Medi­care for All emerges as test for 2020 Dems

The Charlotte Observer (Sunday) - - Obituaries - BY JONATHAN MARTIN AND ABBY GOODNOUGH

Sen. El­iz­a­beth War­ren spoke at length this week about her vi­sion for im­prov­ing the Amer­i­can health care sys­tem, like strength­en­ing the Af­ford­able Care Act and mak­ing pre­scrip­tion drugs more af­ford­able. Twice, though, she ig­nored a ques­tion posed to her: Would she sup­port elim­i­nat­ing pri­vate health in­sur­ance in fa­vor of a sin­gle-payer sys­tem?

“Af­ford­able health care for ev­ery Amer­i­can” is her goal, War­ren said on Bloomberg Tele­vi­sion, and there are “dif­fer­ent ways we can get there.”

To put it an­other way: I am not walk­ing into that po­lit­i­cal trap.

War­ren of Mas­sachusetts and three other lib­eral pres­i­den­tial can­di­dates sup­port a Medi­care for All bill, which would create a sin­gle-payer health plan run by the gov­ern­ment and in­crease fed­eral spend­ing by at least $2.5 tril­lion a year, ac­cord­ing to sev­eral es­ti­mates. But War­ren’s de­ter­mi­na­tion to side­step an es­sen­tial but deeply con­tro­ver­sial is­sue at the heart of the sin­gle-payer model – would people lose the choices of­fered by pri­vate in­sur­ance? – il­lus­trated one of the thorni­est dilem­mas for sev­eral Democrats as the 2020 pri­mary gets un­der­way.

Their ac­tivist base, in­spired by Sen. Bernie San­ders, I-Vt., be­lieves the party should un­abashedly pur­sue univer­sal health care, end­ing pri­vate in­sur­ance en­tirely. But polls in­di­cate that the broader elec­torate, par­tic­u­larly the mod­er­ate- and high-in­come vot­ers who pro­pelled the party’s sweep­ing sub­ur­ban gains in the midterms, is un­easy about this “Medi­care for all” ap­proach in which many would lose their cur­rent in­sur­ance op­tions and pay higher taxes.

Sen. Ka­mala Har­ris of Cal­i­for­nia drew im­me­di­ate at­tacks from Repub­li­cans this week by tak­ing on the is­sue that War­ren dodged. Har­ris breezily ac­knowl­edged in a CNN town hall fo­rum that she would “elim­i­nate all of that,” re­fer­ring to end­ing pri­vate in­sur­ance in a coun­try where al­most 60 per­cent of the pop­u­la­tion re­ceives cov­er­age through an em­ployer.

Her re­mark trig­gered an in­tra­party de­bate about an is­sue that un­til now had been largely the­o­ret­i­cal: Should they build in­cre­men­tally on the Af­ford­able Care Act or scrap the in­sur­ance sec­tor en­tirely and create a Euro­pean-style pub­lic pro­gram?

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