After beating back the repeated Republican efforts to repeal the Affordable Care Act, Democrats, for the first time in years, are taking the offense on health care. While the flashiest proposal—for an entirely government-run system—remains a distant aspiration, Democrats are again looking for new ways to expand Washington’s role in shaping the health-care system.
Their ideas include new plans to expand coverage, restrain drug prices, and create a public competitor to private health-insurance companies. Encouraging all of these efforts are polls showing that support for the ACA clearly increased during the long legislative struggle over its future.
“People are increasingly happy with the Affordable Care Act, but they are increasingly unhappy with the health-care system writ large,” said Senator Chris Murphy, a Democrat from Connecticut who has co-authored one of the most ambitious proposals. “I think there is a greater willingness to accept a bigger role for public programs in repairing the health-care system.”
The most sweeping Democratic proposal is the plan from Vermont Senator Bernie Sanders to create a national health-care system in which government would become the “single payer” for all medical services, eliminating private insurance. But while that long-standing liberal goal has newly galvanized many activists, most Democratic officials and policy experts still consider single-payer plans politically unrealistic because they are too costly and provide government too much control over health-care delivery.