Dems divided, facing risks on health coverage
Workplace-provided plans remain popular
WASHINGTON — With health care at the center of presidential politics, Democrats are split over eliminating employer-provided health insurance under “Medicare for All.”
The risk is that history has shown voters are wary of disruptions to job-based insurance, the mainstay of coverage for Americans over three generations.
Divisions were on display in the two Democratic debates this week, with Sens. Bernie Sanders of Vermont and Elizabeth Warren of Massachusetts calling for a complete switch to government-run health insurance for all. In rebuttal, former Vice President Joe Biden asserted that “Obamacare is working” and promised to add a public option.
Sen. Kamala Harris of California was in the middle with a new Medicare for All concept that preserves private insurance plans employers could sponsor and phases in more gradually. Other candidates fall along that spectrum.
The Medicare for All plan advocated by Sanders and Warren would replace America’s hybrid system of employer, government and individual coverage with a single government plan paid for by taxes. Benefits would be comprehensive, and everybody would be covered, but the potential cost could range from $30 trillion to $40 trillion over 10 years. It would be unlawful for private insurers or employers to offer coverage for benefits provided under the government plan.
“If you want stability in the health care system, if you want a system which gives you freedom of choice with regard to doctor or hospital, which is a system which will not bankrupt you, the answer is to get rid of the profiteering of the drug companies and the insurance companies,” said Sanders.
On the other end is the Biden plan, which would boost the Affordable Care Act and create a new public option enabling people to buy subsidized government coverage.
“The way to build this and get to it immediately is to build on Obamacare,” he said.
The plan wouldn’t cover everyone, but the Biden campaign says it would reach 97 percent of the population, up from about 90 percent currently. The campaign says it would cost $750 billion over 10 years. Biden would leave employer insurance largely untouched.
The Harris plan is the new entrant, a version of Medicare for All that preserves a role for private plans closely regulated by the government and allows employers to sponsor such plans. The campaign says it would cover everybody. The total cost is uncertain, but Harris says she would not raise taxes on households making less than $100,000.
“It’s time that we separate employers from the kind of health care people get. And under my plan, we do that,” Harris said.
A poll this week from the Kaiser Family Foundation underscored the popularity of employer coverage. Among people 18-64 with workplace plans, 86 percent rated their coverage as good or excellent.