Overnight Health Care — Presented by Partnership for America's Health Care Future — ObamaCare premiums dropping for 2020 | Warren, Buttigieg shift stances on 'Medicare for All' | Drug companies spend big on lobbying
Democrats spar over electoral appeal of 'Medicare for All'
The Democratic clash over "Medicare for All" is highlighting perhaps the biggest question for 2020 primaries: Who has the best chance of beating President Trump?
Some top Democrats are warning that the full-scale version of Medicare for All pushed by Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.) would be a liability in the general election, repelling swing voters worried about losing their private health insurance under the proposal or seeing their taxes rise in order to pay for it.
But progressives counter that the "safe" approach counseled by the Democratic establishment has failed in the past, most notably in 2016 with former Secretary of State Hillary Clinton, and that bold proposals are needed to energize voters.
Rahm Emanuel, former President Obama's first White House chief of staff, gave voice to that debate Sept. 8 on ABC's "This Week," calling Medicare for All "an untenable position for the general election" because of its elimination of private health insurance.
"I just biked around Lake Michigan, nearly 1,000 miles, through Michigan and Wisconsin, two really important states," he said. "Nobody at a diner ran at me and said, 'Take my health care away.'"
Progressives view Emanuel and other like-minded individuals as being out of touch with the current direction of the party.
"People that have been schooled in the ways of Washington for decades think that arguments rooted in trying to scare people about the potential of losing what they've got right now is politically powerful," said Neil Sroka, communications director for the progressive group Democracy for America. "But I also think we're in a moment where more and more Americans are getting less and less from their health insurance than ever before."
Sroka said Medicare for All "both energizes the base and provides a robust alternative to people who feel like they've been totally left out and ignored by both political parties for decades."
Warren tried to counter fears about the loss of private insurance in Thursday's debate by arguing that people don't actually like their insurers; they like their doctors.
"I've actually never met anybody who likes their health insurance company," Warren said while arguing that total costs for the middle class would go down, with the elimination of premiums and deductibles, even if taxes went up.
Biden countered that under his proposal for an optional government plan, "the 160 million people who like their health care now, they can keep it. If they don't like it, they can leave."
There are warning signs for Medicare for All in the court of public opinion.
A Marist Poll survey in July found that 41 percent of adults nationally supported a Medicare for All plan when told it would mean replacing private insurance, compared to 70 percent who supported an optional government-run plan.
A Kaiser Family Foundation (KFF) poll this month, which asked about Medicare for All more neutrally, found a slim majority supported the idea, at 52 percent, but far below the optional government plan, which garnered 69 percent support.
"Once people hear about how Medicare for All could and would impact the current system, favorability drops quickly," said Ashley Kirzinger, associate director for the public opinion and survey research team at KFF. "More incremental changes are more popular among independents and Republicans."
Republicans are eagerly attacking Democrats over Medicare for All.
"Democrats' big government socialism would force a government takeover of healthcare" and "eliminate private insurance," the Trump campaign said in response to Thursday's Democratic debate.
Democrats won back the House last year with a focus on health care, one that largely emphasized GOP attacks on ObamaCare and its pre-existing condition protections.
Sen. Kamala Harris (D-Calif.) tried to return to that message in Thursday's debate, pointing out that President Trump backs a lawsuit seeking to overturn all of the 2010 Affordable Care Act.
"Donald Trump's administration is trying to get rid of the ban that we placed on denying people who have pre-existing conditions coverage," she said.
Dante Scala, a political science professor at the University of New Hampshire, said there is a question as to whether Biden can energize younger voters in a way the progressive candidates might.
"I could see young people looking at Biden, looking at Trump and just kind of shrugging their shoulders," Scala said.
But he said appealing to nonvoters with Medicare for All is "a gamble" that might turn away others who think "my life is pretty good except I really don't like President Trump, so I just want to go back to something resembling a normal president."