2020 Dems walk fine line with support for ‘Medicare for all’
Democratic presidential contenders face a dilemma on how far to go in championing “Medicare for all.”
Stopping short of Sen. Bernie Sanders’s fully government-run system risks alienating progressives, but embracing the Vermont Independent’s bill opens up lines of attack around eliminating the private insurance coverage most people already have.
White House candidates have responded with a mix of competing answers when asked how they would tackle health care.
Some, like Sens. Elizabeth Warren (D-Mass.) and Cory Booker (D-N.J.), are trying to pull off a delicate dance by remaining co-sponsors of the Sanders bill while also touting less drastic alternatives.
Sen. Kamala Harris (D-Calif.) has gone further than Warren and Booker, saying of private insurance last month, “Let’s eliminate all of that.” Her aides clarified the next day amid blowback she also supports smaller steps, but that Medicare for all remains her “preference.”
Other possible candidates, like Sens. Sherrod Brown (D-Ohio) and Amy Klobuchar (D-Minn.), are taking a more moderate tack by not supporting the Sanders measure at all, instead pushing an approach that would allow people to buy into Medicare starting at age 55, down from 65.
Supporting Medicare for all “may be a ticket to winning the Democratic presidential nomination, but it could cause them problems in the fall in the general election,” said Brad Bannon, a Democratic strategist. “That’s the balance.”
Republicans are already attacking Democrats over the issue, telegraphing a line of criticism that is likely to continue through the 2020 election cycle.
“Democrats in 2019: If you like your plan, let’s eliminate it,” the Republican National Committee wrote in an email to reporters after Harris’s comments in January.
Sanders has led the charge to bring Medicare for all into the mainstream of the Democratic Party in recent years. But his legislation goes the furthest of the various options, giving government health insurance to everyone and eliminating the private coverage that millions of middle-class people receive through their employers.
Getting rid of that employer-sponsored coverage is a sensitive topic, even for some backers of the Sanders proposal, like Warren.
Asked if she was firm in wanting to eliminate that kind of coverage, Warren told reporters Monday that “one of the options that is certainly under discussion” is to instead give employers the option of buying into Medicare, rather than forcing people into Medicare.
“A lot of options on the table, a lot of good things for us to talk about,” Warren said. “But they all aim in the same direction, and that is that health care is a basic human right.”
Booker likewise did not champion full-scale Medicare for all when asked about it on Monday by CBS News.
“A lot of people use that term and there’s differentiation about what they actually believe,” Booker said.
Asked to clarify Booker’s position, a spokesperson listed six different bills that the New Jersey senator has co-sponsored, ranging from Sanders’s bill to creating a public option on the ObamaCare exchanges to letting employers and individuals buy into Medicare if they choose.
The spokesperson did not say which one Booker prefers or would prioritize if he were elected president.
Former Rep. Beto O’Rourke (D-Texas), another possible candidate who energized Democrats last year during his ultimately unsuccessful Senate bid, is also walking a fine line. He called for a single-payer system in a 2017 Facebook post, but his Senate campaign website the following year was less firm, calling for “achieving universal healthcare coverage — whether it be through a single payer system, a dual system, or otherwise.”
Sen. Kirsten Gillibrand (D-N.Y.), another White House hopeful, said in a statement to The Hill that she supports a single-payer system and Sanders’s bill and wants to have a transition period where anyone could buy into Medicare.
“We must offer Medicare for all,” she said on Wednesday.
Some Democrats who have not expressed any White House ambitions say it’s not a problem that they have several competing ideas at this stage.
“I’ve signed on for Medicare for all. Bernie has signed on for the Medicaid public option,” said Sen. Brian Schatz (D-Hawaii), referring to his bill that would allow people to buy into Medicaid. “I think the idea is we’ve got lots of paths when it comes to health care and we should just have a hearing.”
Getting any of the Democratic plans on health care over the finish line will likely prove challenging. Democrats would have to win back the Senate, as well as the White House, to give their proposals a chance of passing, assuming they keep control of the House.
Even then, Democrats might have to abolish the filibuster rule in the Senate, a significant step many in the party do not want to take, in order to prevent their bills from being blocked by a Republican minority.
A Democratic president could also choose to spend their time and political capital prioritizing a different policy area, like combating climate change.
Brown, for his part, is laying the groundwork for a potential run by touting his populism and connection to the working class, and in doing so he has pushed back on the migration toward Medicare for all that’s more commonplace among the other Democratic contenders.
The smaller step of letting people buy into Medicare at age 55, Brown said during a visit to Iowa last week, is “about helping people now,” and it “might be able to get through Congress.”
“I’m going to talk about what’s practical and we can make happen,” Brown said. “If that makes me different from the other candidates, then so be it.”
At the other end of the Democrats’ political spectrum, Sanders dismissed the idea of taking incremental steps.
“Clearly, if we want a health care system which guarantees health care for all people, and if you want to do it in a cost-effective way, the solution is a Medicare for all, single-payer program,” Sanders told The Hill on Monday.
Asked if he thought some Democrats were worried about pushback for embracing his call to eliminate almost all private insurance coverage, Sanders said, “I think you should talk to some Democrats.”
“But let me just say this: There is a reason why the United States is the only major country on earth not to guarantee health care for all,” he added. “My guess is that as we continue to make progress in Medicare for all, you will see the drug companies and the insurance companies spending many, many hundreds of millions of dollars in opposition.”
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