Sanders health care bill: A cover for Democratic Party deals with Trump

By Patrick Martin

Sanders and the Democrats have not changed their spots. 

The bill was given full-scale media promotion, including an op-ed column by Sanders in the New York Times, lengthy articles in all the major daily newspapers, and reports on the network and cable television news programs. This for a bill which has not the slightest chance of passage by the Republican-controlled Congress, which will never even hold a committee hearing, let alone bring it to a vote.

This makes co-sponsorship an opportunity to strike a left pose without actually incurring the wrath of the insurance companies and other giant corporations that control the provision of health care in the United States. Accordingly, a half dozen Democratic senators who are beginning to promote themselves as potential 2020 presidential contenders signed on as co-sponsors—up from zero co-sponsors the last time Sanders introduced such a bill.

The list of co-sponsors demonstrates the cynical and fraudulent character of the Medicare for All Act of 2017, the bill’s official title. It includes Corey Booker of New Jersey, a favorite of the insurance industry, and Kirsten Gillibrand of New York, the junior senator from Wall Street who received $2.7 million from the financial industry and $500,000 from insurance companies in her re-election last year.

Nearly 60 percent of House Democrats have endorsed a similar “Medicare for all” bill introduced by Representative John Conyers of Michigan, but this support is meaningless, since the Republican majority controls all action on the House floor.

Significantly, neither House Democratic Leader Nancy Pelosi nor Senate Democratic Leader Charles Schumer have signed on to the bill. Neither has the top Democrat on the Senate Health, Education, Labor and Pensions Committee, Patty Murray of Washington, nor key Democrats in the Midwest like Sherrod Brown of Ohio and Debbie Stabenow of Michigan.

The Sanders bill cannot be judged simply by its text, but rather by the political purposes for which it has been brought forward. The goal of the exercise is to provide a political smokescreen for backroom Democratic Party dealings with the Trump administration, on health care and especially on tax cuts.

Representative Kevin Brady, the Republican chairman of the House Ways and Means Committee, which would write the tax cut legislation, said some details would be released on September 25, although the actual bill will not be drafted until after Congress approves a budget resolution.

This sequence is necessary in order to invoke so-called “reconciliation,” a process that allows legislation to pass the Senate by a simple majority, rather than requiring 60 votes to overcome a filibuster. That would require the support of at least eight Senate Democrats and a unanimous Republican caucus, considered unlikely. But even to reach 50 votes in the Senate will likely require some Democratic support to offset Republican defections. Democrats will be equally critical in assuring passage through the House as well, because of likely opposition by the ultra-right Freedom Caucus of Republicans, who want tax cuts combined with massive spending cuts.

The cynicism of the Sanders health bill is that on the same day he introduced legislation that would purportedly put the private health insurance industry out of business, Democratic leaders were dining with Trump at the White House, discussing his plan to give the health insurance giants—and the rest of corporate America—tax cuts worth hundreds of billions, and even trillions, of dollars.

Schumer and Pelosi were to discuss taxes, health care and immigration at the White House dinner, according to press reports. Trump also met Wednesday with a bipartisan group of members of the House of Representatives to discuss his plan for a massive cut in corporate taxes, from the present (largely nominal) level of 35 percent to only 15 percent.

The day before, Trump hosted six senators, three Republicans and three Democrats, at dinner, seeking their support for the business tax cut. Each of the three Democrats—Joe Manchin of West Virginia, Heidi Heitkamp of North Dakota and Joe Donnelly of Indiana—said afterwards they were open to working with the White House.

Besides tax cuts, key Democrats are working with the Trump administration and congressional Republicans on various aspects of health care, in the wake of the failure of the Republicans to push through an outright repeal of Obamacare.

Two Republican senators, Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, made public legislation Wednesday that would not abolish Obamacare, but convert the funds provided by the Affordable Care Act into block grants to the states, which could use the money as they chose—Democratic-run states maintaining the structure of Obamacare exchanges, Republican-run states moving to voucher programs modeled on health savings accounts. Under the complex financing formula spelled out in the bill, money would be taken from high-cost, largely Democratic-run states like New York and California and shifted to poorer states, mostly Republican-run.

This is the last attempt by any section of Republicans to make use of “reconciliation” to pass a major change in Obamacare. Authority to use the reconciliation process will expire on September 30, and Graham appealed to the White House to push for a vote on his bill before then. The measure has not yet been cost-estimated by the Congressional Budget Office, a requirement before it can be voted on, and it is widely rejected by House Republicans, who oppose allowing Obamacare to continue even in states which choose to do so.

Meanwhile, the top Republican and top Democrat on the Senate Finance Committee announced Tuesday an agreement to make significant cuts to the Children’s Health Insurance Program while extending its duration by five years. The program would otherwise expire at the end of September.

Republican Orrin Hatch and Democrat Ron Wyden said the CHIP program would continue at the present level of funding, but the federal share of the joint federal-state program will be gradually reduced to the level that prevailed before the enactment of Obamacare, which boosted the federal share by 23 percentage points. In effect, states will be required to make up the difference, adding a drastic new charge on already strapped budgets.

Another bipartisan effort, this time by Republican Lamar Alexander and Democrat Patty Murray, would guarantee federal subsidies to insurance companies with low-income customers under the Obamacare exchanges. The Trump administration has continued the subsidies on only a month-to-month basis—deliberately undermining the stability of the exchanges—but a lawsuit filed by House Republicans challenges the legal basis of the subsidies. The White House has opposed any legal reinforcement of the subsidies, calling that a “bailout” of the insurance companies.

The Sanders “Medicare for all” legislation is an attempt to disguise all these reactionary maneuvers, each of them aimed at subordinating the health care of millions of people to the profit interests of big business, behind pie-in-the-sky promises that neither Sanders nor any of his co-sponsors take seriously.