Bernie Sanders wants single-payer. So why is he going to defend the ACA on TV?

Bernie Sanders has proposed a single-payer health care system that he had championed during the presidential primaries.
JIM WATSON/AFP/Getty Images/File 2017
Bernie Sanders has proposed a single-payer health care system that he had championed during the presidential primaries.

WASHINGTON — Senator Bernie Sanders wants Medicare for all. But for the next week, he must take his enthusiasm for the Affordable Care Act out of retirement.

For the past nine months, the Vermont senator has traveled across the country holding rallies in an effort to counter Republicans’ persistent efforts to dismantle the Obama-era health care law. After the Senate’s Republican majority failed again to repeal the ACA in July, Sanders seemed to think it was time to move on, proposing a single-payer health care system that he had championed during the presidential primaries.

But on Monday, Sanders will be back defending the ACA — this time in a live CNN debate against South Carolina Senator Lindsey Graham and Louisiana Senator Bill Cassidy, the architects of the latest version of a Republican health care bill.


“Unfortunately, now we’re back to defending the ACA,” Sanders’ spokesman Josh Miller-Lewis said. “But I think the excitement of a couple weeks ago, of ‘Medicare for all,’ has sort of given everyone a boost of energy as we fight this for one more week.”

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Sanders’ partner in the CNN debate, Minnesota Senator Amy Klobuchar, has not signed onto his government-run health care plan. Several high-profile Democrats have, however, displaying their support in a news conference last week that happened to fall on the same day Republicans resurrected their seven-year effort to repeal the ACA.

The Graham-Cassidy bill, which is supposed to reach the Senate floor next week, would turn parts of Medicaid into a lower-cost block-grant program and strip away government mandates.

On Friday, Arizona Senator John McCain — a close friend of Graham’s in the Senate — announced his opposition to the new health care bill, seeming to doom its chances and perhaps turning Monday’s debate into more of a theoretical exercise if it remains on CNN’s schedule.

After CNN announced the event Thursday, a former Obama administration spokesman, Tommy Vietor, tweeted his concern that the program would turn into a debate on the Graham-Cassidy bill versus single-payer insurance, rather than the status quo. Republicans themselves have taken to that strategy, with Graham earlier this week telling reporters that his bill was the “only process left available to stop a march toward socialism.”


Miller-Lewis said Sanders’ priority in the debate would be to inform the public of the potential harm the Republicans’ bill could inflict. According to a poll released Thursday by Public Policy Polling, 50 percent of voters disapprove of the legislation, and 27 percent are not sure about it.

“The senator’s goal here is to expose Graham-Cassidy as the most destructive piece of legislative in the modern history of our country,” Miller-Lewis said.

Republicans in support of the bill, including President Trump, have presented it as a better alternative to the ACA and a way of giving states more flexibility in choosing how to insure their residents. Spokesmen for Graham and Cassidy did not respond to requests for comment.

Robert Blendon, a professor of health policy at Harvard who studies public opinion, said it will be years before Sanders’ single-payer pitch gets a real debate.

“This is a principle, not a real policy. It’s not going to be taken seriously until the year before the 2020 election,” Blendon said. “He has tapped into something that has long-term political potential but no short-term political possibilities.”