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Will the 2020 Election Resolve the Question of Medicare for All?

  • 1Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
  • 2John F. Kennedy School of Government, Harvard University, Cambridge, Massachusetts

Political news coverage might lead one to believe that the 2020 election will settle the question of whether the country will move toward Medicare for All. This is, however, unlikely to be the case.

First, Medicare for All legislation is unlikely to be enacted in the follow-up to the 2020 election. Such an outcome would require the election of a Democratic president committed to Medicare for All, as well as a Democratic majority in the US House of Representatives and 60 or more Democratic senators, all of whom would have to be committed to supporting the legislation. Also, as of today, large numbers of Democrats in the House and Senate have not chosen to sign on to a Medicare for All bill. This is important because, given the political polarization in Congress, it is unlikely that any Republicans will vote for Medicare for All legislation. When the Patient Protection and Affordable Care Act (ACA) was passed in 2010, it did not receive a single Republican vote, in contrast to the 1965 enactment of Medicare, when nearly half the Republican members of Congress voted in favor.

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