WASHINGTON, D.C. – Each of the seven California Democrats who flipped Republican congressional seats in the midterm election campaigned for more government-funded health care – with most of them with an entire government takeover.
So when they join the Golden State's delegation now, they'll allow it to be the largest state bloc to support “Medicare-for-all” within the U.S. House of Representatives. And Democrats, of course, will control the House.
Despite this political shift, the reality is that there's most likely not likely to be much progressive health care legislation appearing out of Congress within the next two years – a point on which even Democratic lawmakers agree.
“We need to do things that are doable – that aren't pie on the horizon,” said U.S. Sen. Dianne Feinstein, a Democrat and the dean of the California delegation.
Democrats will hold 46 from the state's 53 congressional seats in the home. It's the largest contingent of Democrats their state has ever delivered to Congress, according to membership rosters on the congressional History, Art & Archives website. All but seven of these have publicly supported, previously, some form of government-financed healthcare – whether a sweeping Medicare-for-all program that would provide health insurance to any or all Americans, or perhaps an optional “public option” arrange for people who want it.
California's Democratic junior senator, Kamala Harris, who is contemplating a presidential bid, will also support Medicare-for-all, calling it “the moral and ethical thing to do.”
But the U.S. Senate will stay under Republican control, and Republican President Donald Trump has lambasted the thought of more government involvement in healthcare. Because of that political reality, Feinstein and others have said, the state's freshman lawmakers who're eager to push forward on Medicare-for-all or a public option must refocus.
In a midterm election where health care ranked as the No. 1 concern of many voters, congressional newcomers Josh Harder, Katie Porter, Katie Hill, Harley Rouda and Mike Levin won their elections after campaigning for Medicare-for-all, the concept of one government-run healthcare program made popular by Sen. Bernie Sanders (I-Vt.) during his 2021 presidential bid.
Meanwhile, candidates Gil Cisneros and T.J. Cox promoted a public option, which may allow customers to voluntarily buy in to a government-financed health care insurance option, such as Medicare or Medicaid.
None from the seven freshmen Democrats decided to a job interview to discuss their ideas about healthcare in the new Congress, nor would they give a spokesperson. It's unclear whether they'll create a big push for that progressive causes they pitched on the campaign trail.
In a twist, a mid-December ruling by a Texas judge that declared the Affordable Care Act unconstitutional could actually help Democrats. Instead of arguing for Medicare-for-all, they can now pivot to protecting the law and it is popular provisions, including protections for people with preexisting conditions.
“A conservative judge in Texas might have given new Democratic representatives in California a lot more leeway on health care compared to what they were built with a week ago,” said Dan Schnur, a University of Southern California professor and former Republican strategist. “There's lots of potential healthcare legislation that will be very popular in their districts.”
In the weeks prior to the election, Harder, who beat Republican incumbent Jeff Denham in the Central Valley, had been tempering expectations about how exactly effective Democrats might be next year.
“I think the reality is under a Trump presidency, it should be not really passed within the next two years,” Harder said about Medicare-for-all. “But we have to be making it clear what we're being bold, and we're standing up for the truth that every individual needs to be covered.”
A day after she won her congressional seat, Porter, who made Medicare-for-all an integral part of her campaign, told supporters it might have to wait.
“I think until we pass campaign finance reform, doing anything on healthcare will probably be a large challenge,” she said.
Part of the challenge for Porter, along with the remainder of her new colleagues, is that they hail from swing districts. All of them flipped Republican seats, and they'll need to adopt a far more centrist tone when they wish to stay in Congress, political observers say.
“The reality of advocating for single-payer and the actuality of what it means is sobering,” said Lanhee Chen, director of domestic policy studies at Stanford University. “If you're vulnerable, on The first day, through the nature of demographics of the district, It becomes harder to embrace.”
And while California voters ushered in a new type of progressives, they also gave a sixth term to Feinstein, that has openly warned against the cost and feasibility of the Medicare-for-all system. And likely incoming House Speaker Nancy Pelosi (D-San Francisco) has stated she promises to focus on fixing lingering issues with the government health care law, not push ahead with Medicare-for-all.
Other centrist Democrats say Congress ought to work out how to stabilize the health care markets or allow Americans 55 and older to purchase into Medicare, that is currently available to those 65 and older. Feinstein, for example, also supports giving Medicare the ability to negotiate the cost of drugs.
“Let's build off of the gains we produced in the Affordable Care Act,” said Rep. Ami Bera (D-Elk Grove), “but let's also address a few of the things Republicans did to undermine the ACA markets.”