Call it a single payer boomlet.

More and more members of the House of Representatives are signing on to co-sponsor HR 676, the single payer bill in the House.

Just this week, five more members signed on — Peter DeFazio (D-Oregon), Tulsi Gabbard (D-Hawaii), Donald Payne (D-New Jersey), Nydia Velazquez (D-New York), and Frederica Wilson (D-Florida).

That brings the total number of co-sponsors to of HR 676 to 77.

(And that leaves 19 members of the House Progressive Caucus, which has as a group endorsed HR 676, to yet sign on as co-sponsors. They are: Ruben Gallego (Arizona), Maxine Waters (California), Jared Polis (Colorado), Rosa DeLauro (Connecticut), Lisa Blunt Rochester (Delaware), Val Demings (Florida), Lois Frankel (Florida), Andre Carson (Indiana), Dave Loebsack (Iowa), Anthony Brown (Maryland), Joseph Kennedy (Massachusetts), Debbie Dingell (Michigan), Ruben Kihuen (Nevada), Carol Shea Porter (New Hampshire), Frank Pallone (New Jersey), David Cicilline (Rhode Island), Eddie Bernice Johnson (Texas) Lloyd Doggett (Texas) and Don Beyer (Virginia).)

There is no single payer bill in the Senate.

Senator Bernie Sanders, whose single payer platform was the centerpiece of his 2016 Presidential run, has been sending mixed signals about his intentions.

Last week, Sanders said will introduce a single payer bill into the Senate soon, although his staff says it won’t be an HR 676 companion bill.

He has also indicated clearly that he will be pushing for a public option to fix Obamneycare. (“Right now we need to improve the Affordable Care Act and that means a public option,” Sanders tweeted last week.)

He has also said he would support dropping the Medicare age of eligibility from 65 to 55.

Single payer activists weren’t buying an Obamneycare fix.

They want to scrap the current system and start over with what they call an improved Medicare for all.

Dr. Margaret Flowers of Health Over Profit, wrote that “Senator Sanders and others are pushing a public option.”

“This would be a public insurance that people could choose instead of private insurance,” Dr. Flowers wrote. “It sounds good in theory but has not worked in practice because it draws the sickest patients and struggles to cover their care while keeping premiums and out-of-pocket costs affordable. Private insurers are experts at attracting the healthiest enrollees. In fact, I have argued that a public insurance is just what the private insurers want (though they are unlikely to admit it) because it serves as a relief valve to take sick people off their hands. That leaves private insurers to focus on the young, employed and wealthy, from which they can collect premiums and who won’t need much in the way of health care.”

“Senator Sanders is also raising the possibility of lowering the age of Medicare to 55, just as Alan Grayson suggested in 2010. This is another gift to the insurance industry because it takes a group that is more likely to have health problems off of their books. It will place more of a burden on the Medicare system without bringing the cost savings needed to cover health needs. I call this Medicare for some to contrast it with Medicare for all.”

Chris Lowe, an activist with Health Care for All Oregon, said that by floating the three ideas at once — single payer, public option and lowering the Medicare age — Senator Sanders created “considerable confusion.”

“We in the true universal health care movement need Senator Sanders to remain a clear, powerful voice for a well funded public system that has everybody in, nobody out on an equal basis,” Lowe said. “My view is that we in the grassroots should advocate directly to Sanders to keep up that voice at this moment when the health care debate has been re-opened. (Bernie’s Washington office number is (202) 224-5141, Burlington is (800) 339-9834).”

“Of the shorter term reforms, the public option is the gorilla in the room,” Lowe said. “It is offered by proponents as a ‘fix’ to problems with the individual market under the Affordable Care Act, but in general it can’t do that. A public plan that is strong in benefits compared to private plans will tend to attract riskier patients, and will leave room for private plans to practice adverse selection and cherry pick healthier patients. ‘Competition’ from a public plan would have to take the form of competing to lower premium prices by weakening benefits. That of course is the basic problem with the ACA individual market itself. So in general, so-called public option becomes a distraction from advocating for the universal publicly funded health care we need, among progressive advocates. Sanders appears to be pushing the idea forward to build his relationships with Democrats who favor it.”

Lowe says that one possible supporter of a single payer bill in the Senate is Oregon Senator Jeff Merkley.

“Now that three U.S. representatives from Oregon are co-sponsoring H.R. 676, it seems likely that a next step for Oregon single payer advocates at the national level will be to try to persuade Senator Jeff Merkley to sponsor or co-sponsor a single payer bill in the Senate,” Lowe said.

“Jeff Merkley is one of the strongest progressive voices in the Senate. =Since he ran for U.S. Senate in 2008 he has consistently treated single payer advocates with respect, meeting with us personally and having staffers meet with us.”

“In 2009, at a town hall held in a movie theater in Portland, hosted by Ed Schultz for his old radio show on Air America, I personally heard Merkley commit to voting for a single payer bill any time one came before him. He made similar promises around the state in that period.”

“So I will be working with other Oregonians to persuade Senator Merkley either to sponsor a Senate counterpart to H.R. 676, which would be ideal, or to continue his cooperation with Senator Sanders by co-sponsoring Sanders’ promised Senate single payer bill,” Lowe said. “We will be urging both senators to raise up the visibility of the single payer idea, and to ensure that single payer advocates are included in all future public debates and hearings on health care.”