Medicare-for-all has plenty of obstacles standing in its way — the price tag, tax hikes, American aversion to disruptive change — but none might be as intractable as the Senate’s procedural rules.
There is the filibuster, of course, the 60-vote threshold for moving to a final vote on almost all legislation. Democrats aren’t going to have a 60-vote supermajority anytime soon, and Republicans seem unlikely to suddenly convert to the single-payer cause. Democrats could get rid of the filibuster entirely the next time they win a simple majority of 50 and let any bill advance with just 51 votes. But even Sen. Bernie Sanders (I-VT), the godfather of Medicare-for-all, is ambivalent about that.