Like many Democratic legislators, U.S. Rep. Richard Neal of Springfield has had to contend with his share of conservative hecklers as he's worked his way through his district trying to drum up support for the Obama administration's healthcare reform plans. Earlier this month, Neal and U.S. Rep. Jim McGovern received a hostile reception at a town-hall meeting at the UMass Medical School in Worcester, where opponents booed the lawmakers and trafficked the inflammatory notion that Obama's plan could force the sick elderly off life support; one particularly worked-up opponent even dragged out the inevitable "Nazi" analogy, comparing McGovern to Josef Mengele, the Worcester Telegram & Gazette reported.
This far into the healthcare debate, that kind of organized attack from the political right has almost lost its shock value. But for Neal, it's only part of the story. While the President is being chided by the political left for apparently backing away from a public healthcare option, Neal is likewise facing pressure—from fellow Democrats, Green Party members and other progressives—who say his notion of reform doesn't go far enough.
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At issue is H.R. 676, the so-called "Medicare for All" bill sponsored by U.S. Rep. John Conyers (D-MI). The proposed legislation would expand the existing Medicare program to create a universal, publicly financed, privately delivered healthcare system accessible to all U.S. residents. The system would cover a full range of medical services, including primary care, emergency and outpatient care, dental services, mental healthcare, treatment for substance abuse and prescription drugs. Patients would be free to choose their own healthcare providers. Neither co-payments nor deductibles would be permitted.
Proponents say the program would provide cost-effective, quality care, saving money for both individuals and employers. Healthcare-NOW!, a national activist group that backs the bill, cites a study by the Center for Economic Research and Policy, a non-partisan think tank in Washington, D.C., that found that, under the bill, healthcare costs for a family of three with an annual income of $40,000 would total $1,900 a year. Right now, according to a 2008 survey by the Henry J. Kaiser Family Foundation, the average employer-provided plan for a family of four costs almost $13,000 a year, 30 percent of which is paid by the employee. The universal-Medicare program would be funded by a payroll tax of 4.5 percent (on top of the existing 1.45 percent Medicare tax).
While Conyers first introduced the bill in 2004, supporters around the country have been especially active this summer, as they try to inject the plan into the larger healthcare debate. On July 30, the 44th anniversary of the Medicare program, activists (more than 1,000 of them, according to Healthcare-NOW!) converged on Washington to lobby for the bill, delivering Medicare-birthday cupcakes to legislators.
Locally, Chicopee mayor Michael Bissonnette hosted a Medicare birthday celebration, where attendees urged Neal to sign on as a co-sponsor of Conyers' bill. As of last month, 85 members of Congress were co-sponsors. Among the co-sponsors are six members of the Massachusetts delegation, including Western Massachusetts' other congressman, John Olver.
Neal's absence from that list is conspicuous, given his historically strong support of Medicare. Jon Weissman, coordinator of Western Mass. Jobs With Justice and a member of the Western Mass. Single-Payer Network, said local supporters of the bill have been asking Neal to sign on to H.R. 676 for three years; more recently, they've also added a request that Neal ask the Congressional Budget Office to conduct a cost-benefit analysis of the bill.
"We've given him hundreds of cards, letters—original letters, form letters. We've sent people to his website," Weissman said. The Northampton and Springfield City Councils have both passed resolutions urging Neal to become a co-sponsor.
But, Weissman said, activists have heard no response, other than general comments from Neal's office to the press. "We don't know why," Weissman said.
Some observers suggest that Neal—whose district includes the struggling but still powerful MassMutual, and whose campaign war chest draws heavily from the insurance and healthcare sectors—is wary of a proposal that would mean such drastic changes for those industries. Others posit that Neal, who holds a subcommittee chair on the House Ways and Means Committee, is treading carefully because he has his eye on the Ways and Means chairmanship should the current chairman, scandal-plagued New York Democrat Charlie Rangel, step, or be prodded, aside.
Neal appears to be following the lead of Obama, who has increasingly backed away from remarks he'd made in support of a single-payer system earlier in his political career. "I happen to be a proponent of a single-payer universal healthcare program," Obama—then a state senator with ambitions for the U.S. Senate and beyond—told the Illinois AFL-CIO in a 2003 speech. "But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House."
A few years later, as Obama was on his way to taking the White House himself, he was parsing his words more carefully. By then, Obama was saying that if he were "starting from scratch," he'd support a single-payer plan, but that such a dramatic change from the existing system would be too disruptive. "[W]e've got all these legacy systems in place, and managing the transition, as well as adjusting the culture to a different system, would be difficult to pull off," Obama told The New Yorker in 2007. "So we may need a system that's not so disruptive that people feel like suddenly what they've known for most of their lives is thrown by the wayside."
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Last month, in response to questions about why he would not co-sponsor the Medicare-expansion bill, Neal's office sent the Advocate a copy of an open letter to organizers of the Medicare-anniversary rally. In the statement, Neal emphasized his admiration and support for the program: "There is no program in the history of America that has been more successful than the Medicare program. … And you should know, in the United States Congress there is no more ardent and vocal supporter of the Medicare program than me."
Noting the 47 million Americans without health coverage, Neal added, "Like President Barack Obama, I subscribe to the notion that we can do better in America." And, like Obama, Neal indicated that he wasn't looking for a dramatic, all-changing reform. "We are building on what currently works in our system, and as President Obama says, the tenet of this plan before us is that 'if you like what you currently have, you can keep it,'" the statement went on.
"I admire your commitment to the single payer cause and universal coverage," Neal wrote to the activists. "It is simply not the approach being taken up by the President, or the House or the Senate."
Single-payer might not be the approach taken by the administration, but it's hardly a fringe proposal, given that 85 members of the House have already signed on in support. According to Weissman., at a 2006 meeting with about a dozen local labor leaders, Neal said he would vote for the bill if it ever got to the House floor.
It looks like he'll soon have that opportunity. House Speaker Nancy Pelosi has said she'll allow a full House vote after the August recess on an amendment by U.S. Rep. Anthony Weiner (D-N.Y.) that would insert the universal-Medicare language of H.R. 676 into a House healthcare bill, H.R. 3200. In addition, Rep. Dennis Kucinich (D-OH), has an amendment to H.R. 3200 that would allow states to develop their own single-payer programs.
John Olver, the Valley's other congressman, has pledged to vote for both those amendments. Local activists are stepping up the pressure on Neal to do the same.
