Under Biden, it’s time for Democrats to let go of Medicare for All

With twin victories in the Georgia Senate run-offs, Democrats are poised to take control of the presidency and both houses of Congress. Their margin in the Senate is narrow—it’s a 50-50 tie with Democratic Vice President Kamala Harris casting the deciding vote. Nonetheless, a unified Democratic government has given the left renewed hope. It also gives the opportunity to push Biden and Congress to enact a progressive agenda.

Over the past four years, the focus of a progressive agenda has been Medicare For All (M4A). Vermont Senator Bernie Sanders ran on the platform of free healthcare for everyone in the Democratic primary. He ran twice, in 2016 and 2020, and lost both times. President-elect Joe Biden, who won, explicitly rejected M4A.

Given Sanders’ losses, and Biden’s opposition, it may be time for progressives and others on the left to consider uniting around other goals. This is especially the case because, despite its importance, Medicare For All, even if passed, is unlikely to radically transform our politics. But other progressive legislation might.

Sanders, and other proponents of M4A, hoped that the legislation could change the political landscape. Their logic was reasonable. M4A would simplify our Byzantine, cruel healthcare system. It would offer relief to tens of millions of people who can’t get adequate care. Helping people in this way, Sanders believed, would be a massive vote getter, and it would supercharge participation by working-class people of all races.

It was a good idea. But it hasn’t worked.

Health care reform is complicated and technical. And while progressives took up M4A as a battle cry, other constituencies were less swayed. Sanders lost his primaries soundly twice. His two losses mean that the Democratic party has seen M4A rejected by voters repeatedly over the last four years. If M4A was going to energize a new, overwhelming voting constituency, we would have seen some evidence of it by now.

So what could progressives push that Biden might be more willing to pass? What might make further progressive gains easier? There are two important possibilities: voting rights and labor rights.

Voting rights have been rising in importance and visibility over the Trump years. Trump and the Republicans have attacked democracy more and more openly, culminating in Trump’s extended, baseless assault on the legitimacy of Biden’s presidential victory.

Democrats in the House passed HR1 in 2019, a bill that provides for Automatic Voter Registration and limits gerrymandering. It also restores the Voting Rights Act gutted by the Supreme Court. The John Lewis Voting Rights Act of 2020 prevents key states from passing laws to disenfranchise Black people without federal oversight. House Democrats also passed a bill giving statehood, and Senate and House representation, to DC.

All these bills were blocked in the Senate. But now that control of that chamber has flipped, they might have new life. The filibuster makes passage difficult. But the bills are worth fighting for and expanding. Progressives can push for lowering the voting age; for votes for all those in prison; for votes for immigrants; and to eliminate the electoral college.

These reforms would make it easier for Democrats to get into office by empowering Black and poor constituencies that support them. But they would also move the party left. For example, Senators from reliably Democratic Washington DC are likely to be significantly more progressive than Democratic reps from purple states like Arizona or Colorado. More, embracing voting rights as a central, signature left issue might help progressive candidates with Black voters inrepre the South—a key group that voted against Sanders in both 2016 and 2020.

Progressives could also try to elevate an issue that has gotten less news coverage: labor rights.

The left has been badly hurt by the erosion of union membership and union power over the last fifty years. Unions represented 1 out of 5 workers in 1983; now it’s only 1 in 10.

Part of this decline is because of structural factors, like deindustrialization and globalization. But it’s also because the US Congress has put a stranglehold on unions for decades. The Taft-Hartley Act in 1947 paved the way for right-to-work laws, which prevents unions from requiring dues or membership from anyone who doesn’t want to join, even if the workforce votes a union in. This has made it extremely difficult for unions to raise funds or challenge employers.

Corporate interests and billionaires have spent millions pushing right-to-work laws in the South, Southwest, and most recently in the Midwest. Their successes have crushed union organizing,and are part of the reason for the wage stagnation of the last 40 years.

Joe Biden has come out in favor of abolishing right-to-work laws. But it’s not a part of his agenda that has gotten much media attention or scrutiny. Without a popular push, he’s unlikely to feel much pressure to prioritize it. If progressives centered right-to-work laws the way they’ve centered M4A, they might be able to get a vote on a bill. And while they might not repeal right-to-work laws in this Congress, since the filibuster is still in place, the fight itself could energize unions, and perhaps pave the way for advances in the future.

Progressives already support sweeping labor reforms, of course. Sanders’ also promised to eliminate right-to-work laws in his presidential campaign, and proposed a suite of other policies to strengthen unions. Progressives have also pushed for voting rights. But neither issue has been at the center of progressive organizing or demands the way that M4A has been.

The left should not abandon M4A. It’s a central human rights demand and an issue of life or death for huge numbers of people. But we need to be strategic about how we get there. It seems clear that, for the moment, given the current makeup of American democracy, we don’t have the support we need to pass this legislation. So we need to change the makeup of American democracy. Concentrating on voting rights and labor rights could do that.