Politico Pro: The veteran House Democrat leading the party's new health care offensive

House Democrats swept into power Tuesday night on the strength of vows to protect the Affordable Care Act and check the Trump administration. Now it's up to a longtime congressman from New Jersey to keep that promise.

Rep. Frank Pallone will take the gavel of the Energy and Commerce Committee for the first time next year, thrusting him to the fore of a high-volume health care debate likely to form the backdrop of the 2020 presidential race.

Pallone's charge will be managing the delicate balance between Democrats' burgeoning progressive wing and its moderate establishment. It's a challenge that could define the party's trajectory on major health care issues, like single-payer health care, and put Pallone's own allegiances to the test.

"All of us feel very strongly that health care is one of the major issues in the election and that Democrats are for affordable health care for all," said Rep. Eliot Engel of New York, a committee member. "There may not be total agreement on how to do that."

For Democrats, the committee's chief goal will be protecting Obamacare after years of concentrated efforts in the House to undermine the law.

The GOP's failed repeal effort last year only served to make Obamacare more popular than ever, propelling Democrats who campaigned on preserving patient protections and expanding coverage.

Pallone, who was elected to his 16th term Tuesday, declined to be interviewed for this story. However, in a brief interview last month, Pallone said he'd explore negotiating a bipartisan bill stabilizing Obamacare insurance marketplaces if Democrats took back the House. A similar effort was derailed earlier this year in the Senate, and there may be little room for compromise with the 2020 campaign starting in just a few months.

The committee will dig into a slew of Trump administration policies that Democrats claim have undermined the health law, like shortening sign-up periods, cutting outreach funding and expanding cheaper coverage alternatives. That means hauling Trump's health officials into hearings on Capitol Hill and spotlighting the fallout from their policies.

"We need to have oversight about what they're doing to sabotage the ACA," Pallone said.

Democratic lawmakers say they're also wary of appearing to be solely obstructionist. They see the next two years as an opportunity to pitch their own health care vision, passing legislation that signals what they'd pursue with full control of Washington in 2020, even if those bills are sure to die in the Republican-controlled Senate or face a White House veto before that.

The legislative agenda will focus primarily on rolling back the Trump administration's moves against Obamacare, with the Energy and Commerce panel crafting bills restricting the sale of short-term plans and reinstating funding for "navigator" groups that aid Obamacare enrollees.

Democratic leaders will also face mounting pressure to prioritize far more ambitious and potentially divisive policies animating the party's base, like sweeping drug price legislation and single-payer.

A House bill, H.R. 6505 (115), with 100 co-sponsors, would allow Medicare to directly negotiate drug prices — a concept liberals have long argued should be the backbone of any plan for lowering pharmaceutical costs.

It's also likely to be an early focal point for Democrats on the Ways and Means Committee, the tax-writing panel whose broad jurisdiction includes government health programs. Rep. Lloyd Doggett of Texas, who could end up chairing the panel's health subcommittee, co-authored the Medicare negotiation bill and is a vocal advocate of a drug price overhaul.

Some other Democrats have suggested they may even be able to court President Donald Trump on the issue, given his focus on drug prices. Trump campaigned on allowing Medicare to negotiate directly on prescription drugs but backed away from the idea as president.

Pallone has pledged to tackle drug prices as committeechairman, but he's yet to sign onto the bill. Advocates privately worry he may shy away from antagonizing the pharmaceutical industry, which is among one of his biggest donors and has a major presence in New Jersey.

"Pallone will absolutely be on board with some of the drug pricing agenda, but he also has to keep in mind he has a lot of pharmaceutical employees who are his constituents," said one health care lobbyist who works on drug price issues. "It's going to be a very difficult position, because I do think there's going to be a lot of pressure for them to go hard on the pharmaceutical industry."

The committee will also need to manage what could rapidly devolve into a deep intraparty rift: Whether to focus solely on shoring up the ACA, or to seize the momentum and rally support for single-payer.

Most of the House Democratic conference has already signed onto legislation, H.R. 676 (115), establishing a universal health care system, a once-fringe idea now backed by several likely presidential candidates and most voters (at least in theory). They'll face pressure from the party's liberal base to hammer out a "Medicare for All" plan to tee up for 2020, or risk frustrating the voters who just catapulted them into power.

Long-serving committeeDemocrats, back in the majority for the first time since Obamacare's passage, bristle at jumping into another health care fight. They warn it could squanderthe party's newfound political advantage by upending a system that voters are just beginning to like.

"I tell some of these young activists, 'Before you were born, I was for universal health care,'" said Rep. Jan Schakowsky of Illinois. "I am all for moving as fast as we can for doing that. But there are things we can do right away."

For Pallone and Democrats, that means ensuring the committee's work over next two years feeds the same goal of beating Trump and the GOP in 2020.

Democratic leaders "need to come up with a health care agenda that makes sense for the political moment we're in," said Brad Woodhouse, executive director of pro-ACA group Protect Our Care. "It's a really high priority to keep the focus on Republicans and what they've done to harm health care."