Democrats Move On Government-Run Health Care While GOP Dawdles

A little over a year ago I warned that “Far-left Democrats are in the early stages of a push for a government-run health care system in the U.S.” I also urged the GOP to start making the case against it, that there was “no excuse for getting caught flat-footed.” The Republicans, not surprisingly, have done almost nothing on this. Meanwhile, the Democrats have taken another big step toward their goal.

In mid-March, 12 Democrat senators, including Ron Wyden, Elizabeth Warren, and Mark Warner, signed a “Dear Colleague” letter calling for “health coverage that works for everyone.” It is filled with the usual leftist tripe like “reforms that put patients over profits” and taking on “corporate greed.” But the final paragraph shows that they are serious:

In the coming weeks and months, we plan to release more details about the above policies. We invite any interested colleagues to join us by participating and providing input into this effort. We want to make sure the Senate is prepared to take action on these issues the next time Democrats have an opportunity to enact the bold, meaningful change the American people seek. [Emphasis added].

By starting now, Democrats could have a serious reform plan to rally around during the 2028 election. It could help Democrats win back the White House and gain control of both chambers of Congress. Should that happen and, as many predict, Senate Democrats nuke the filibuster, then another big expansion of government-run health care is all but assured.

Meanwhile, Congressional Republicans have made what can be described, at best, a pitiful attempt at health care reform. At the end of last year, enhanced subsidies for buying health coverage on the Obamacare exchanges came to an end. To soften the blow, House Republicans passed legislation that would make it easier for small businesses to obtain coverage for their employees. While the ideas in the legislation have merit, Republicans can’t get a big reform passed as part of a desperate attempt to extricate themselves from a bad political situation.

Major reform takes years to achieve. Reformers must relentlessly persuade the public that the current system is broken, prepare members of Congress for what will be a difficult battle, convince interest groups to come on board or, at least, stay out of the way, and make reform a substantial part of a presidential campaign. That’s what it took to pass Obamacare. Democrats understand that. As Sen. Wyden recently told the Bulwark, “It takes a lot of sweat equity if you want to get into major changes.”

Republicans need to adopt the Democrat’s strategy. They can start by making the case to the American public that Obamacare has failed. The good news is the Democrats have made this easy for the GOP.

The Democrats’ Dear Colleague letter states, “As premiums continue to skyrocket faster than wages, Americans are more dissatisfied with their health insurance than they have been in 20 years … over one-third of adults with health insurance report delaying or skipping care altogether due to cost [and] one in five American households report struggling with medical debt.”

Obamacare was supposed to solve those problems. In a 2013 speech, President Obama lamented a health care system that left some patients with huge medical bills and forced others to choose between paying for health care and paying their mortgage. “No one should go broke because they got sick,” Obama declared. “That’s why we took on a broken health care system.”

The Dear Colleague letter is a tacit admission that Obamacare has failed to reduce the number of people skipping or delaying care or households with medical debt. Republicans must point out that Democrats created a system that doesn’t work and now want to do more of the same.

They also need to make the case that Obamacare failed at holding down health care costs. For example, President Obama claimed his health care plan would save the average family of four $2,500. Those savings never materialized. Instead, costs went up.

Most of the major provisions of Obamacare, including the exchanges, took effect in 2014. In the eleven years prior, 2003–2013, health care expenses grew an average of 3.1 percent annually. They grew at a slightly higher 3.3 percent from 2014–2024. On the exchanges, the cost of health insurance ballooned. The average premium of a benchmark plan on the exchanges in 2014 was $793 a month for a family with two parents aged 35 and two kids. In 2026, that monthly premium is $1,942, a real increase of 76 percent.

Republicans can defeat the Democrats’ push for government-run health care and enact free-market reform. But they must get moving. They can start by informing the public about the failures of Obamacare.

David Hogberg is a writer living in Washington, D.C. Sign up for his Substack ,Beyond Stage One, where he applies the thinking of Thomas Sowell to current issues.