How Medicare for All Became a Dirty Word

Tom Williams/CQ Roll Call via AP Images

Representative Richard Neal during a House Ways and Means Committee hearing in Washington

Sludge produces investigative journalism on lobbying and money in politics. The American Prospect is re-publishing this article. 

The House Ways and Means Committee was scheduled to hold a hearing today on Medicare for All, but its chairman, Representative Richard Neal, suddenly changed the focus of the hearing and instructed his Democratic colleagues to not even mention the term. Instead of focusing on the proposal to establish a single-payer universal health care system, the hearing now covers all options for making health coverage universally accessible, including tweaks to the Affordable Care Act.

Since taking his powerful chairmanship at the start of the current legislative session, Neal, a longtime skeptic of Medicare for All, has raked in tens of thousands of dollars from health care industry interests. Neal received $61,800 from PACs and individuals affiliated with health care interests from January 1, 2019, to March 31, 2019, Sludge’s review of the most recent Federal Election Commission records found. 

In his last election, the pharmaceutical and health professionals industries were Neal’s second and third top industry donors, according to the Center for Responsive Politics, contributing $282,250 (8 percent) and $264,612 (7.4 percent) of his total raised. 

According to The Intercept, Neal met privately with Democrats on his committee last Wednesday to discuss the pivot. Neal “told the Democrats on the panel that he didn’t want the phrase ‘Medicare for All’ to be used,” The Intercept reported. “Instead, he said, the hearing should focus on all the different ways to achieve ‘universal health care’ or ‘universal health coverage,’ which he said was a better term to deploy. Medicare for All, he argued, was wrong on policy and is a political loser.”

The Ways and Means Committee, which oversees the revenue side of any health care legislation, plays a crucial role in determining which bills advance to the floor for votes. Representative Primala Jayapal, along with 112 other House members, are sponsoring the Medicare for All Act of 2019, so Neal’s prohibition of the term “Medicare for All” presumably forbids his colleagues from directly referencing their own bill.

Neal’s recent industry contributors include members of trade associations participating in the Partnership for America’s Health Care Future (PAHCF), a “dark money” lobbying organization created to oppose Medicare for All.

Pharmaceutical companies Merck, AstraZeneca, and Genentech, all members of the lobbying group and PAHCF coalition member Pharmaceutical Research and Manufacturers of America (PhRMA), made contributions to Neal in the first quarter of 2019 through their PACs. Abbott Laboratories and Horizon Pharmaceuticals, both members of PAHCF coalition member the Biotechnology Innovation Organization (BIO), also donated to Neal through their PACs. The contribution amounts were all between $1,000 and $2,500.

Under a single-payer health care system like Medicare for All, pharmaceutical companies’ profits could take a hit as the government would have increased power in pricing negotiations and the price of drugs would likely be driven down. 

Other health care interests whose PACs donated to Neal in the first quarter of 2019 include medical associations such as the Society of Thoracic Surgeons and the American Society of Anaesthesiologists, as well health care providers including Genesis Healthcare and Hanger Orthopedic.  

In December 2018, Sludge reported on Neal’s history of support from the health industry:

Over his two-decade career in the House, Neal has relied on support from the health care industry, receiving $950,000 from health professionals and associations and $750,000 from the pharmaceutical industry, according to data compiled by the Center for Responsive Politics. Neal also received $2.4 million from the insurance industry, which includes health insurers amongst other types of insurance companies, more than any other member of the incoming 116th Congress.

In the 2017-18 election cycle, insurance and pharmaceutical PACs alone combined to deliver a mammoth $546,000 to the congressman, who faced a primary challenge from progressive lawyer Tahirah Wadud. Neal won by a margin of 40 percentage points and ran unopposed in the general election.

Neal raised nearly $1.5 million more in the 2017-18 election cycle than the average Democratic House member. PACs made up just over 75 percent of the total $3,130,248 Neal pulled in during the 2017-18 cycle, with almost a third of that money coming from PACs and individuals in the health care industry.

Neal has long held leadership positions with the Democratic Congressional Campaign Committee (DCCC), an organization that supports incumbent Democrats. In 2018 Neal was named a co-chair of the DCCC’s Partners & Allies Council, which works with businesses and PACs.

As Sludge reported in partnership with MapLight, lobbyists affiliated with members of the PAHCF coalition have  recently increased their fundraising for the DCCC. Six lobbyists who, combined, have bundled hundreds of thousands of dollars for the DCCC so far in 2019, currently lobby or previously lobbied for members of the PAHCF coalition. They include Zach Pfister, a lobbyist for managed care company Centene and pharmaceutical company Novartis, who has bundled more than $280,000 for the DCCC so far in 2019, and John Michael Gonzalez, a lobbyist whose clients include PhRMA and drugmakers Amgen, Astellas Pharma U.S., and AstraZeneca, who has bundled $100,000 for the DCCC this year.

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