Nixing private insurance divides 'Medicare for All' candidates

Some Democratic presidential candidates who say they support “Medicare for All” are walking a tightrope on whether to fully embrace a key portion of the proposal that calls for eliminating private insurance.

Only a few White House hopefuls raised their hands when asked at last week’s debates if they were willing to abolish private insurers, even though others who were on the stage have publicly backed legislation from Sen. Bernie SandersBernie SandersProtect women's right to choose how and when they work Senate braces for a nasty debt ceiling fight Schumer leaves door open for second vote on bipartisan infrastructure deal MORE (I-Vt.) which would do just that.

ADVERTISEMENT

Sen. Elizabeth WarrenElizabeth WarrenWarren: Canceling K in student debt could 'transform an entire generation' 10 books that take readers inside the lives of American leaders Schumer leaves door open for second vote on bipartisan infrastructure deal MORE (Mass.), Sen. Kamala HarrisKamala HarrisRon Johnson: 'I may not be the best candidate' for 2022 midterms Poll: Potential Sununu-Hassan matchup in N.H. a dead heat  Biden's belated filibuster decision: A pretense of principle at work MORE (Calif.) and Sanders all raised their hands, as did New York City Mayor Bill de BlasioBill de Blasio43 percent of NYPD employees vaccinated: report The Hill's Morning Report - Infrastructure vote fails; partisan feud erupts over Jan. 6 panel Israeli politician calls on Ben & Jerry's to 'rethink' ban MORE. But Harris later said she misunderstood the question, and clarified that she does not support eliminating private insurance.

“I am supportive of Medicare for All, and under Medicare for All policy, private insurance would certainly exist for supplemental coverage,” she said Friday morning on CBS News.

Sanders’s plan would cover every medically necessary service, including dental, vision and long-term care for people with disabilities.

That leaves little room for private insurers to cover anything except cosmetic surgery, Sanders has said.

Harris has seized on that exception to argue Medicare for All wouldn't eliminate private insurance, and that “supplemental coverage” would still exist.

Her comments, along with the discrepancy between those who have supported the Sanders bill on and off the debate stage, illustrate the delicate balance some Democrats are trying to achieve: They want to highlight their progressive chops by talking about Medicare for All, even though much of the voting public isn’t ready to give up their private insurance.

Harris has waffled on the issue of private insurance for months, despite being a co-sponsor of Sanders’s legislation. But she isn’t the only candidate in this situation.

Among the 2020 Democratic candidates, Sens. Cory BookerCory BookerDemocrats criticize FBI's handling of tip line in Kavanaugh investigation Biden: Republicans who say Democrats want to defund the police are lying For true American prosperity, make the child tax credit permanent MORE (N.J.) and Kirsten GillibrandKirsten GillibrandSenators hail 'historic changes' as competing proposals to tackle military sexual assault advance Overnight Defense: Military justice overhaul included in defense bill | Pentagon watchdog to review security of 'nuclear football' | Pentagon carries out first air strike in Somalia under Biden Duckworth, Pressley introduce bill to provide paid family leave for those who experience miscarriage MORE (N.Y.) are co-sponsors of Sanders’s bill, while Reps. Tulsi GabbardTulsi GabbardTulsi Gabbard on Chicago mayor's decision to limit media interviews to people of color: 'Anti-white racism' Fox News says network and anchor Leland Vittert have 'parted ways' New co-chairs named for congressional caucus for millennials MORE (Hawaii), Tim RyanTimothy (Tim) RyanSix takeaways: What the FEC reports tell us about the midterm elections Schumer, Tim Scott lead as Senate fundraising pace heats up Here's what Congress is reading at the beach this summer MORE (Ohio) and Eric SwalwellEric Michael SwalwellTech executives increased political donations amid lobbying push Justice in legal knot in Mo Brooks, Trump case Mo Brooks's Jan. 6 defense raises questions about official immunity and DOJ strategy MORE (Calif.) are co-sponsors of a similar House bill introduced by Rep. Pramila JayapalPramila JayapalSchumer feels pressure from all sides on spending strategy Liberal House Democrats urge Schumer to stick to infrastructure ultimatum Democrats ramp up spending sales pitch MORE (D-Wash.), a co-chair of the Congressional Progressive Caucus.

