Medicare for All rally sign HouseSpeaker Nancy Pelosi has said repeatedly she does not want to pushMedicare for All while Republicans control the Senate and the WhiteHouse. (Photo: Shutterstock)

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The first congressional hearing on a “Medicare for All”bill in at least a decade took place Tuesday, but without the usualphalanx of T-shirted supporters—or even the presidentialcandidates—who have been pushing the bill.

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That's because the hearing took place not at one of three majorcommittees that oversee health policy in the House, but in theornate—and comparatively miniature—hearing room of the House RulesCommittee. That panel's primary role is to set the terms for Housefloor debates, and its hearing room can seat about 50 people in theaudience, compared with hundreds in the larger rooms of the Capitolcomplex's office buildings. Also, members of the public cannoteasily access the room on the third floor of the Capitol as theycan the House office buildings across the street.

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Related: Medicare for All: Where the 2020 presidentialcandidates stand

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That arrangement was no accident—the Rules Committee is oftencalled the “Speaker's Committee” because it is so closely alignedwith the speaker's goals and is more heavily populated with membersof the majority party than the usual committee breakdowns. HouseSpeaker Nancy Pelosi has said repeatedly she does not want to pushMedicare for All—a plan popular among progressive Democrats to move thecountry to government health care system—while Republicans controlthe Senate and the White House.

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So, this hearing was the fulfillment of a promise she made tosome of the more left-leaning members of her caucus when shecourted them to support her candidacy for speaker. Another hearing,this one by the House Budget Committee—also not among thecommittees that would normally handle major health legislation, isexpected to follow soon.

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Those usual panels—Ways and Means, Energy and Commerce, andEducation and Labor—are busy working on health legislation,including bills to address prescription drug prices and “surprise” medical bills, but not currently ona Medicare for All bill.

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Rep. Michael Burgess (R-Texas) pointed out that anomaly. “Idon't want to say this hearing isn't normal, but normally, healthcare policy would come … through the authorizing committees,” hesaid in a gibe to the House Democratic leadership. Burgess is alsoa member of one of those committees: Energy and Commerce.

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Pelosi did make a cameo at the Rules hearing, escorting activistAdy Barkan, who has the neurodegenerative disease amyotrophiclateral sclerosis, or ALS, and was the star witness for theproponents of Medicare for All. Barkan, an outspokencritic of Republicans' efforts to repeal and replace the AffordableCare Act in 2017, testified Tuesday by computer-generated voice,since his disease has progressed to the point he can no longerspeak easily.

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Still, despite the unusual venue, backers of universal healthcare hope the hearing marks the beginning of a journey to a newnational health system.

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“This is a historic moment,” Rules Chairman Jim McGovern(D-Mass.) said, surveying the standing-room-only crowd. “I don'tthink we can squeeze anyone else in here.” McGovern said he is astrong supporter of the Medicare for All bill introduced by Reps. Pramila Jayapal(D-Calif.) and Debbie Dingell (D-Mich.), which has more than 100co-sponsors.

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For all the political machinations and sometimes overheatedrhetoric about a major overhaul of the U.S. health system, thehearing itself was remarkably unremarkable — with witnesses bothfor and against the idea of the federal government providing healthcoverage to all Americans calmly discussing the pros and cons.

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“The ugly truth is this: Health care is not treated as a humanright in the United States of America,” Barkan told the committee.“This fact is outrageous. And it is far past time that we changeit.”

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Republicans were also eager to talk about Medicarefor All — so they could bash it.

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“This bill is an extraordinary bill,” said Rep. Tom Cole(R-Okla.), the panel's ranking member. “It would completely changeAmerica's health care system. And not for the better.”

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And while the most enthusiastic backers of the bill were not inthe hearing room, they were not far away.

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More than 300 members of the California NursesAssociation/National Nurses United, one of the unions that has beenpushing Medicare for All for years, watched thehearing from an overflow room in the Cannon House Office Buildingand visited offices to try to gin up support, said co-PresidentMalinda Markowitz.

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Markowitz said she was optimistic about the path forward for themeasure. “We're going to continue to go to legislators that aren'tsupporting this and let them know we're not letting them off thehook,” she said.

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Republicans want the debate to continue in Congress, too. Theyhope they can stoke fear of a government takeover of health carethat will work to their advantage in the next election.

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The top Republicans on the House Ways and Means Committee onTuesday wrote to Chairman Richard Neal (D-Mass.) urging him to schedulea hearing on the bill. “A public accounting of H.R. 1384 isnecessary to inform the working families and seniors we representto the risks of their health coverage under this proposal,” saidranking Republican on the full committee, Rep. Kevin Brady (Texas),and the health subcommittee, Rep. Devin Nunes (Calif.).

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That is apparently fine with Neal. In a brief interview Tuesday,he said his committee “likely would” hold a hearing in the currentCongress. “I think we should have a full-throttle debate” aboutMedicare for All, he said.

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Kaiser Health News isa nonprofit news service covering health issues. It is aneditorially independent program of the Kaiser Family Foundation,which is not affiliated with Kaiser Permanente.

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