Last week, a group of Senate Democrats rallied behind single-payer health care at a splashy news conference. This week, the same group is scrambling to beat back the GOP's latest Obamacare repeal blitz.

The contrast shows the chasm between the two parties’ approach to health care: Republicans claim that Bernie Sanders’ “Medicare for All” pitch fueled their revived repeal effort, an argument that even Democratic single-payer foes dismiss as untrue. Yet some Democrats wish more attention had been paid to protecting the Affordable Care Act before some of the party's biggest names turned to single payer.


It's also a reminder that in Washington you can never underestimate the power of a president, even if they don't always win. President Donald Trump wanted one last shot at repealing Obamacare, and Democrats are now struggling to preserve a victory they thought they'd already secured.

“I thought that anyone who believed that you should take your eye off the ball before Sept. 30 wasn’t being smart,” said Sen. Heidi Heitkamp (D-N.D.), who does not support single-payer. “So it doesn’t surprise me that this is coming back.”

Sen. Tom Carper (D-Del.) acknowledged that “maybe” the single-payer rollout had been premature, recalling a Methodist minister who once advised him as governor that “the main thing is to keep the main thing the main thing.”

“In this case the main thing is stabilizing the [Obamacare] exchanges, so people in every state, every county, can have better health insurance at a better cost,” said Carper, who has not signed on to Sanders’ bill. “That’s what we should be about right now.”

Sanders' single-payer plan drew support from no fewer than five fellow potential challengers to Trump in 2020. Liberal activists crowed that any Democrat who wants the party's next presidential nod would have to support a path to universal health care.

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The same cast of liberal luminaries, including Sens. Kamala Harris (D-Calif.), Cory Booker (D-N.J.) and Elizabeth Warren (D-Mass.), is now turning to stoking grass-roots fury about the new Republican repeal plan.

Senate Minority Whip Dick Durbin (D-Ill.), the minority whip, said it “remains to be seen” whether Democrats shifted too quickly to debating single-payer even as Obamacare repeal was still lurking.

Sens. Bill Cassidy (R-La.) and Lindsey Graham (R-S.C.) were crafting their latest version of a repeal measure “even as Bernie was working on his press conference” on single payer, Durbin added, "so it’s been around a while.”

Though no Democratic senator faulted single payer’s supporters, some in the party lamented the choice to unveil single payer before the GOP reached its deadline to repeal Obamacare with a simple majority vote. Trump and Senate Majority Leader Mitch McConnell (R-Ky.) are working hard to lock down Republican support for repeal, and they're close. A climactic vote could come next week, as the clock runs out on any hope of getting rid of Obamacare.

“Doing it when he did it was a gift to the repealers,” one Democratic strategist said of Sanders’ single-payer push. “It took focus off them and put it on us at an unhelpful time.”

One Senate Democratic aide wondered whether the single-payer splash could have waited until next month, when the GOP's window to repeal Obamacare with 50 votes will have closed.

“It’s the timing that’s the problem,” the aide said. “If this was introduced Oct. 1, that’d be one thing, but this is almost perfectly timed to make it harder to defend the ACA.”

“We should be trying to save the most progressive health care overhaul in decades, because it’s really at risk. But instead, they’re riling up the base over single payer, making the perfect the enemy of the good at the worst possible moment,” the person added.

A liberal activist whose group supports single-payer health care sounded a similar note, saying that the timing of Sanders’ rollout had handed “Republicans a lot of space” to quietly twist arms on the Cassidy-Graham repeal plan.

If the GOP can push through that repeal legislation, which would scrap Obamacare’s individual mandate and slash its Medicaid expansion, second-guessing about single payer promises to grow louder. Senate Minority Leader Chuck Schumer (D-N.Y.) and House Minority Leader Nancy Pelosi (D-Calif.) did not endorse Sanders’ health care plan, but some liberals say their short-term government funding and debt limit deal with Trump earlier this month also helped clear space for Senate Republicans' new repeal effort.

Sanders, for his part, joined Schumer at a Tuesday rally of progressive activists against the new repeal bill. The 2016 presidential candidate also recorded a video slamming the Cassidy-Graham plan to be circulated on his social media platforms. Sanders is likely to participate in more pro-Obamacare events over the next 10 days and considers the defeat of repeal his No. 1 priority right now, an aide said.

“Our job over the next five to 10 days is to get the word out about this horrific legislation and do everything we can to defeat it,” Sanders tweeted on Tuesday.

Sen. Brian Schatz (D-Hawaii), a single-payer supporter, agreed that the party should wait to talk further about its vision for the future of health care until after the latest Republican repeal effort is defeated.

“Let me put it this way: We need all hands on deck to try to save the Affordable Care Act, and there will be a time when this is over to talk about our own proposals to improve the health care system,” Schatz said in an interview. “But right now they are trying to destroy the American health care system, and we have to stop them.”

Sen. Jon Tester (D-Mont.), who has not signed on to single-payer, said that “whether it’s a distraction or not, I think the focus really does need to be on the smoke and mirrors they’re trying to do with this bill.” Tester slammed the Cassidy-Graham plan as “the worst” version of Obamacare repeal that Republicans have offered.

Democrats continued their campaign against the Cassidy-Graham measure on Tuesday, with the pro-Obamacare group Save my Care launching a six-figure TV ad buy targeting moderate Republican senators. Meanwhile, Pelosi is rallying her caucus from afar.

"This is an all-out red alert," she told members of her leadership team.

John Bresnahan and Heather Caygle contributed to this report.