What the Single Payer Movement Can Learn From “Repeal and Replace”

by Benjamin Studebaker

Single payer healthcare seems to be getting more popular. More people are becoming aware of the advantages of single payer. A majority of Americans now say that the government has a responsibility to make sure all Americans have healthcare coverage, and more than half of that majority now think the best way to do it is single payer:

The current push for single payer does however have a lot in common with another political movement–the Republican effort to repeal and replace Obamacare.

Throughout the Obama presidency, Republicans in congress tried to pass legislation repealing Obamacare. Depending on how you count, they tried somewhere between 6 and 54 times. But when President Trump took office and there was a real possibility that the president would sign repeal legislation, suddenly many Republicans had cold feet. Now many Republicans admit that the repeal votes were posturing.

Representative Mo Brooks (R-AL) said:

We have Republicans who do not want to repeal Obamacare. They may have campaigned that way, they may have voted that way a couple of years ago when it didn’t make any difference. But now that it makes a difference, there seems to not be the majority support that we need to pass legislation that we passed 50 or 60 times over five or six years.

When Representative Pat Meehan (R-PA) was asked if the Obamacare votes were merely “ceremonial,” he responded in the affirmative. He then went on to say:

I don’t think anyone would quarrel with the idea that they were largely position votes. They were as political as they were anything else because there was a recognition that those were unlikely to be moved.

The Intercept has cataloged several more occasions where Republicans have talked this way. They calculated that it would be politically advantageous to appear to support repeal even though they had no intention of following through. Republicans who used the Obama-era repeal votes to judge Republican support for repeal were badly misled and easily caught off guard by repeated Republican failures to pass any substantive healthcare policy.

Like the Republicans, the Democrats now find themselves in opposition, and like the Republicans the Democrats have been able to identify a sexy policy that their base loves–single payer. It doesn’t matter that none of these Democrats co-sponsored single payer when Senator Sanders proposed it in 2013. It doesn’t matter that many of these Democrats endorsed Hillary Clinton, who even now compares single payer to “a pony”. It doesn’t matter that someone like Cory Booker (D-NJ) voted against allowing Americans to purchase less expensive Canadian drugs as recently as this past January. We’re now expected to believe that at least 16 Democratic senators–many of whom are rumored to have presidential aspirations–genuinely support single payer.

In the wake of the Republican “repeal and replace” disaster, we would be tremendously foolish to buy it. Is it possible that some of them have evolved, or made new political calculations as single payer has grown more popular? Sure. But we’ve seen the entire Republican caucus line up for repeal and replace, only for crucial chunks to defect as soon as it stopped being a game. This happened even in spite of a concerted effort by hardline “Tea Party” Republicans to purge the party of RINOs, the Republicans In Name Only they feel they can’t trust. In the 2016 election there was one Democratic candidate who was for single payer and one who was against it, and only one senator–Jeff Merkley (D-OR)–endorsed the pro-single payer candidate. Even Elizabeth Warren (D-MA) didn’t think single payer was important enough to intervene on its behalf.

Maybe some of them thought that Clinton was inevitable, that supporting Sanders would just diminish their access to and influence in a new Clinton administration. But not all of them. And with Republicans determined to block proposals like single payer, Democrats need every single person in their caucus to be ready and willing to pull the trigger. There can be no Lisa Murkowski, no Susan Collins, no John McCain.

The Republicans tried really hard to weed these people out, and in spite of their best efforts, they failed. In 2010, they beat Murkowski in a primary, but with help from Alaska Democrats she beat their candidate as a write-in. They tried to knock McCain off in the 2010 and 2016 primaries, to no avail. Now they find they can’t do most of the things they promised. They can’t build the wall, they can’t repeal and replace, and we may soon find that they can’t even cut taxes. The Democrats will end up in the same place in four or eight years if there is no intensive grassroots effort to purge the party of the DINOs and DODs (Discrimination-Only Democrats) who don’t recognize forms of economic injustice and care only about discrimination and inequalities of social status. It won’t be enough to do what the Republicans did–the Democrats must go further if they wish to unite their caucus behind anything substantial.

By the 2010 midterms, the Republicans were already trying to unseat untrustworthy people in primaries. 2018 is important, not because we need to find out if the Democrats will win seats–the opposition party almost always gains seats during midterms–but because we need to find out if the right kind of Democrats will win seats. In the first two years of Obama’s presidency, the Democrats had a supermajority in congress and couldn’t even find the votes to pass the public option, let alone attempt single payer. If we repopulate congress with Democrats who don’t care about economic injustice, we’ll get the same old result, in spite of the loud promises they may make to the contrary.

Beware those Democrats who didn’t support single payer in 2013, who didn’t support the candidate who backed single payer in 2016, who didn’t vote to help poor and working Americans buy cheap Canadian drugs in 2017, but who now tell you they’re happy to co-sponsor a single payer bill that President Trump has already promised to veto:

We’ve seen this play before. We know how it ends.