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Health: The Youngest Black Woman In Congress Has An Alternative To “Medicare for All”

Illinois Rep. Lauren Underwood has a plan to fix health care. But unlike some of her progressive peers — such as Reps. Alexandria Ocasio-Cortez, Ilhan Omar and Rashida Tlaib — she’s looking to reform the system, not replace it.


Underwood is, at 32, the youngest black woman in Congress. She defeated Rep. Randy Hultgren, the Republican incumbent, in 2018, flipping the seat that GOP House Speaker Dennis Hastert once held.

Her district is 85 percent white and was won by both Mitt Romney and President Trump. But Underwood won it by nearly five points in 2018 thanks to her laser focus on health care in the campaign. Hultgren voted to repeal the Affordable Care Act (ACA) in 2017, while Underwood ran on strengthening it.

A registered nurse, she says that working in health care prepared her to work in Washington. Along with Rep. Alma Adams, Underwood formed the Black Maternal Health Caucus to help develop policies to address the disproportionately high black maternal death rate in the United States.

“In nursing school, we learn how to walk into a patient’s room to look into their eyes and let them know you’re there to take care of them,” Underwood said. “I’m really surprised at how similar it was as a candidate to be able to connect with folks across my community.”

But unlike many of the most prominent freshman Democrats in Congress, Underwood is not a co-sponsor of the “Medicare for All” bill proposed by Rep. Pramila Jayapal. She said that she supported the goal of offering universal coverage, but was worried about the costs of expanding government health care to cover all Americans.

“If we’re going to talk about transforming our health care system in this really big bold way we should also be willing to have a candid conversation about how to pay for it and where the resources are going to come from,” Underwood said.

Underwood waved off comparisons between herself and Ocasio-Cortez, saying that while the large number of young women and people of color recently elected to Congress may make people “uncomfortable,” they all need to ignore such distractions.

“My colleagues and I have been very clear on our goals,” she said, referring especially to health care. “We’re going to continue with that kind of laser focus.”

Underwood has introduced her own bill, H.R. 1868, as part of the package of health care bills proposed by House Democrats to shore up and expand the ACA. Her bill would qualify more Americans to receive tax credits, expanding eligibility for premium tax credits beyond 400 percent of the federal poverty line, and lower premium prices for health insurance.


A person living on 4 times the federal poverty line may still struggle to pay health care costs, particularly if their premiums are high. Underwood said that expanding the tax credit would allow around 20 million more Americans to buy and use coverage.

“If we make the premiums more affordable, then people can actually use their coverage,” Underwood said. She added her bill was likely to pass in the House, and had a “strong chance of consideration” in the Republican-controlled Senate.

President Trump said last month that he wanted the GOP to become the “party of health care.” But with the Republican lawmakers wary of putting forth a health care plan of their own, Underwood said that the only way for him to do that is to embrace what Democrats are proposing.

“Well, sir, we’ve got a whole agenda item teed up for you,” Underwood said, referring to Mr. Trump. “We need to strip away all of this partisanship and get something done to lower health care costs.”

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