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Pelosi on Medicare for All: The Affordable Care Act Gave People 'Better Benefits'

Nancy Pelosi
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April 5, 2019

Speaker of the House Nancy Pelosi (D., Calif.) on Thursday appeared to pour cold water on the idea of Medicare for All, suggesting that Democrats should be building on the Affordable Care Act, not scrapping it.

Pelosi, who has also expressed skepticism about the Green New Deal, told the Washington Post that she is "agnostic" about Medicare for All, which is backed by several 2020 Democrats.

"I’m agnostic. Show me how you think you can get there," Pelosi said. "We all share the value of health care for all Americans — quality, affordable health care for all Americans. What is the path to that? I think it's the Affordable Care Act, and if that leads to Medicare-for-all, that may be the path."

"When most people say they're for Medicare-for-all, I think they mean health care for all. Let's see what that means. A lot of people love having their employer-based insurance and the Affordable Care Act gave them better benefits," Pelosi continued.

She also said that she believes Medicare for All is more of a buzzword for liberal activists versus policy that will actually produce results, according to the Post.

Her comments come as President Trump abandoned plans to press for a vote on a bill to replace the increasingly more popular ACA, often called Obamacare, ahead of next year’s election, as Republicans have had little appetite to take on an issue that benefited Democrats politically.

Pelosi’s remarks served as the strongest words of caution from a senior Democrat about a policy proposal that is serving as an ideological fault line on the campaign trail and among her own caucus. Republicans also have sought to use Medicare-for-all as a cudgel against the Democrats.

Medicare-for-all, once seen as a far-off hope of Sen. Bernie Sanders (I-Vt.) in his 2016 ­presidential campaign, is now the focus of legislation co-sponsored by more than 100 House Democrats. Rising stars such as Rep. Alexandria Ocasio-Cortez (D-N.Y.) have linked arms with veteran liberals in the caucus to promote the legislation.

"I don’t think you can say, 'Let's get rid of the Affordable Care Act so we can have Medicare-for-all,' because you can't get to Medicare-for-all unless you have some of the resources of the Affordable Care Act," Pelosi said.

Earlier in the week, Congressional Progressive Caucus co-chair Pramila Jayapal (D.,Wash.) confronted Wendell Primus, who serves as Pelosi's senior health policy adviser, over reports that he privately castigated her Medicare for All proposal. Jayapal, the lead author of the plan, H.R.1384, said she made sure Primus knew she wasn't happy, according to Politico

"I made it clear that I was not happy," Jayapal said. "I think it’s really inappropriate for staff representing the Speaker’s office to be undercutting members of our caucus."

Pelosi's spokesperson Henry Connelly pushed back against the notion that Primus offered a one-sided analyses of single payer, saying, "No one has anything to fear from good-faith research on Medicare for All."