(CNN)There's a new entry into the rising Democratic debate over wide-ranging overhauls of the US health care system, this one from a House Democratic freshman who flipped a Republican district in 2018.
New York Democratic Rep. Antonio Delgado plans to introduce legislation Monday that would allow all Americans to buy into a version of Medicare -- an approach designed to avoid the substantial system-wide overhaul that would come with any effort to create a government-run health care system.
"There's a need here to figure out where we all can come together and rally around achieving -- achieving -- a real change to our health care system," Delgado said in an interview with CNN.
The move opens up a new front in the Democratic debate over the future of health care, which has created divisions that have been laid bare in recent months as progressives in Congress make a strong push under the banner of "Medicare-for-All" -- that is, ditching the private insurance system and the Obamacare exchanges in favor of universal coverage paid for through taxes.
More than 100 of Delgado's colleagues have already signed on as co-sponsors to a Medicare for All proposal introduced in February by Reps. Pramila Jayapal and Debbie Dingell. It has the support House Democratic freshmen like Reps. Alexandria Ocasio-Cortez and Rashida Tlaib.
It has also emerged as a purity test for Democratic 2020 candidates as they look to navigate an energized party base, with Sen. Amy Klobuchar urging caution as Sen. Bernie Sanders and others embrace the idea.
Republicans, including President Donald Trump, have lined up to dismiss Medicare for All as "socialism" and have already laid out a series of attacks they plan to deploy throughout the 2020 election cycle.
Delgado says his goal is a smaller bore overhaul in the marketplace -- one that explicitly wouldn't displace people currently using private insurance and would have a mechanism to cover its cost, but still would open the door to universal coverage.
"If you introduce a public competitor within the private insurance market place, there is no doubt that will have a real effect on the premiums, on deductibles and it will drive down the cost of health care," Delgado said of the bill, which is a companion measure to a proposal already introduced in the Senate by Democratic Sens. Tim Kaine of Virginia and Michael Bennet of Colorado and is similar to a proposal introduced previously by Reps. Brian Higgins and John Larson last Congress.
Both Higgins and Larson are original co-sponsors of Delgado's bill this time around.
It also sets Delgado, who deliberately didn't back Medicare for All during the campaign and instead advocated for a Medicare buy-in proposal, apart from his more aggressive colleagues who may hail from districts considered more politically safe than his.
Delgado unseated incumbent Republican Rep. John Faso in 2018 by five points -- in a district Trump won by nearly seven points just two years earlier.
Asked whether now having a proposal of his own to tout back home would shield him from criticism on the right, Delgado said probably not -- but that's fine by him.
"That's not why I do these things. I'm not here to inoculate myself," he said.
The proposal marks a substantial addition to the current Affordable Care Act, which Democrats have rallied around in recent days to protect after the Trump administration sided with a Texas judge who ruled in December that the entire law should be found unconstitutional.
Democrats are divided on the future of health care, according to a March poll by the nonprofit health care think tank Kaiser Family Foundation, which showed 44% of those surveyed said Congress should focus on improving and protecting Obamacare, while 46% said Congress should move forward on Medicare for All.
The Delgado bill would create a public insurance option on the Affordable Care Act exchanges, alongside the private insurance plans. The goal would be to give Americans more choices when buying Obamacare coverage, particularly in areas where few carriers participate. The proposal would set premiums for public plan enrollees to cover all the benefit costs, including administrative expenses.
In other words, it would slot into the current system, as opposed to radically overhaul it altogether.
Delgado acknowledged the path forward would be difficult given the stakes -- and competing proposals in the debate -- but that his goal was to "actually find a sweet spot here that allows us to actually navigate these waters and get to a place where we don't just tinker around the system but we actually meaningfully change the system."
The proposal would be phased in over a period of five years, with the plan's implementation kicking into gear first in rural counties with only one or zero health plan on the current Obamacare marketplace, then expanding to the entire country and eventually, opening the door for small businesses to also enroll.
Delgado and his staff have had early stage discussions about the next steps for the bill with the committees that oversee health care policy, as well as Democratic leadership, according to an aide, and will seek to use the heft of a freshman class that swept House Democrats into power largely running on health care, to bolster the outlook for his effort. A more aggressive effort to line up supporters will be launched in the coming days, Delgado said, as he seeks to overcome what he says he's found to be an immediate roadblock in his early months in office: dysfunction.
"People talk to each other in headlines," Delgado said. "They engage in a fashion that allows for clickbait to ensue. There seems to be very little room for substantive debate on issues that we know are of critical importance. I want figure out how to own that space and be one of hopefully a growing group of individuals in DC who are committed to really doing the business of solutions oriented work."