Medicare for All or Fight

Should Progressive House Democrats Force a Floor Vote on Medicare for All?

Progressive Democrats in the House of Representatives find themselves in a very unique position resulting from centrist Democrats losing 12 seats in the 2020 election. With a narrow majority of only 222 Democrats, Nancy Pelosi could be denied reelection to the speaker position if 5 Democrats were to defect.* A movement known as #ForceTheVote has recently emerged, calling on progressive House Democrats to withhold their votes from Pelosi unless she allows a floor vote on Medicare for All (M4A).

Premise and Process

This type of political bargaining is not unheard of and is very common in countries with parliamentary systems where coalition-building between parties is necessary to form a government. In these systems, small parties can wield an enormous amount of power, especially when the largest party is short only a few seats needed for a majority. Consider, for example, a parliament where 100 seats are needed for a majority, but the largest party wins only 95 seats. To form a government, the largest party must find a smaller party consisting of at least 5 seats to build a coalition with. Assuming the larger party can find a smaller party to coalesce with, the smaller party has a lopsided amount of bargaining power because, if they withdraw from the coalition, they can “bring down the government”.

#ForceTheVote is petitioning all members of the Congressional Progressive Caucus to agree to a “Pelosi for Speaker - Medicare for All” vote trade, specifically targeting 15 progressives who ran on Medicare for All. With a 222 vote majority and 218 votes needed for the speakership, this small, but powerful, progressive faction can block Pelosi from the speaker position if she doesn’t agree to their demands. This type of strategy was successfully used by the far-right Freedom Caucus in 2015 to bring down John Boehner. At the time, the Freedom Caucus consisted of only 37 Representatives (just under 15% of the entire House Republican caucus), but that was enough to deny Boehner the speakership.

Would Medicare for All Actually Pass?

At first blush, it seems odd that the House hasn’t voted on Medicare for All by now. A majority of House Democrats have cosponsored the latest Medicare for All bill, meeting the requirements of the so-called “Hastert Rule”. Additionally, according to a Hill-HarrisX poll conducted earlier this year, Medicare for All has a public approval rating of 69%. Compare that with Nancy Pelosi, who currently has an approval rating lower than Donald Trump!

These facts notwithstanding, there’s no reason to believe that M4A would pass in the House. Even if all 118 cosponsors of the bill voted in favor of it, that’s well short of the votes needed for it to pass. In a scenario where House Democrats miraculously banded together and passed M4A, it would be DOA when it reached the Senate (the Senate version of M4A only has 14 cosponsors). It should also be noted that both the incoming President and Vice President oppose M4A. Ergo, even under the most optimistic set of circumstances where (a) the Democrats control 50 Senate seats by winning both Georgia Senate races and (b) band together and vote in favor of M4A, Kamala Harris could break the tie by voting against the bill and, if she doesn’t, Joe Biden could veto it. That’s a lot of high and, arguably, insurmountable hurdles for M4A to clear. Therefore, would forcing a vote on M4A be a pyrrhic victory for progressives? No!

The Long Game

While a majority of House Democrats are cosponsoring the M4A bill, there is a major qualitative difference between cosponsoring a bill and voting for it. The former is largely symbolic when compared to the later where legislators’ actual positions on a bill become public record. Interestingly, Kamala Harris is an example of “symbolic cosponsoring” - she is listed as a cosponsor on the Senate version of M4A… but doesn’t support M4A.

A floor vote would create a public record of which legislators are in favor of Medicare for All and which are not. Therein lies the “problem” for centrist House Democrats - having to put their money where their mouth is. Democrats that vote “no” would set themselves up for primary challenges from the left in 2022. It won’t be easy for them to justify denying health insurance to all U.S. residents amid a pandemic. Republicans representing swing districts could put themselves at risk as well, depending on how they vote. If M4A did manage to pass the House, centrist Senate Dems would face the same “dilemma”.

Thus, in theory, a failed Medicare for All vote could provide progressives an opportunity to increase their numbers in 2022 and, therefore, increase the likelihood of passing progressive legislation in the future.

Do or Don’t Do?

The pushback against #ForceTheVote has centered around the themes of preserving “party unity” and the risk of “helping the enemy.” More specifically, detractors argue that #ForceTheVote would further fracture the Democratic party, weaken the party’s ability to get anything done, and provide the Republicans with additional ammo going into 2022. Also, with regards to the progressive movement as a whole, #ForceTheVote could cost progressives a significant amount of political capital, which they might otherwise be able to leverage more effectively in the future.

However, much like the lack of interest on the part of Republicans to work with Democrats as a whole, centrist Dems have shown little to no interest in working with progressive Dems. Recently, House progressives were frozen out of key committee positions. There isn’t much reason to believe that the centrists will negotiate with the progressives unless forced to do so. As for the Republicans, they’re going to engage in obstruction and call Democrats “radical socialists” no matter what they do, so there’s no sense in sacrificing the progressive agenda in the name of “bipartisanship”.

With that in mind, the #ForceTheVote movement may not be going far enough. This rare opportunity behooves progressives to use the “door-in-the-face technique” and come to the table demanding more than they’re willing to settle for. In other words, don’t just ask for a floor vote on Medicare for all, ask for votes on the Green New Deal, canceling medical and student debt, College for All, raising the minimum wage, a federal jobs guarantee, taxing wall street speculation, campaign finance reform, etc. Also, demand that progressives receive ranking positions on committees. Then, negotiate downward.

Presently, Pelosi is in the worst possible position in her political career. By allowing a Medicare for All floor vote, she risks exposing the true beliefs of her centrist colleagues. But, if she doesn’t allow a floor vote, progressives could not only withhold their votes to deny Pelosi the speakership, they could double-down and pledge to only vote for a speaker who will allow a vote on Medicare for All. The power that progressives have at this moment should not be understated.

There is another compelling reason for progressives to seize this opportunity: if they don’t, the centrist Dems might. Pelosi does have enemies within her own faction and, again, only 5 Dems would need to defect to deny her the speakership. Pelosi’s “fundraising prowess” notwithstanding, centrists Dems may choose to punish her considering a dozen Democratic House seats were just lost in an election where voters summarily rejected Trump. But, centrists most certainly would not horse trade with any progressive legislation, and the result could be the election of a speaker more conservative than Pelosi. As such, progressives must steer this ship.

For the People

The COVID-19 pandemic has shined the brightest light ever on the failures of our current healthcare system. It is shameful enough that the United States is the only industrialized nation to not guarantee health care to all of its citizens while simultaneously being the wealthiest country in the world. But for Republicans and centrist Democrats to not see the need for an overhaul of our health care system in light of the 300,000+ lives lost from COVID-19 is just plain heartless. It’s time for our elected officials to once and for all go on record with how they really feel about healthcare. The way to make this happen is to force a floor vote on Medicare for All. Regardless of their party affiliation, elected officials who do not believe that healthcare is a human right have no business being in elected office in the first place.

The status quo is killing people.
Friendly methods of negotiation have failed.
The time to fight is now!

Sign the petition at #ForceTheVote


* As of the writing of this article there is one house race that is still undecided. Thus, it’s possible that 6 Democrats will need to defect to deny Pelosi the speakership.

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