This story was produced in conjunction with Tarbell.org, a Philadelphia-based investigative news site.
A decade after the nation’s biggest health insurance lobby spent more than $100 million on a campaign to defeat President Barack Obama’s signature health care reform law, Obama’s former top strategist told the organization’s executives that “Medicare for All” likely won’t pass even if Democrats control both branches of Congress.
David Axelrod, who served as Obama’s chief campaign strategist and senior White House adviser, spoke Friday at a conference in Nashville, Tenn., hosted by America’s Health Insurance Plans (AHIP), a Washington, D.C.-based trade organization. AHIP opposes the idea of Medicare for All since it would eliminate the need for private insurance.
Axelrod, now a senior political commentator for CNN, acknowledged that health care costs represent “an onerous burden” for many families. Even so, he predicted Democrats won’t approve a government-run, universal health care system if they manage to defeat President Donald Trump and win control of the Senate in 2020.
“I don’t think Medicare for All, certainly not at this stage, I don’t think there’s a consensus,” he said. “Even if there were a Democratic president -- frankly even if there were a Democratic Senate and a Democratic House -- I don’t think the [Bernie] Sanders version of ‘Medicare for All’ is going to be implemented.”
Between 2009 and 2010, AHIP quietly funneled more than $100 million to the U.S. Chamber of Commerce to defeat the Affordable Care Act. Although the bill passed, Democrats ultimately scrapped the idea of a “public option,” or a government health insurance plan that had been sought by progressives.
Health-care costs have continued to spiral, and have more than tripled over the last 20 years. In 2017, roughly $3.5 trillion, or almost $1 of every $5 spent in the U.S. went to health care. An April poll by the Kaiser Family Foundation shows more than 50 percent of Americans favor a national health-care program, although that support softens if the possibility of private health insurance plans is removed.
Axelrod said that Medicare for All has “become a phrase as much as anything else.” He suggested that some Democratic presidential candidates may not want to go as far as Sen. Bernie Sanders, a Vermont independent credited with sparking support for Medicare For All during his 2016 presidential campaign, and might support more limited reforms like a public option or allowing some people under the age of 65 to buy into Medicare.
“Americans don’t generally want to destroy the private health care system,” Axelrod said. “They want to strengthen it. And they think maybe they can augment it. They want options, and they mostly want to bring down costs.”
The AHIP conference featured a slew of other former Obama officials, including Andy Slavitt, who led the Centers for Medicare & Medicaid Services; former Surgeon General Vivek Murthy; Sam Kass, the former White House chef and nutrition adviser; and Kavita Patel, who served as a policy aide in the Obama White House.
Patel, currently a Brookings Institution nonresident fellow and vice president at the Johns Hopkins Health System, harshly criticized Medicare for All. “People who are very serious about health policy on either side of the fence know this is not reality,” she said. She suggested that Democratic presidential candidates’ support for Medicare for All is “all just campaign talk.”
“You don’t see [House Speaker] Nancy Pelosi out there stumping for this,” she said. “I think it’s because she knows while there is some incremental gain in access, the cost will be dramatic, and that could lead to a decrease in access over time, potentially.”
Tim Zelina contributed to this story.