Republicans Want to Dismantle Medicare; Democrats Must Fight for Medicare for All

Sixty-one years ago, President Lyndon Johnson signed Medicare and Medicaid into law, while former President and long-time national health insurance champion Harry Truman watched. What Johnson and Truman understood was that the fight for guaranteed healthcare for everyone has been a generations-long struggle. The creation of Medicare and Medicaid was a key victory in that struggle. Importantly, though, Medicare and Medicaid are—to paraphrase what President Franklin Roosevelt said about the signing of Social Security into law—“a cornerstone in a structure which is being built but is by no means complete.”

After President Truman was unable to achieve his goal of guaranteed healthcare for all Americans, healthcare advocates decided to move incrementally. They began by pushing to cover seniors. Older Americans have the highest medical costs, the hardest time affording private health insurance, and need care the most often. The signing of Medicare achieved this important milestone, alongside the creation of Medicaid to cover healthcare for low-income Americans.

In 1972, Medicare was expanded to cover people with disabilities. But that is where progress stopped. It is well past time that we expand Medicare to cover children and everyone in between. We must also improve Medicare to cover such vital services as hearing, vision, dental and, perhaps most importantly, long-term care. And we must, in this age of abhorrent income and wealth inequality, require the wealthiest to contribute more while eliminating all premiums, co-payments, co-insurance, and deductibles.

Currently, we are at a crossroads. While America’s current healthcare system is painfully vulnerable to Republican attacks, there is an opportunity to create a better future where all Americans can rely on guaranteed healthcare.

With Republicans doing everything they can to disrupt and dismantle the current healthcare system, it is the perfect time to fight for a more durable and universal alternative.

Shamefully, Republicans are chipping away at both Medicare and Medicaid. The attacks take many forms. They include the effort to confuse Americans with the inferior, propagandistically named “Medicare Advantage;” the Trump administration giving AI the power to overrule doctors and block care for Medicare patients; the $1 trillion in cuts to Medicaid and the Affordable Care Act in the so-called Big Beautiful Bill (beautiful for billionaires, ugly for everyone else) passed by Republicans; and new Republican rules for Medicaid that would force cancer patients to get back to work and would cause millions of Americans to lose their healthcare coverage. Though Republican politicians would deny it, their hostility to Medicare and Medicaid is overwhelming.

Meanwhile, Democrats are working to expand and improve Medicare and Medicaid. They have taken concrete steps to lower prescription drug prices. The Inflation Reduction Act, which gives Medicare the power to negotiate for lower prices, was signed into law by a Democratic president, Joe Biden. Democrats are fighting to provide those same savings to those with commercial insurance and lower prices in other ways as well. Importantly, a growing number of Democrats are supporting and fighting for improved and expanded Medicare for All.

It may seem daunting and overwhelming to think about achieving improved and expanded Medicare for All in the current political environment, but it is within sight. Indeed, I have written a book-length road map to achieving improved and expanded Medicare for All, which will be released this September. It is called The Road to Medicare for All: A Call to Action (Routledge Press, forthcoming, 2026).

What would improved and expanded Medicare for All mean? It would mean this: no premiums, co-pays, co-insurance, or deductibles. It would mean comprehensive healthcare coverage for everyone in America, automatically. It would mean going to the doctor of your choice, without worrying whether your provider is in your insurer’s network. The vision of improved Medicare for All would include all services being covered automatically, including dental, vision, and hearing coverage. Medicare should also be expanded to cover long-term care, both at home and in nursing homes.

This November’s election will determine the future of Medicare and Medicaid. Will Republicans make Medicare and Medicaid work even worse for Americans? Will even more hospitals and nursing homes close? Or will Democrats be able to fight back and not only defend Medicare and Medicaid from Republican attacks, but enact a bold vision of improved and expanded Medicare for All?

With Republicans doing everything they can to disrupt and dismantle the current healthcare system, it is the perfect time to fight for a more durable and universal alternative: improved and expanded Medicare for All. Instead of a precarious and shaky patchwork system where a disruption to your healthcare is one job loss or plan change away, it is time to fight for a world where healthcare is truly a right, not a privilege.