The View from Capitol Hill: A Very Special Conference Episode

It’s the most wonderful time of the year! For activists in the movement to make Medicare for All a reality, this is the week when we gather to plot, scheme, and kvetch. Welcome to the 2024 Annual Medicare for All Strategy Conference, “Healthcare Beyond the Ballot Box,” organized by Healthcare NOW! For those of you who are attending the conference right now, you are getting a sneak preview of our Very Special Conference Episode!

Since our theme this year is about what happens to Medicare for All in an election year — and beyond — we wanted to invite some of our favorite policy people with their fingers on the pulse of what’s happening in DC to help us sort out what’s happening with healthcare on Capitol Hill and what role we can play to get some justice out of DC in the coming year!


Our guests are Eagan Kemp and Alex Lawson.

Eagan Kemp is the health care policy advocate for Public Citizen’s Congress Watch division. He is an expert in health care policy and served as a senior analyst at the U.S. Government Accountability Office prior to coming to Public Citizen.

Alex Lawson is the Executive Director of Social Security Works, the convening member of the Strengthen Social Security Coalition— a coalition made up of over 340 national and state organizations representing over 50 million Americans. 

Show Notes

With one of our major candidates being a guy who is solidly against Medicare for All and the other being Trump, is 2024 a bad federal election cycle, or the worst federal election of our lifetime, and why? Alex puts a positive spin on it: we are closer to M4A with a Biden presidency than any other Democratic presidency. He’s definitely not a M4A guy, but all his other economic policies are based on Sanders-esque populism, rather than Obama-esque neo-liberalism. We’ve seen Biden enact serious corporate reform in several sectors, and in a second Biden administration, taking on corporate greed and sociopathy in health insurance is on the agenda. On the other hand, we know exactly what’s at stake with another Trump presidency, driven entirely by profit for his billionaire friends.

Eagan notes that there has been movement on Medicare in recent years, including die-hard GOPs shying away from talking about cuts to Medicare until after the election. At the same time, we’re seeing Biden moving more toward the M4A movement and the folks trying to expand and improve traditional Medicare. We’re seeing insurance companies running scared, feeling the pressure from our movement in a way they haven’t before.

Alex notes that Biden’s economic vision contains a lot that Medicare for All folks can work with. Our movement worked hard to expand Medicare to include vision, hearing, and dental, which was ultimately included in Biden’s Build Back Better plan. We didn’t get that, but we did get prescription drug negotiations, which is a huge part of improving Medicare before we expand it to everyone. (Go back and listen to another episode where we were joined by Alex to discuss prescription drug negotiations for more details.)

We’ve also seen a lot of good work against Medicare privatization, via Medicare Advantage, and that solidarity has moved the ball a lot – more than ever before to restrain private insurance companies. We didn’t just give up when we knew Biden wouldn’t sign M4A; we pivoted to expanding benefits and reversing the privatization with a lot of success.

Eagan found a silver lining in – of all places – the subject of private equity in healthcare. He thinks we’ve passed the peak of PE ravaging healthcare, and they are now backing off the healthcare sector in part because of increased pressure from the DOJ, FTC and HHS. That’s due to pressure from doctors, patients, and whistleblowers.

Eagan also notes that the Trump administration pilot of throwing seniors in traditional Medicare into private relationships with providers. Our movement worked with seniors to fight that off, and get the Biden administration to curtail the scariest parts of the “Direct Contracting Entities.” Alex credits FTC Chair Lina Khan for challenging corporate power and winning, in a way the FTC hasn’t in decades. Next up the FTC is teeing up UnitedHealth and their massive monopoly. Industry is scared. The movement is putting on the pressure, the agencies are getting wins and the media is starting to pay attention.

Ben says we’re seeing a significant shift in Democratic strategy around healthcare reform, away from the ACA model of just giving more money to private insurance, and toward taking on the industry and cutting off some of their income streams.

When we look at issues like prescription drug negotiations or curbing Medicare Advantage where we’ve gained some ground over the past year, it’s been due in large part to activists increasing the pressure. Public Citizen is working on M4A resolutions, seeing more excitement especially in southern states.

Alex says politicians are lagging indicators (they don’t start reflecting public opinion for a while after a shift happens) and he’s noting that even some are finally ready to accept that privatizing Medicare is ripping us off and killing people.

Another big shift is on the issue of the age of eligibility for Medicare. Not long ago we were fighting off attempts to raise the age to 67. Now President Biden is talking about lowering the age. Biden continues to feel the pressure on healthcare andhas resulted in some real progress.

We talk about the good, the bad, and the ugly post-election scenarios. Good would be a Democratic trifecta (there’s a path, if you squint a little) where we could make a lot of progress toward expanding and improving Medicare. In the Fair column would be another Biden presidency with a divided congress, in which case our movement will have to continue to work on executive actions the president could take. Ugly would be a Republican trifecta, which will immediately mean huge corporate tax cuts and possibly right-wing violence like we saw on January 6. In that case, our job will be to stand in solidarity with our allies against fascism.

It’s becoming harder and harder for people – politicians and voters alike – to deny that we’re on a bleak path. There’s been a real change on the hill, driven by organized people pushing for a better future. We’re seeing real results like drug price negotiations, insulin price reform, and bills addressing medical debt.

If we want to continue the work, one of the most important things we can do is get and stay engaged with our Members of Congress, and start building relationships with the people who are waiting in the wings to run for something in the future. Get involved in local elections now, and those are the folks who will be running for Congress and President in the near future. Tell them your stories! We may never have the perfect scenario with the perfect elected officials, but we need to be ready for M4A to have a moment. Keep building so we will be as ready as we can be.

Alex leaves us with the story of Eugene V. Debs. Socialist and labor leader Debs ran for president and lost several times (1904, 1908, 1912, 1920), but was all lost for his pro-worker priorities? A little over a decade after Debs’s final loss, Frances Perkins and the New Dealers essentially put forth his whole platform and got it done during the Roosevelt administration. If we don’t win M4A, don’t throw up your hands and give up. Keep laying the foundation so we’re the ones who are ready when the time comes.

TL;DR: organize, organize, organize.

If you’d like to hear more presentations from the 2024 Medicare for All Conference, visit the Healthcare-NOW Youtube channel!

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