Obamacare passed in 2010 only because Senate Democrats had 60 votes and were able to shut down the Republican filibuster. Could the same happen again in 2021? (U.S. Senate Chamber. Credit: Architect of the Capitol)
An already intense, high-stakes election season hit a new peak with the passing of Supreme Court Justice Ruth Bader Ginsberg, creating a Supreme Court vacancy just six weeks prior to the presidential election. Shortly after the news of her death, Senate Majority Leader Mitch McConnell (R-KY) issued a statement offering condolences, while also making his next move crystal clear: "President Trump's nominee will receive a vote on the floor of the United States Senate."
For liberal Democrats, this is the nightmare scenario they dreaded. And in a chilling, bitter response, Senate Minority Leader Chuck Schumer (D-NY) reportedly told congressional Democrats on a recent conference call, "Nothing is off the table next year." His thinly veiled threat alludes to a radical institutional change Democrats will almost certainly pursue in 2021 should they win both the White House and the Senate: ending the Senate filibuster.
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Before I entered the benefits industry, I worked in public policy. I ran two policy think tanks, testified before legislative committees, and lobbied on behalf of our free-market principles. As someone whose experience and expertise bridges the policy world and the benefits industry, to say I am extremely concerned about this election would be a gross understatement.
It's not alarmism or hyperbole to state that the future of America's private health care system – and the health insurance industry – is at stake in the upcoming election. If the Democrats sweep the Senate and the White House, expect them to change the rules and build the political infrastructure needed to ram through single-payer health care in the first year of the Biden administration.
Even prior to the death of Justice Ginsburg, U.S. Senator Chris Coons (D-DE) had already tipped the Democrats' hand. Sen. Coons, a friend and close ally of Democratic nominee Joe Biden, has long been a staunch defender of the legislative filibuster, a procedural device allowing a minority in the Senate to prevent a vote on a legislative bill and requires 60 votes to end. Obamacare passed in 2010 only because Senate Democrats had 60 votes and were able to shut down the Republican filibuster.
In a June interview, however, Sen. Coons expressed his openness to abolishing the filibuster if the Democrats win the Senate and the presidency. He gave as his reason his refusal to "watch the Biden administration's initiatives blocked at every turn." Don't believe that Coons floated this trial balloon without the knowledge and support of the Biden campaign and the party leadership.
With Biden in the White House, a Democratic Senate that ends the use of the filibuster would need only 50 votes – with Vice President Kamala Harris breaking the tie – to pass legislation establishing single-payer health care and ending our private health care system. The near certainty of this scenario, should the Democrats sweep, is based on four well-established factors.
The first is the critical role that the left-wing of the Democratic Party will play in a Biden victory. Biden's careful cultivation of left-wing Senators Bernie Sanders (I-VT) and Elizabeth Warren (D-MA) and his receptivity to much of their radical agenda points to his campaign's recognition that Biden needs the energy and enthusiastic support of Sanders' and Warren's supporters. If Biden wins, he will owe the party's left wing – and if the Democrats take the Senate, the left will expect a major legislative victory.
The second factor is the almost fetishistic devotion of the left to the goal of single-payer health care. Sanders and other leftist leaders have elevated health care reform from a policy matter to a human rights issue, which places single-payer at the very top of the left's wish list. When it's payback time after a Biden White House victory, Sanders, Warren and their followers will expect and demand passage of single-payer health care.
The third factor is the nature of Joe Biden, whose political past shows him to be nothing more or less than a very practical politician, guided not by any underlying philosophy or ideology, but by political expedience. His history in office marks Biden as a political chameleon, willing to change his colors as circumstances require. Despite his refusal to embrace single-payer during the presidential campaign, once elected, indebted to the left, and facing their vociferous demands for single-payer, Biden is almost certain to accommodate the left and support abolishing private health care in favor of a single-payer system.
The final factor, the left's ace-in-the-hole, is Kamala Harris. As the newly elected Vice President, Harris is certain to be looking ahead to the 2024 presidential race. Given that Biden would be 82 after his first term, it is widely expected that he will serve only the one term, setting up his vice president to be the 2024 front-runner. Harris will want to consolidate support early in anticipation of her own run for the roses. She cultivates the left's support by leaning on Biden to support the single-payer legislation. By lending an assist to the left by helping overcome any Biden resistance, Harris also gains the right to take credit for single-payer since it would have passed under the Biden-Harris administration.
Passage of single-payer health care means the end of private health insurance and the jobs of those who work for the carriers and the brokerages. What to do if single-payer passes is the topic for another article. But I can tell you what to do now, vote. This election is very possibly the last stand for our industry and our private health care system.
Nelson Griswold is the Managing Director of the NextGen Benefits Network and author of industry bestsellers NextGeneration Healthcare, Breaking Through The Status Quo and DO or DIE: Reinventing Your Benefits Agency for Post-Reform Success.
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