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The divisions and infighting plaguing the GOP’s efforts to repeal and replace Obamacare are contagious — the Democrats face a rift of their own on health care.
Once-unified Democrats are splintering into competing factions over how to best move forward, with progressive lawmakers and activists aligned with Sen. Bernie Sanders, I-Vt., telling NBC News Wednesday they see the problems in the GOP as an opportunity to double down on their preferred health care reforms, like single-payer health insurance. They have shown little to no interest in negotiating with Republicans.
On the other hand, several Senate Democrats, including Minority Leader Charles Schumer, D-N.Y., have said they have in mind a variety of modest changes to Obamacare that they’d love to sit down and discuss with Republicans. Schumer even invited President Donald Trump to a bipartisan meeting with all senators.
That difference in how to approach improving the health care system has created a stark split in messaging within the Democratic party — a divide the White House has rushed to exploit.
Schumer, who had played an instrumental role in quietly persuading all 48 Senate Democrats to remain together in opposition — until the Senate GOP’s proposal fell apart this week — said Wednesday that his party wanted to be part of talks with the president.
"President Trump, I challenge you to invite us, all 100 of us, Republican and Democrat, to Blair House to discuss a new bipartisan way forward on health care in front of all the American people," Schumer said in a speech on the Senate floor.
"I would make my friends on the Republican side and President Trump an offer: Let's turn over a new leaf. Let's start over," added Schumer, who insisted that cooperation with the GOP would have to center around fixing Obamacare, not repealing and replacing it.
Other moderate Senate Democrats, like Sens. Joe Manchin, D-W.Va., and Heidi Heitkamp, D-N.D., have been behind that message since last year’s election and have said recently they’re willing to talk to Republicans, as long as repealing Obamacare is off the table and the White House drops any threats to sabotage the law for political leverage.
“For me and for my Democratic colleagues we’ve got to take the gutting of Medicaid and health care off the table,” said Sen. Debbie Stabenow, D-Mich. "That has nothing to do with the premiums in the private market."
In interviews with NBC News, Democrats rattled off a list of ideas where they think common ground is possible.
Several members, including Manchin, have co-sponsored a bill that would add a cheaper catastrophic plan to the insurance exchanges, among other tweaks. Sen. Claire McCaskill, D-Mo., recently introduced legislation that would allow people in counties with no insurers to buy from the same exchanges members of Congress use.
Other Democrats have talked about restoring Obamacare provisions that cushion insurers against unexpected high costs that were removed in a prior bipartisan spending deal.
Sen. Mark Warner, D-Va., for his part, has suggested allowing insurers to sell across state lines, a proposal that has also gotten support from Trump.
Warner acknowledged that "folks on both ends of the extreme” could torpedo efforts to work across the aisle, but said he would still try.
“I've taken my share of hits from both sides for being bipartisan," he said. "I'm going to keep doing that."
The liberal wing of the Democratic party, meanwhile, has urged using the latest Republican struggles to pass a health care bill to push universal health care.
"It’s a good jobs program if you expand health care to everybody," said Rep. Tim Ryan, D-Ohio. "You can’t outsource an occupational therapist, you can’t outsource a physical therapist, you can’t outsource a nurse who does cancer screenings. Those are jobs that could be right here in the United States of America and we’ll be healthier and prevent a lot of diseases and bend the cost curve on health care, which is the goal we’re trying to accomplish now."
Sanders, who has long been an advocate for a single-payer system, has also pleaded with his colleagues to work to expand coverage and to reject the GOP bill.
In a blistering speech on the Senate floor Monday night, following a weekend of Rust Belt rallies against the Republican proposal, he blasted the bill as "barbaric" and "immoral" and demanded it "must be defeated."
Single-payer advocates, however, have provided Republicans with an opening to argue that Democrats aren’t genuinely interested in negotiations. The White House has repeatedly tried to capitalize on the split, saying that the left wing of the Democratic party is pushing an untenable idea.
“When you look at the majority of House Democrats, they support a single-payer, $32-trillion bill backed by Bernie Sanders. That’s what the alternative is,” White House Press Secretary Sean Spicer said on Monday.
Other Democratic lawmakers haven't gone quite as far as Sanders in their criticism of the Republican bill, but they're still hardly rushing to the negotiating table with Republicans.
Party activists on the left have taken an even more hardline position, with some calling on Democratic lawmakers to stand up on the issue and boycott any prospective meetings with Trump.
RoseAnn DeMoro, the head of National Nurses United, a Sanders-allied union that represents 150,000 nurses and has championed single-payer health care, said Democrats should “absolutely not” enter into negotiations with Republicans on health care.
"No, they shouldn’t negotiate with the Republicans,” she added. "The Democrats should actually stand for something.”