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Democrats in Congress are unified in their support for significant federal involvement in healthcare, but they are not unified on the extent of that involvement.

Although there have been several reports about growing support for a single-payer system within the Democrat caucus, most Democrats are still apprehensive to embrace a European-style approach, such as the one long-espoused by Sen. Bernie Sanders, I-Vt., in which a national government serves as the sole funder and arbiter of care.

A letter sent on Monday by Senate Democrats to Majority Leader Mitch McConnell, R-Ky., highlights four potential Obamacare reform proposals, none of which introduces a single-payer system.

The plans propose extensions to existing tax credits, subsidies, and cost-sharing payments, but none of them removes private insurers or other intermediary organizations from the equation, as a single-payer system would do.

Even "Medicare for all" proposals have fallen short of being bona fide single-payer systems. Rep. John Conyers, D-Mich., introduced the Expanded & Improved Medicare For All Act in January, which garnered a lot of support. Although pitched as "Medicare for all," Conyers' bill did not attempt to set up the federal government as the sole arbiter of care. Though the bill excludes private, for-profit insurance companies from involvement, it welcomes public or private non-profit organizations.

Sen. Kirsten Gillibrand, D-N.Y., has similarly supported what she calls a "Medicare for all" proposal, but only as an option for people to buy into the program at an affordable price. Her proposal leaves private insurance companies mostly as they are under Obamacare.

The ACA was a big step in the direction of single-payer, as it significantly increased federal involvement in healthcare. Though their reform proposals continue moving the conversation toward socialization, few Democrats are prepared to dismantle the marketplaces and the health insurance system as they stand, and to take a wholesale leap toward a national system.

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Despite reports, Democrats not yet ready to embrace single-payer healthcare - Washington Examiner