Alexandria Ocasio-Cortez is probably starting to regret that vote to reinstate Nancy Pelosi as speaker of the House.

As the "Democratic Socialist" Latina from Queens pushes her "green New Deal" and support for "Medicare for All" gathers steam among the ever-more-leftward leaning 2020 contenders for president, the Intercept reported on Wednesday that a top aide to Pelosi met with executives from one of the country's largest health insurers and assured them that the Democrats had "strong reservations" about single-payer health care, and that the party's agenda was more focused on lowering drug prices.

Wendell Primus

Wendell Primus, the Pelosi advisor in question, made the arguments during a PowerPoint presentation to insurance company executives where Primus pitched them on supporting Democratic efforts to shrink drug prices.

Pelosi adviser Wendell Primus detailed five objections to Medicare for All and said that Democrats would be allies to the insurance industry in the fight against single-payer health care. Primus pitched the insurers on supporting Democrats on efforts to shrink drug prices, specifically by backing a number of measures that the pharmaceutical lobby is opposing. Primus, in a slide presentation obtained by The Intercept, criticized single payer on the basis of cost (“Monies are needed for other priorities”), opposition (“Stakeholders are against; Creates winners and losers”), and “implementation challenges.” We have recreated the slides for source protection purposes.

While Democrats are united on the idea of ensuring universal access to health care, Primus said, Pelosi and the leadership believe the best rout to universal coverage is through bolstering the ACA and lowering prescription-drug prices.

Instead of MFA, Pelosi supports "three options" for making health care more affordable for all Americans.

The first, the CREATES Act, is bipartisan legislation, strongly opposed by Big Pharma, that would make it easier for generic drug companies to get access to a sufficient quantity of medications needed to produce generics.

that would make it easier for generic drug companies to get access to a sufficient quantity of medications needed to produce generics. The second measure addresses what’s known as “pay for delay,” in which a drug company pays a generic manufacturer to not produce a generic version of an expensive drug. Democratic leadership wants to ban that practice.

in which a drug company pays a generic manufacturer to not produce a generic version of an expensive drug. Democratic leadership wants to ban that practice. The third revolves around the issue of “evergreening,” which is a pharmaceutical industry practice of extending patent protection for a particular drug through a variety of practices. Democrats want to restrict evergreening to encourage cheaper generics make it to the market faster.

Pelosi says she supports MFA "aspirationally", but that the reality of enacting such a massive shift in the US health-care system is much more complicated.

"I was carrying around single-payer signs probably before you were born, so I, you know, I understand that aspiration," she said in 2017 during an interview with TV host Joy Reid. "This is an idea that if we had a tabula rasa, if we were just starting clean, would be the most cost-effective way to go forward. We don’t have that," she said. "Over 120 or 150 million people in our country have employer-based access to their health coverage and insurance."

The Speaker has complained that the push for MFA has distracted from the fight to preserve the ACA, and warned progressive lawmakers not to "tinkle all over the ACA right now."

Of course, we doubt Pelosi's socialist critics would agree with her view that MFA would ultimately be harmful due to the requirement of blowing out the deficit (because, thanks to Modern Monetary Theory, central banks can monetize debt until the cows come home without triggering a savings-eroding wave of inflation).

Readers can find the full presentation here.