Larry Levitt has an excellent tweet on trying to analyze Bernie Sander’s health care plan.
It’s very hard to analyze Sen. Sanders’ health plan, because you have to imagine a political environment in which it could actually pass.
— Larry Levitt (@larry_levitt) January 18, 2016
One of the issues that is being elided over by the plan is the assumption that the Hyde Amendment won’t apply. The Hyde Amendment is a long standing restriction on federal funds for abortions. The Stupak Amendment in the House Bill and the Nelson Amendment in the passed PPACA enshrined Hyde into PPACA.
My company offers full coverage for elective abortion for commercial, employer sponsored coverage unless the employer specifically requests that we don’t cover it. Most insurers offer full coverage with only normal co-pays, co-insurance and deductibles for elective abortion because it is a simple and straightforward medical procedure.
Going to single payer in a universe where Hyde/Nelson applies means the vast majority of women who don’t have $500 to $1,000 in spare cash lying around lose access to affordable abortion options.
And this is where Larry Levitt’s comment comes into play. Our political universe has a demonstrated durable anti-female sexual autonomy majority of 240+ votes in the House during the most liberal Congress in two generations. Any Democratic House majority on current maps will have dozens of representatives from districts that are more Republican than the nation. Better maps in 2022 will still have a marginal House seat be a Republican leaning seat. Even deep Blue seats are not guarantees to produce pro-female sexual autonomy votes (Lipinsky, Lynch etc).
There is a political universe where Hyde would not apply to single payer. It is a universe where the Democrats have a massive majority in the House and the Senate and the marginally decisive vote is coming from a D+3 district. Everyone in that universe also has a goatee.
These are the types of details that have not been addressed by Sanders or other single payer advocates which will prompt significant coalition fractures among probable allies.