WASHINGTON — Vying to become House speaker in a few months, Minority Leader Hakeem Jeffries outlined four items on the agenda that he said would enjoy “uniform Democratic support” and advance the party’s goal of “making life more affordable.”
The first two were about healthcare, and all four set a direct contrast with President Donald Trump.
“We have to reverse the Medicaid cuts. We should extend the Affordable Care Act tax credits,” Jeffries, D-N.Y., said Monday in response to a question from NBC News. “We should restore congressional authority as it relates to tariffs, because the Trump tariffs are making life more expensive for the American people. And we should end, decisively, if it’s still going on, Donald Trump’s reckless and costly war of choice in the Middle East.”
Rep. Don Beyer, D-Va., said there is consensus that Democrats’ first bill out of the gate, legislation that carries high symbolic weight known as H.R. 1, would need to focus on affordability.
But there’s not yet consensus on what the bill would look like, as voters cite the cost of living as a top concern heading into November’s elections.
Beyer argued that the best way to tackle the topic would be to restore hundreds of billions of dollars in Medicaid and the ACA subsidies that were cut in Trump’s “one big, beautiful bill.”
“In the affordability debate, nothing’s more central to it than healthcare,” Beyer said in an interview. “My expectation is that it’ll very much be about affordability one way or the other.”
Jeffries said there are “a whole host of things” still to work on, saying, “We’ve established five working groups on affordability” — on housing, healthcare, childcare, groceries and food, and gas and utilities.
He added that Democrats would also conduct aggressive oversight of the Trump administration and “certainly will fight to hold the crooks accountable.”
Jeffries’ agenda for a possible majority reflects an emerging consensus among many Democrats across the party spectrum, who said healthcare should top the party’s legislative to-do list in 2027. The lowest-hanging fruits are restoring Trump’s Medicaid cuts, which no Democrats voted for, and reviving the expired ACA, or “Obamacare,” tax credits, which every Democrat wanted to extend last year before Republicans blocked them, leading to coverage losses and substantially higher premiums for millions.
Still, many Democrats say reversing Trump on Medicaid and the ACA would be the bare minimum — and want the party to do much more on healthcare.
Rep. Alexandria Ocasio-Cortez, D-N.Y., said it would “absolutely not” be enough to simply restore Medicaid and ACA funds.
“Of course, we need to take immediate action on those ACA subsidies and making sure that we lower those prices immediately. But it doesn’t fix the deeper systemic issue that has led healthcare to be one of the primary drivers of inflationary costs over the last decade, frankly,” she said in an interview.
“We need to be doing a lot more to take on corporate power, to break up a lot of these monopolies that are rolling up — Big Pharma, insurance, private equity entering the space of healthcare unchecked,” she added. “I think there’s a lot here for us to really dig in on, to work on.”
While there’s agreement on restoring the Medicaid and ACA funds that were undone by Trump and the Republican-controlled Congress, there are divisions inside the Democratic Party about what its own healthcare agenda should be.
A large and influential faction on the left wants to pursue a “Medicare for All” system that would diminish — if not abolish — private insurance and give the government power to negotiate prices of medication and services downward. Many moderate Democrats have rejected that idea in favor of less disruptive changes, although the center-left hasn’t coalesced around a preferred vision. One outside center-left group floated “free primary care for all” as a way to break the stalemate between supporters of a single-payer Medicare for All system and of focusing on building on the current ACA.
Part of what House Democrats would do next year depends on the size of their majority, should they win. If it’s a narrow majority of a handful of seats, as the House has operated in since 2021 under either party, they might be limited to the lowest common denominator and blocked from doing anything too aggressive on healthcare or any other major issues.
Jeffries, who is politically cautious by nature, is leery of getting ahead of his conference and overpromising without knowing what kind of majority he’d have.
A source familiar with Jeffries’ thinking said Democrats plan to take action in three tranches: the first 100 hours, when they would focus on urgent priorities with party consensus to provide relief for Americans; then the first 100 days, to build on that foundation with more aggressive efforts to lower costs alongside investigative moves; and then the first year.
Rep. Jared Moskowitz of Florida, a moderate Democrat in a competitive district, said the Medicaid and ACA plans may not be “a complete agenda” but backed those positions as a good place to start.
“Let’s talk about what we can get done quickly to provide the American people economic relief,” Moskowitz said. “You know we need 60 votes in the Senate for any piece of legislation, and then we need the president to sign it.”
Democrats have consistently enjoyed an issue advantage on healthcare since 2018, the last time they captured the House. A recent Reuters/Ipsos poll found that Americans trust Democrats over Republicans to handle healthcare by 38% to 25%.
Rep. Brendan Boyle, D-Pa., who is poised to chair the Budget Committee if Democrats flip the House, also said he would be focused in the new year on “reversing the damage” to healthcare from Trump’s megabill.
“Keep in mind that when we take over in January, we will literally just be one month into the Medicaid cuts’ taking effect. That’s the biggest bulk by far of their healthcare cuts and where millions more people are going to lose their healthcare,” Boyle said in an interview. “So from the Budget Committee perspective, that’s what I’m focused on.”
Rep. Veronica Escobar, D-Texas, a member of the Appropriations and Budget committees, said she wants the party to take a much broader, more ambitious approach.
She said she is proud of the work House Democrats did on President Joe Biden’s Build Back Better agenda, which died in the Senate because of opposition from moderate Joe Manchin of West Virginia, who is no longer in office. Escobar said she would want to pursue much of that framework in Democrats’ first bill, including paid family and medical leave, universal prekindergarten, childcare subsidies and ACA subsidies, as well as student loan forgiveness.
“I would want to go big. My constituents and Americans all over the country are really hurting — it is so profound. And the increase in utility bills has been so overwhelming. I have constituents in my district who are paying more for their utility bills than their mortgage, and so people are really suffering right now. And my view is we have to offer the solutions that they deserve and they need, and we’ve done it before,” Escobar told NBC News.
“There is a way to message it. Obviously, the bigger it is, the more challenging that is,” she added.
But, she said, “there would be one central theme: bring down the costs that are making your life difficult.”
