Eight years ago, as a once-in-a-generation Democratic Senate supermajority debated health care reform, Sen. Max Baucus, D-Mont., kept their focus narrow. As the chairman of the Senate Finance Committee, Baucus was focused on passing a reform bill that moderate Republicans could support. At one point, he had single-payer health care supporters removed from a hearing; Sen. Bernie Sanders, I-Vt., an advocate for Canada-style universal coverage, set up a meeting to tide them over. But he did not expect much from Baucus.
"[Is he open] to single-payer?" Sanders asked rhetorically. "Not in a million years."
His estimate was just 999,999,993 years off. At a Thursday night forum in his home state, a now-retired Baucus suggested that single-payer health care could pass, and not too long from now.
"My personal view is we've got to start looking at single-payer," Baucus said, according to the Bozeman Daily Chronicle. "I think we should have hearings. . . we're getting there. It's going to happen."
Baucus' comments came as Sanders wraps up a lengthy launch for his own Medicare-for-All bill, which will be released on Sept. 13. As he's fended off questions about Hillary Clinton's 2016 campaign memoir, Sanders, who makes no secret of his disdain for "gossip" question, has repeatedly pivoted to discuss the Medicare-for-All bill. ("Tell me you don't care about this," Sanders chided MSNBC's Chris Hayes when the host asked about Clinton this week.)
The bill has no chance of passage in a Republican-run Senate; an 11th-hour proposal to repeal the Affordable Care Act, favored by Sen. Bill Cassidy, R-La., is the only major overhaul that might be considered before the end of the month. (Senators on both sides consider it unlikely.) But with fanfare and splashy headlines, Sen. Kamala Harris, D-Calif., and Sen. Elizabeth Warren, D-Mass., both possible 2020 presidential candidates who had previously talked up single-payer, have preemptively endorsed the Sanders bill. Two other Democrats, Sen. Brian Schatz (Hawaii) and Sen. Chris Murphy (Conn.), have also spun off their own universal health care bills after discussing them with Sanders.
"We're not going to pass a single-payer health care bill any time in the next few years," Murphy told Politico this week, "and so we need to have a conversation about how we get there."
All of that has demonstrated a shift in Democratic Party politics that began in 2016 and accelerated during the Republicans' eight-month fumble of the repeal effort. No Democrat, nor Sanders, expects all 48 members of the party's caucus to endorse one of the universal health-care bills this year. But even Democrats in competitive races have begun talking about single-payer as an eventual end point. At a Homeland Security committee meeting this week, Sen. Jon Tester, D-Mont., who faces re-election next year, went out of his way to call single-payer "something we should, quite frankly, take a solid look at."
The Republican Party's response revealed a reason for Democrats' new confidence. In a statement, Tester challenger Matt Rosendale, who was not the GOP's first choice for 2018, accused Tester of favoring a "government takeover" of the insurance market. "I'm appalled that Tester would suggest such a radical plan that would blow up our nation's budget and put Montanans' health in the hands of the federal government," he said.
But like the web ads run by Republicans in August, Rosendale's attacks repeated what Republicans had already said about the Affordable Care Act. In conversations this week, several Democrats said that a lesson from the 2016 campaign, applicable to health care, was that voters favored an idea they could quickly understand over an idea that was means-tested but overly complicated.
Democrats remain cautious, however, of the single-payer bills that exist right now. In July, Sen. Steve Daines, R-Mont., introduced an amendment to the GOP's repeal bill that would have replaced its text with Rep. John Conyers', D-Mich., universal coverage bill - one that would replace private insurance, essentially, with a national system. Sanders gave colleagues permission to oppose it, and four did, while the rest voted present. Daines, after all, had been elected to fill the seat once held by Max Baucus.