How does Speaker of the House Nancy Pelosi (D-Calif.) feel about two of the three leading Democratic presidential candidates campaigning on a Medicare-for-all health care system? Not great, Bob. Not great at all. In an interview with Bloomberg News published on Saturday, Pelosi argued for a more modest expansion on the status quo, the 2009 Affordable Care Act:
Pelosi said Democrats should seek to build on Obamacare instead of pushing ahead with the more sweeping Medicare for All plan favored by Warren and Sanders that would create a government-run health insurance system and abolish private coverage.
“Protect the Affordable Care Act—I think that’s the path to health care for all Americans. Medicare For All has its complications,” Pelosi said, adding that “the Affordable Care Act is a better benefit than Medicare.”
Pelosi, who expressed similar sentiments to Bloomberg in a Friday TV interview, also took aim at the Green New Deal, a sweeping economic overhaul backed by Sanders and Warren to forestall the worst effects of climate change.
The speaker’s rebukes to the party’s left flank aren’t anything new—she has subtly and not subtly signaled her disagreement’s with the party’s most outspoken first-term members—but it comes at a time when the presidential primary is beginning to enter the home stretch just before Iowa’s caucus goers have to make their final choices. Her comments also come the day after, following weeks of questions, Warren released a funding plan to pay for her Medicare-for-all proposal.
Pelosi’s word carries a lot of weight—as speaker, she not only determines what legislation comes up for a vote, she also sets the rules. In the same interview, she signaled that in the next Congress, she’d once again adopt “pay-as-you-go” rules requiring any new spending to be offset or paid for—a House rule that progressives have objected to in the past because they believe deficit spending is often necessary. Pelosi’s comments on Saturday may not move the needle in the Democratic primary—she’s still not endorsing a candidate. But it’s a sign that some of the party’s biggest fights may be yet to come.