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How 'Medicare for All' became a casualty of the Biden era

Poor turnout at the March for Medicare for All symbolizes how the policy has lost momentum.
Illustration of a photo showing protesters attending a Medicare for All Rally on July 24, 2021 in Milwaukee.
While Saturday’s nationwide event was meant to revive public attention around the policy, it ultimately revealed how far the policy has fallen from national prominence since the election.MSNBC; Ebony Cox / Milwaukee Journal Sentinel via Imagn

In dozens of cities across the nation this weekend, demonstrators marched to advocate for government-run health insurance under a “Medicare for All” plan. Unfortunately, it wasn’t exactly a success.

The marches were not huge: They ranged from dozens to hundreds of participants. While they got some attention on social media, they received sparse, almost nonexistent media coverage. And the rallies did not receive backing from many of the biggest champions of Medicare for All — including Rep. Alexandria Ocasio-Cortez, D-N.Y., and, most notably, Sen. Bernie Sanders, I-Vt., who had put it on the map in 2015 and was such a fierce and effective fighter for the policy that it defined the 2020 Democratic presidential primary.

While Saturday’s March for Medicare for All was meant to revive public attention around the policy, the event ultimately revealed how far the policy has fallen from national prominence.

While Saturday’s March for Medicare for All was meant to revive public attention around the policy, the event ultimately revealed how far the policy has fallen from national prominence since the election. Despite the fact that Medicare for All has generally polled very well in recent years and surged in popularity during the early stages of the pandemic, its momentum has reversed at an astonishing pace.

Much of that is due to the hard realities of the Senate. But it also reflects how President Joe Biden has won over — and arguably co-opted — more progressive lawmakers by tilting to the left in other policy areas and how much the socialist left still relies heavily on a few major politicians to express its grievances.

The fading of Medicare for All — one of the most promising ways to alter the way Americans think about the shortcomings of a radically privatized society — has in turn probably reduced the likelihood of the badly needed compromise of a public insurance option.

Some of this isn’t exactly a surprise. Biden ran as a moderate opposed to Medicare for All in the Democratic primaries and suggested he might even veto the legislation in the event that Congress passed such a bill. Even if his administration were somehow secretly interested in the concept, he’s currently working with a Senate Democratic majority so slim that a policy as sweeping and polarizing as Medicare for All — which would require a 60-vote majority to overcome a filibuster — is simply a political impossibility.

But still, the idea of Medicare for All has vanished from the national consciousness surprisingly quickly. Initially after the election, a small sector of the online left, led by Sanders’ former press secretary Briahna Joy Gray, advocated for leftie Democrats like Ocasio-Cortez to hold Nancy Pelosi’s speakership hostage unless Pelosi brought a Medicare for All bill to a floor vote. But after that idea failed to win buy-in from lawmakers and the broader left due to strategic concerns that it could backfire, there’s not been much talk of the policy.

One of the big factors here is that Biden has effectively turned his biggest gadfly, Sanders, into an ally. After Biden won the primaries, he savvily formed a unity task force to garner buy-in from the Sanders wing of the Democratic electorate. That relationship has carried through into the Biden presidency, and Sanders is now energetically promoting the bills of a Democratic president rather than slamming them as milquetoast.

This is not to suggest that Sanders is a dupe — the Biden administration has listened to progressive input on issues like nominating Deb Haaland for interior secretary and tapping Lina Khan to chair the Federal Trade Commission. And the initial Covid-19 relief bill was strikingly ambitious for a politician who had once promised rich donors “nothing would fundamentally change” if he became president. Biden’s interest in big spending on programs like infrastructure reform and child tax credits has convinced some progressives that there may be more to be gained from working with him than against him.

Biden seems to be setting aside any serious health care reform effort — at least for now — that could deal with the underlying issues that plague our disgraceful health care system.

But Biden also seems to be setting aside any serious health care reform effort — at least for now — that could deal with the underlying issues that plague our disgraceful health care system. His major reform policy of a public option — which could arguably serve as a forerunner to more sweeping efforts along the lines of Medicare for All — didn’t even make it into the spending plan of his latest budget proposal.

The Biden administration’s disinterest in pushing for the public option can’t be explained away by the Democrats’ slim Senate majority: Some experts say it is possible to pass the public option with a simple majority through the budget reconciliation process. And the most conservative Democrat in the Senate, West Virginia's Joe Manchin, has said he’s open to the idea. It certainly couldn’t hurt to try — but the longer it sits on the back burner, the harder it will be to pass.

This all underscores the tragedy of the ebbing of Medicare for All’s public profile. The plan itself might not be realistic until Democrats can establish more dominance in the Senate, but its salience is a guiding light for critical reform efforts to make our barbarous and unusual health care system a bit more civilized. Without Medicare for All in the discussion, the ability of the nation to think about the virtues of social democracy is hobbled.

Ultimately the low turnout and poor coverage of the Medicare for All marches this weekend showed how much the burgeoning American left requires the backing of a handful of star politicians to make a splash. It still has a long way to go in terms of growth and organization in order to protect itself from being so easily sidelined.