ADVERTISEMENT

Booker said he thinks there is a role for private insurance, and told The New York Times in a recent candidate survey that he would pursue a public option.

During the debate, Booker was less clear about his plans.

“We have to do the things immediately that provide better care,” he said. “We can do this better, and every single day I will fight to give people more access and affordable cost until we get to every American having health care.”

In a statement after last week’s debates, Sanders said there can be no middle ground, and his campaign called on all the candidates to unequivocally say where they stand on Medicare for All. 

"If you support Medicare for All, you have to be willing to end the greed of the health insurance and pharmaceutical industries. That means boldly transforming our dysfunctional system by ending the use of private health insurance, except to cover non-essential care like cosmetic surgeries," Sanders said. "And it means guaranteeing health care to everyone through Medicare with no premiums, no deductibles and no copays."

Democrats are trying to coalesce around a single health care message, much like they did in 2018 to take back the House.

Some on the left maintain that backing Medicare for All legislation is a must for anyone who wants to secure the Democratic presidential nomination next year, but moderate candidates are wary of giving President TrumpDonald TrumpNew Capitol Police chief to take over Friday Overnight Health Care: Biden officials says no change to masking guidance right now | Missouri Supreme Court rules in favor of Medicaid expansion | Mississippi's attorney general asks Supreme Court to overturn Roe v. Wade Michael Wolff and the art of monetizing gossip MORE and Republicans an opening to accuse Democrats of pushing for a “socialist” takeover of health care.

Polls show that voters like the idea of Medicare for All, though most don’t know that the legislation would eliminate private insurance.

June survey by the Kaiser Family Foundation found that despite what the authors of two Medicare for All bills in Congress have said, a majority of poll respondents thought they would still be paying premiums, deductibles and co-pays.

A similar Kaiser poll from January found that support for Medicare for All dropped from 56 percent to 37 percent when respondents were told it would eliminate private health insurance.

Robert Blendon, a health policy professor at Harvard University, said most candidates will be deliberately vague about Medicare for All, even the ones who are co-sponsors of the Sanders bill.

“I think many candidates signed onto the principle,” Blendon said. “They want a Medicare dominated system but didn’t fully understand that today’s Medicare … has a private alternative which is very popular. I just don’t think they are aware of that.”

Candidates like Sanders, who has been advocating for single-payer for years, understand the nuances, Blendon said, but most others are new to the debate.

“They wanted to show they are committed to moving the country … and now this issue has surfaced in the primary, and it will definitely surface in the general election about a private alternative if you want one,” Blendon said.

Before last week’s debate, Warren had drawn some criticism from the left for equivocating about her health care policy. But on Wednesday, she left no doubt about her position, and made an aggressive play for the progressive vote.

“I’m with Bernie on Medicare for All,” Warren said on the debate stage. She added that politicians who say Medicare for All isn’t feasible just aren’t willing to fight for it.

Warren’s shift puts pressure on Sanders, and was praised by progressive groups.

“When it mattered most, and with millions of people watching, she made the strongest case yet,” said Adam Green, co-founder of the Progressive Change Campaign Committee.

“There’s a huge difference between checking a box on a position, versus actually making the case for the public and persuading them you are right,” Green added. “If all you do is check a box, you aren’t prepared with strong rebuttals to the obvious Republican attacks.”

But Warren’s embrace of Medicare for All also makes her a prime target for attacks from Trump and his GOP allies. Trump has relished attacking Medicare for All, and brought it up again last week, unprompted, as he signed an executive order about health cost transparency.

“More than 120 Democrats in Congress support Bernie Sanders’s socialist takeover of American healthcare. It’s very dangerous,” Trump said. “The Democrat plan would terminate the private health insurance of over 180 million Americans who are really happy with what they have.”

Democratic candidate Sen. Amy KlobucharAmy KlobucharHillicon Valley: Democrats introduce bill to hold platforms accountable for misinformation during health crises | Website outages hit Olympics, Amazon and major banks Competition laws could be a death knell for startup mergers and acquisitions Democrats introduce bill to hold platforms accountable for misinformation during health crises MORE (Minn.) touched on those attacks during the debate. She supports a Medicare public option, but is not a co-sponsor of the Medicare for All bill.

“I am just simply concerned about kicking half of America off their health insurance in four years, which is what this bill says,” Klobuchar said.