Remarkably, the real legislative fight to win Medicare for All is just beginning. With a hearing today, the Ways and Means Committee of the US House is the first congressional committee to consider Medicare for All that has primary policy and funding jurisdiction.

Witnesses will include Rebecca Wood, who spoke in 2017 at the introduction of Sen. Bernie Sanders’s Medicare for All bill about her inability to get appropriate dental treatment, among other horrors visited upon her and her family by the US health care industry — a bleak typical picture of workers’ experience with their private health insurance. Former CMS administrator Donald Berwick, a strong single-payer advocate, will also testify.

Otherwise, at the hearing academics and consultants affiliated with the health care industry offer their prescriptions for “universal coverage.” State-based health exchanges created by the ACA, in the business of marketing private plans, have latched onto the “public option” (at least in Democratic-led states), so they will be represented in the hearing as well.

The hearing is the first step, setting the table for how Medicare for All will be debated in the House: how the hearing gets conducted, who testifies, matters. But here’s the thing: this powerful committee is not actually exercising its power on Wednesday.

The Ways and Means committee has the power to pass the funding and policies to establish improved Medicare for All, in what’s called a “mark up” of the HR 1384 — the single-payer bill — to prepare it for consideration by the full US House. This hearing on “universal coverage” is not a mark-up.

It may instead be the final act of this year’s mini-drama, “The Left and Progressives versus Nancy Pelosi.” This winter, at closed-door meetings, top Democratic staff assured health insurers that Medicare For All isn’t going anywhere, and public statements by Speaker Pelosi and by other leaders of the Democrats’ congressional campaign operation repeated industry talking points on costs and the impact on current Medicare. But within the last two weeks the snide is gone and key congressional leaders, including the chair of Ways and Means, Richard Neal, has co-sponsored HR 1384.

So what happened? Movement pressure and the popularity of Medicare for All, reflected in the continuing support of Democratic presidential candidates, particularly for Sanders’s Medicare for All bill, S 1192.

When 85 percent of your party favors a reform, as they do with Medicare for All, it should create a problem for leaders if they are not leading on the issue.  But despite these Democrats’ giving in on the hearing, they continue clinging to rhetoric about Americans being able to “keep your private insurance.” This directly follows the health care industry’s campaign developed by the Partnership for America’s Health Care Future to scare Americans about losing their existing private health care coverage and having it replaced by Medicare for All.

The reality is congressional Democrat campaigns and state Democratic parties  are funded by the health insurance, pharmaceutical, and hospital corporations, whose “community hospital” CEOs  are on speed dial of their district Democratic House members’ chiefs of staff. These relationships matter. Very few congressional staffers are left-progressive, and most strongly believe taking on the health care industry cannot succeed.

That creates a very cynical dynamic in Washington, reflected in the DC paper the Hill reporting that Democrats want to highlight the costs of Medicare for All and Republicans believe opposing Medicare for All works politically.

We have to set the terms of debate now. The Ways and Means Committee must be used as a platform today and a focus for organizing based on our program. Let’s amplify the messages of cost savings and comprehensive benefits; more important, let’s make every politician who doesn’t support Medicare for All defend the health care industry — its rapacious profits ($35 billion in 2018!), the obscene CEO salaries (average is $22 million per year), the denials of care, and the tax subsidies that make it all possible.

We cannot stop our outside agitation. The doors knocked, the local support built, the actions organized now will continue to determine if there are more rooms to take over, and what happens inside those rooms.

Our demand is very simple: guaranteed health care when we need it, with no barriers to care.

It’s a matter of justice, rooted in solidarity, to create a humane health care system based on caregiving, raising up the material quality of life for workers, providing security and expanding freedom. If we want to go beyond just House committee hearings on Medicare for All to actually winning it, let’s keep building a mass movement that demands nothing less.