Sen. Bernie Sanders (I-Vt.) is urging Senate Democrats to unite behind an expansive health care proposal in the party’s negotiations with Republicans to extend Affordable Care Act tax credits.

Why it matters: GOP leaders have promised Democrats a vote on the expiring tax credits next month as part of their deal to end the government shutdown.

• Sanders wants the Democratic proposal to extend the ACA tax credits, repeal $1 trillion in GOP health care cuts, expand Medicare and lower prescription drug prices, he said in a letter to colleagues late Monday.
• Republicans, however, have signaled that any deal to extend the tax credits must be short term and require reforms.
• Premiums will more than double for millions of ACA enrollees next year if Congress does not renew enhanced marketplace subsidies by year’s end, according to a new analysis.

The big picture: Democratic leaders have argued that the government shutdown has made health care a top political issue.

• Sanders, the top Democrat on the Senate Health, Education, Labor and Pensions Committee, said Democrats must make proposals that address “systemic deficiencies.”
• “We should not be defending a system which is not only, by far, the most expensive in the world, but one which numerous international studies describe as one of the worst,” Sanders wrote to Democratic senators.

Sanders’ HELP committee is expected to be involved in negotiations with Republicans over a potential bipartisan deal to extend the credits next month.

• A spokesperson for Senate Minority Leader Chuck Schumer (D-N.Y.) said: “The bill Democrats bring to the floor will be a caucus product.”

Between the lines: Sanders acknowledged in his letter that his Medicare For All proposal “does not yet have majority support” in the caucus.” But he said his latest proposal included “much-needed reforms.”

• Sanders also encouraged Democrats to propose investments to expand primary care services, ban stock buybacks and dividends and substantially reduce CEO compensation in the health care industry.