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The way to beat Donald Trump and the mess he has made of an already off-the-rails Republican Party is not by promising a kinder, gentler alternative to utter chaos. The way for Democrats to return from the political wilderness to which the party was consigned in the 2014 and 2016 elections is with bigger and bolder ideas. And the idea to start with is a single-payer, Medicare-for-All reform of America’s broken health-care system. Ad Policy

Senator Bernie Sanders keeps making the point that there is a growing popular demand for “a plan that responds to the needs of the great majority of the America people,” and adds, “That’s what single payer does.”

Sanders and other progressives recognize the importance of defending what’s good about the Affordable Care Act in the face of constant threats from the Trump administration and its congressional allies, as Democrats have over the past year and a half. But going forward, the party that seeks to replace Trumpism must get to the heart of the matter with proposals for replacing private profiteering with a system that truly recognizes health care as a right.

Democrats have to get a lot more comfortable speaking the language that Congresswoman Pramila Jayapal (D-WA) employed Thursday when she said, “Health care cannot be a luxury that’s only available for the wealthy and well-connected—it is a human right.” “Health care cannot be a luxury that’s only available for the wealthy and well-connected—it is a human right.” — @RepJayapal

Jayapal used those words to announce the formation of the House Medicare for All Caucus. Chaired by Representatives Jayapal, Debbie Dingell (D-MI) and Keith Ellison (D-MN), and strongly supported by key figures such as Congressional Progressive Caucus co-chairs Raúl Grijalva (D-AZ) and Mark Pocan (D-WI), the caucus will take the lead in arguing for HR 676, a Medicare for All measure sponsored by Ellison.

Ellison’s bill has already attracted 122 House co-sponsors—two-thirds of House Democrats—and the caucus will seek to expand those numbers. But it will do a lot more than that. The development of the caucus raises the profile of the fight for health-care reform not just in Congress but nationally.

“Every day more Americans are rallying behind the need for fundamental reform of our flawed and fragmented health-care system that denies care to millions of our neighbors and family members,” says National Nurses United co-president Deborah Burger, RN. “With polls showing increasing support for Medicare for All, and new signs every day of a system that is out of control, the formation of this Congressional caucus could not be more timely. Nurses see patients every day who are harmed by a system in crisis, and we know that the solution is within our reach.” Current Issue View our current issue

Burger is right. A solution is within reach. The only real barrier is a political one. It’s not just that Republicans have been opposed to necessary reforms, it is also that insider Democrats have been cautious—and in some instances openly resistant—when it comes to advancing a popular solution to a genuine crisis.

But there was nothing tepid about the launch of the new caucus Thursday. “In America, affordable and quality healthcare is a right—not a privilege,” declared Dingell.

With 70 House members already on board, Jayapal says the caucus will be positioned to “make sure that everyone has a practical understanding of how we can make this system work.”

This focus on education is essential to single-payer advocacy, as groups such as Physicians for a National Health Program have long argued. Republicans in Congress and on the campaign trail are quick to dismiss real reform as too costly and too bureaucratic to be practical. That’s not true, but that has led some Democrats at the national level to avoid a full embrace of Medicare for All proposals.

The resistance to real reform is giving way to realism in the House, where more and more members recognize that Pocan is right when he says that, “Medicare for All represents the only way forward to lower costs and increase access to health care for all Americans.”

The same goes off the Senate, where the key progressives (and potential 2020 presidential contenders) such as Elizabeth Warren of Massachusetts, Jeff Merkley of Oregon, Kamala Harris of California, Cory Booker of New Jersey, and Kirsten Gillibrand of New York have all signed on to Medicare for All legislation proposed by Sanders.

Pocan argues that the shift is coming from the grassroots, where the support for a Medicare for All system has grown exponentially in recent years. Across the country, state and local Democratic Party organizations have signed on. And activists are not just campaigning for change, they are campaigning for and getting elected to Congress on Medicare for All platforms—as Jayapal did in 2016, and as Pocan, himself, has since 2012. “If the people lead,” says Pocan, “eventually the leaders will follow.”

That needs to be the case with Democratic leaders in Congress and with Democratic presidential contenders in 2020, because Medicare-for-All advocacy is essential to organizing, mobilizing, and implementing the next American politics.