Statement by Congressman Jim McDermott, Ranking Member-Ways and Means Health Subcommittee

I read with great interest the article entitled, “A State-Based Plan Strong Enough to Stand on Its Own,” in the Health Care for All – Washington 2014 spring newsletter. I appreciated having the time to meet with the author and the President of this great organization in my Washington, DC office recently. I would just like to clarify a couple of points from that article.

First, I believe that we will indeed get to single payer eventually. I have been following the efforts in Vermont and was pleased Senator Sanders was able to hold a hearing on this issue. Single payer has the important benefit of being able to rein in costs and I this is one of the most critical pieces of any health reform effort.

While I believe we will get to single payer, I believe that we must remain committed to implementing the Affordable Care Act (“ACA”). The ACA has done more to reform health care since the passage of Medicare and Medicaid in 1965. No, it is not perfect. But we are close to universal coverage and the law includes significant reforms such as guaranteed issue and the law allows children to stay on their parents’ health insurance plans while they try to find jobs in a less than favorable job market. The law also requires insurance companies to spend a certain amount of each premium dollar on actual care, rather than administrative overhead and executive salaries.

While the ACA continues to hold much promise, it is under assault. We witness this each time the Republicans bring legislation to the floor that would repeal or undermine the ACA – we are at about 53 repeal votes and counting. The House is controlled by Republicans at this point – they set the agenda. This is why nothing will be done to improve the ACA – and I definitely have ideas about how to improve the law – but nothing significant will come to the floor anytime soon. Even the author acknowledged that Senator Sanders’ health staffers “…were pessimistic that any further reform legislation would pass before the presidential election of 2016.” It simply is not going to happen. I give a further example: recently, there was a bill put forth by Republican leadership that would have “improved the law” by granting a couple of insurance companies certain exemptions around paying taxes and providing essential health benefits required under the law: the bill failed to make it through the House – even with the support of Republican leadership. I did not support the legislation because it represented a special bailout for a couple of insurance companies but this is the environment in the House of Representatives: nothing substantive to improve the ACA will make it through – especially before the midterm elections.

This isn’t to say that single-payer advocates should stop advocating. There are two things that can be done: first, advocates should push state legislators to implement the federal basic health option in their states. This is an important provision that we fought hard for and it will result in improved access to care. Second, advocates should push their legislators to support implementing single payer in their states in 2017 – under the authority already included in the ACA. This will take time: even Vermont, which is committed to this effort is going through the painstaking steps of evaluating costs and understanding how exactly single payer will work. It isn’t as if states have to wait until 2017 to begin this process and I think it will take years to actually get there – which is why I commend Vermont for beginning this process.

I believe Vermont offers many lessons for advocates who want to implement single payer on a state by state basis. I have been following Vermont’s efforts closely and I believe the state offers many lessons for those of us who believe single payer will ultimately be the system that guarantees health care for all.