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Two Democratic senators rolled out a proposal Tuesday that would allow anyone to buy Medicare plans, a proposal they say is a more realistic than proposals like Medicare for all that would eliminate private insurance companies and reshape the American health care system. The introduction of “Medicare X” comes as the Democratic Party debates its next steps on health care, with the left wing of the caucus pushing for a single-payer "Medicare for all" system and more moderate members supporting efforts to strengthen the Affordable Care Act (ACA). (Hellmann, 4/2)

Congressional Progressive Caucus co-chair Pramila Jayapal (D-Wash.) on Tuesday confronted a top aide to Speaker Nancy Pelosi, expressing frustration over his private dismissals of "Medicare for All" legislation. Jayapal, a lead author of the plan, H.R. 1384, told Wendell Primus, who serves as Pelosi's senior health policy adviser, that she did not appreciate what she perceived as his efforts to undermine lawmakers’ bills. Jayapal pressed him to explain reports that he made disdainful remarks about the proposal in separate meetings with health policy researchers and insurance executives. (Cancryn, 4/2)

President Trump on Tuesday lashed out at Puerto Rico’s local lawmakers as “grossly incompetent” and singled out one of his favorite targets, Carmen Yulín Cruz, the mayor of San Juan, as “crazed and incompetent.” Mr. Trump’s latest invective toward the local leaders of an island devastated by a hurricane in September 2017 came in a torrent of tweets, which began on Monday night and spilled into Tuesday morning. Mr. Trump was reacting after the Senate on Monday blocked billions of dollars in disaster aid for Midwestern states, in part because Democrats said a proposed $600 million in nutritional assistance to Puerto Rico fell short of its needs. (Karni and Mazzei, 4/2)

House Democrats on Tuesday suggested that the National Institutes of Health is poised for another funding increase in fiscal 2020, continuing an upward trend after the research agency’s budget climbed significantly in recent years. “I would like to increase this budget as much as we possibly can,” New York Democrat Nita M. Lowey, the full Appropriations Committee’s chairwoman, told NIH officials at a hearing of the House Appropriations Labor-HHS-Education Subcommittee. (Siddons, 4/2)