Rep. Josh Harder is the only Democrat from a moderate district who is front and center as House progressives rolled out their plan on Medicare for all Wednesday.
He was also the only California Democrat and freshman Democrat to appear at the announcement, putting his face on a plan fraught with pitfalls for moderates. The move puts an even larger target on his back as Republicans move to unseat him. It will be a test of whether districts outside of the solidly Democratic will support the bold effort at health care overhaul as it takes steps towards becoming law — which Republican groups have painted as a socialist dream.
Harder, D-Turlock, has said he decided to run for Congress in 2018 because of health care, and he focused his successful campaign on health care, including explicitly saying he supported Medicare for all. He’s not planning to quit now.
“The key piece I’ve heard again and again and again ... is ‘please keep the promise to work for Medicare for all,’” Harder said, citing constituent concerns he heard during a listening tour on health care he’s been holding in his district.
“People want to see major progress on the No. 1 issue they care about,” he added.
The Medicare for all plan unveiled Wednesday is a government-run single-payer plan that would allow Medicare to negotiate prices with drug companies, which is currently not allowed. The measure is sponsored by Rep. Pramila Jayapal, D-Washington, a chair of the Progressive Caucus.
While there are no official estimates for how much it would cost, the libertarian Mercatus Center has estimated a similar proposal would cost around $32 trillion over 10 years. The federal government spent about $1.1 trillion on health care in fiscal year 2018.
Members of the Blue Dog Coalition, a moderate group of 27 Democrats focused on fiscal responsibility, have said they would not support such a proposal without a clear way to pay for it. It’s unclear how that would be done, and most are unwilling to consider a tax increase or furthering the country’s debt.
“I think it’s important to have the conversation, except without talking about how you’re going to pay for it, it’s a hollow promise,” said Blue Dog Rep. Jim Costa, D-Fresno. “It puts us in a position of further increasing Americans’ debt, which we all loathe.”
A slight majority of Americans favor a health care plan where everyone gets government-supplied health care, especially when they feel it will eliminate costs and guarantee coverage, according to polls by the Kaiser Family Foundation. But 55 percent also believe they would be able to keep their own health insurance plan, and a significant majority say they would oppose Medicare for all if it meant delays in medical treatment, higher taxes or threatening the current Medicare program.
Most Democrats — 51 percent — said they want Congress to focus on fixing the Affordable Care Act, rather than passing a Medicare-for-all plan, which 38 percent want Congress to prioritize.
But Harder said he’s confident this is what the people of his district want and need, despite large price tags. Though he’s not an author of the legislation, he said he’s had frequent conversations with Jayapal over the past two years to make sure the bill addressed the needs of districts like his own, such as guaranteeing coverage and improving quality of care.
“People already pay way too much for health care,” Harder said. “We need a system that drives down costs and improves patient outcomes.”
Health care is a significant issue in Harder’s San Joaquin Valley district, where unemployment is consistently higher than the national average and air and water quality problems worsen the issue of pre-existing conditions. Harder and Democratic groups repeatedly spotlighted his Republican opponent’s votes to repeal the Affordable Care Act in a campaign Harder ultimately won by about 10,000 votes.
There are over 350,000 uninsured individuals in the Central Valley, according to Harder’s office, one of the highest proportions of uninsured people in the state. Most of those who are uninsured in California are Latino and a quarter are millennials, and a third earn less than $25,000 per year.