Biden to face pressure on Medicare for All

Former Vice President Joe BidenJoe Biden2020 Democrats react to 'send her back' chants at Trump rally Can Biden's canceled cancer initiative be salvaged? Biden's health care gaffe shows he's not ready for prime time MORE’s entry into the 2020 race is putting a renewed focus on the sharp divide between Democratic candidates who want to strengthen ObamaCare and those who prefer to make the leap to “Medicare for All.”

For Biden, questions will center on whether he sticks exclusively with ObamaCare and his promise to improve on it or if he gives in to pressure from the left and gravitates toward Medicare for All, the progressive proposal backed by many of his opponents.

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Biden hasn’t publicly spoken about Medicare for All or related proposals. But he stumped for House Democrats during the 2018 midterms and touted the benefits of the 2010 Affordable Care Act (ACA), warning of efforts by Trump and Republicans to repeal it.

On his campaign website, Biden says his vision on health care is to make sure the “peace of mind of health insurance is a right, not a privilege,” and that he will “defend and build upon” the ACA.

His campaign did not respond to a request for more details.

But as someone who helped push the ACA through Congress, Biden is considered unlikely to back the single-payer system put forth by fellow candidate Sen. Bernie SandersBernie Sanders2020 Democrats react to 'send her back' chants at Trump rally Cardi B posts message of support for Ilhan Omar #IStandWithIlhan trends after crowd at Trump rally chants 'send her back' MORE (I-Vt.) that eliminates private insurance and is shunned by most of the Democratic establishment in Washington.

“There is a zero percent chance Joe Biden will be a genuine champion of Medicare for All,” said Adam Green, co-founder of the Progressive Change Campaign Committee, a group that backs Sen. Elizabeth WarrenElizabeth Ann WarrenNew CDC overdose estimates are nothing to celebrate 2020 Democrats react to 'send her back' chants at Trump rally Democratic Houston councilwoman announces Senate bid MORE (D-Mass.), a co-sponsor of Sanders’s bill.

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Progressives also dinged Biden on his campaign launch day for plans to hold a fundraiser hosted by, among others, the CEO of Independence Blue Cross, Philadelphia’s largest health insurance company.

And his comments about the right to “peace of mind of health insurance” rubbed some progressives the wrong way, saying it sounds like Biden does not intend to stand up to insurance companies.

“I think he’ll face pressure to stand up to the health insurance industry that has bankrupted people and done very little to control the ever rising costs of health care,” said Neil Sroka, communications director for Democracy for America, a progressive PAC founded by Howard Dean.

As the second in command to former President Obama, Biden helped pass the ACA, the largest health care reform undertaken in decades, extending coverage to 20 million people.

But, almost 10 years later, 27 million people in the country still lack health insurance, and many who are covered say they can’t afford their premiums, deductibles or prescription drugs.

And in recent years, a split has emerged in the Democratic Party over how best to move forward, with Sanders and others on the left pushing Medicare for All, which would move all Americans into one plan managed by the government.

Biden will have to reckon with growing support in his party for Medicare for All, which has been transformed from a fringe proposal to legislation that has more than a hundred co-sponsors in Congress.

Sens. Cory BookerCory Anthony Booker2020 Democrats react to 'send her back' chants at Trump rally The Hill's Morning Report - Trump seizes House impeachment vote to rally GOP Democrats warm to idea of studying reparations MORE (N.J.), Kirsten GillibrandKirsten Elizabeth Gillibrand2020 Democrats react to 'send her back' chants at Trump rally First responder calls senators blocking 9/11 victim funding 'a--holes' Democrats warm to idea of studying reparations MORE (N.Y.) and Kamala HarrisKamala Devi Harris2020 Democrats react to 'send her back' chants at Trump rally Biden's health care gaffe shows he's not ready for prime time The Hill's Morning Report - Trump seizes House impeachment vote to rally GOP MORE (Calif.) are among the Democratic candidates who back the bill. 

Biden’s supporters argue he’s a pragmatist who will be buoyed by the record-high support for the ACA. They also note that Democrats won back the House last year because they ran on defending ObamaCare.

“I think he’s going to make the case of being the chief defender of the ACA, knowing that it’s a winning argument for Democratic primary voters, and less so moving to a single-payer position or a Medicare for All position,” said Kevin Walling, a Democratic strategist who supports Biden.

Walling said Biden could contrast his defense of the law with Trump, who has tried to dismantle the ACA through executive action and is seeking to have the law overturned in the courts.

“He can run on protecting pre-existing conditions and lowering the cost of health care,” Walling said.

Biden wouldn’t be the only Democratic candidate in the 2020 field who isn’t embracing Medicare for All. 

South Bend, Ind., Mayor Pete ButtigiegPeter (Pete) Paul ButtigiegThe Hill's Morning Report - Trump seizes House impeachment vote to rally GOP 2020 Democrats adapt to changing social media landscape Trump blasts 2020 Dems during campaign rally MORE (D) has said he believes the country should move “in the direction” of a Medicare for All system, but that private health insurance companies shouldn’t be eliminated.

Sen. Amy KlobucharAmy Jean Klobuchar2020 Democrats react to 'send her back' chants at Trump rally Democrats warm to idea of studying reparations Bullock makes CNN debate stage MORE (D-Minn.), meanwhile, has called for improving ObamaCare while creating a public option, run by the government, to compete with private insurance.

Biden and Obama both pushed to include a public option in ObamaCare, but it was cut to garner the necessary support from moderate Democrats.

A public option is now a favorite proposal among moderate Democrats.

“The public option is a guarantee that there will be an affordable choice,” Biden said in an ABC interview in 2009.

While running for president in 2007, Biden unveiled a plan that would have allowed some Americans between the ages of 55 and 64 to buy into the Medicare program.

Democratic leaders in Congress have called for improving the ACA instead of focusing on Medicare for All, proposing legislation to expand access to tax credits that help people get insurance, while making the credits more generous.

Doug Thornell, a Democratic political consultant who says he’s neutral in the primary, said Biden will benefit from being the only candidate who has actually managed to pass health care reform.

“I think he can credibly say that under Obama and him, they were able to bring all parts of the Democratic Party together to pass a very ambitious health care bill, something that hadn’t been done in decades,” Thornell said. “I think he’ll point both to what he’s done but also look ahead and having an aspiration to get the country to where we all want it to be — a place where everyone can afford health care and not go bankrupt when they get sick.”