothing-for-its-people Congress to two state venues.

Democratic New York City Mayor Bill de Blasio announced Tuesday (January 8, 2019) the City will spend $100 million on health care for low-income residents, including undocumented immigrants, says Fortune. De Blasio’s announcement follows Monday’s pledge in California by incoming Democratic Gov. Gavin Newsom to extend publicly subsidized healthcare to low-income undocumented residents.

In New York, de Blasio’s plan, to begin this summer, provides primary and specialty care to more than half a million uninsured New Yorkers. Called NYC Care, it’s an expansion of the existing MetroPlus program for low-income residents and will be a mix of insurance and direct spending, according to The New York Times.

Eric Phillips, the mayor’s press secretary, said on Twitter that NYC Care is “the city paying for direct comprehensive care (not just ERs) for people who can’t afford it, or can’t get comprehensive Medicaid–including 300,000 undocumented New Yorkers.” De Blasio’s announcement comes as Medicare for All and immigrant rights are being pushed into the political mainstream by progressive politicians and as the conservative Republican Trump administration has launched attacks against both. Critics of expanding the reach of Medicare or Medicaid say it’s too costly.

Regarding de Blasio’s proposal, Fortune reports that Donna Lieberman, executive director of the New York Civil Liberties Union, said her group looks “forward to reviewing the details of this proposal, which has the potential to make basic health care more available to New Yorkers of all backgrounds.” Lieberman said, “Access to health care is a right that should be available to everyone, regardless of income or immigration status.”

Meanwhile, Democrats are trying to convince the public that they’re serious about moving forward on universal health care. On Tuesday (January 8, 2019)House Budget Committee chair Rep. John Yarmuth (D-KY) sent a letter to the Congressional Budget Office requesting a comprehensive analysis of how a single-payer health system would work in the U.S. Yarmuth said that although the Affordable Care Act significantly reduced the number of people without healthcare coverage, “millions of Americans remain uninsured, and millions more–even though they have insurance–struggle to afford their healthcare costs.”

The CBO report will provide a starting point for upcoming Budget Committee hearings “to review potential ways to achieve affordable, high-quality healthcare coverage for everyone, including Medicare for All.” Yarmuth added that an overall cost estimate was not his main objective: “The report would not necessarily provide CBO’s estimate of the effects of any particular proposal for a single-payer system on federal spending or national healthcare spending but would, to the extent feasible, provide a qualitative assessment of how the choices with respect to major design issues would affect such spending.”

Bottom line:

MarketWatch’s Steve Goldstein said Yarmouth’s request signals that Democrats are serious about “moving beyond Obamacare,” but that given Republican control of the Senate, “there’s virtually no chance of a single-payer system being enacted this Congress.”

Steve Benin at MSNBC says it’s too soon to predict the outcomes of Medicare-for-All proposals or what hearings on the idea will produce. He’s right.

But Benin notes that, “The fact that Democrats are taking scrutiny of the idea seriously and are preparing to do the necessary and substantive legwork, suggests they’re at least meeting the bare-minimum standards of how legislating in the United States is supposed to work.”

So, in spite of the endless, insipid drama in Washington, don’t forget the power of individual states like California and influential, progressive cities like New York to push through their own universal health care. It can happen no matter what President Trump, Senator McConnell and even Speaker Pelosi have to say about it.

Who knows: Perhaps this week’s California state and NYC “local” developments signal a much-needed trend toward action, instead of pointless, political TV malarkey by the same talking heads. I hope so.

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