Health Care

Pelosi on Universal Health Care: ‘How Do You Pay for That?’

House Speaker Nancy Pelosi (D., Calif.) speaks during a press briefing in Washington, D.C., January 17, 2019. (Joshua Roberts/REUTERS)

House speaker Nancy Pelosi cast doubt on the practicality of a single-payer health-care system in an interview published Thursday, asking how the country would foot the enormous bill for such a system.

“That is, administratively, the simplest thing to do, but to convert to it? Thirty trillion dollars. Now, how do you pay for that?,” Pelosi remarked to Rolling Stone.

Democratic representative Pramila Jayapal of Washington on Wednesday introduced a sweeping Medicare for All bill that sparked vigorous debate within the party. The new legislation would cover disability, prescription drugs, mental health, maternal care, vision, dental, and substance-abuse care, would scrap Medicare’s age requirement, and would not charge patients copays, premiums, or deductibles. It does not detail how the program’s cost would be covered.

The House Democratic caucus is fractured over the issue of health care, with moderate members saying the proposal to insure all Americans through Medicare is too expensive, while more than 100 other Democrats support the new bill.

Pelosi has signaled her willingness to consider a single-payer system by supporting hearings on the legislation, but has stopped short of endorsing it.

“So I said, ‘Look, just put them all on the table, and let’s have the discussion, and let people see what it is. But know what it is that you’re talking about,’” the California Democrat said.

Pelosi added that she personally would prefer to preserve and flesh out the Affordable Care Act, one of the Obama administration’s signature legislative accomplishments.

“All I want is the goal of every American having access to health care,” the speaker said. “You don’t get there by dismantling the Affordable Care Act.”

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