Democrats’ views on healthcare
A look at their views on ‘Medicare for all,’ abortion and opioid crisis
Biden, Bloomberg, Gabbard, Sanders and Warren reflect on “Medicare for all,” abortion and the drug crisis.
There’s a reason the Democratic debates have spent so much time on healthcare — it emerged as one of the most contentious battles in the presidential primary.
“Medicare for all,” and how candidates line up for or against it, is the biggest healthcare issue, a proxy war for the broader philosophical fight between the progressive and moderate wings of the Democratic Party. But there’s a lot more to healthcare policy than Medicare for all.
Most of the Democratic candidates have delved into some of the other major issues pertaining to Americans’ well-being, including combating the opioid crisis, expanding mental health treatment and addressing the country’s poor maternal-health outcomes.
All the candidates support abortion rights and back codifying into federal law the 1973 Supreme Court ruling in Roe vs. Wade that legalized the procedure nationwide. They also support repealing the Hyde amendment, which largely prohibits federal funding for abortions.
Here’s a look at what the candidates are proposing:
Joe Biden
The former vice president has been a vocal critic of Medicare for all, arguing that it would be too costly.
Instead, Biden proposes building on the Affordable Care Act by offering a public health insurance option that would be financed primarily through higher taxes on capital gains. People could also stay on their employer-based coverage or buy into a private plan on their own.
Biden’s plan would increase tax credits to ensure no one is spending more than 8.5% of their income on insurance. To lower drug prices, he would allow the federal government to negotiate with pharmaceutical companies, and he wants to limit launch prices for drugs that face no competition and to limit price increases for all brand and biotech drugs and high-priced generics to inflation. He would allow consumers to import drugs from other countries, as long as they are certified as safe, and would terminate drug companies’ tax breaks for marketing costs.
Michael Bloomberg
Former New York Mayor Bloomberg’s healthcare plan includes a public option that would prioritize uninsured, low-income people while also leaving room for private insurance.
As early as January 2019, before he announced his presidential bid, he said a Medicare-for-all plan would
“bankrupt us for a very long time.” His plan would expand subsidies to cap premiums at 8.5% of a household’s income and expand Medicare to include an optional policy to cover dental, hearing and vision care.
Although Bloomberg has not rolled out his full healthcare plan or its proposed cost, he outlined key points that hit a lot of progressive notes, such as supporting reproductive rights and capping the cost of pharmaceuticals. Bloomberg’s plan leans on his experience as mayor, citing his work such as creating the Prescription Painkiller Abuse Task Force to address the national opioid crisis.
Tulsi Gabbard
Gabbard supports Medicare for all, but unlike some other proponents of the plan does not call for eliminating private insurance. The congresswoman from Hawaii has noted that other countries with universal healthcare systems still have a role for insurance companies. She has not spelled out a specific healthcare plan, nor has she specified how she would pay for expanded coverage.
Gabbard wants the government to negotiate with prescription drug companies to bring down the cost of medication. She also supports importing cheaper drugs from Canada. Her campaign website says she supports codifying the Roe vs. Wade decision “while making sure that, during the third trimester, abortion is not an option unless the life or severe health consequences of a woman are at risk.”
Bernie Sanders
Vermont Sen. Sanders is the candidate most closely associated with Medicare for all. After all, as he likes to say, he “wrote the damn bill!”
Sanders’ plan would do away with private insurance companies. Instead, his proposal would cover all residents, including those without legal status, under a government-run plan that would have no out-of-pocket costs for consumers except for prescription drugs. He has proposed financing the plan through a payroll tax on employers, higher income taxes on families making more than $29,000 per year and higher taxes on the wealthy.
The government would negotiate with drugmakers over prescription prices, and he would also allow patients, pharmacists and wholesalers to buy from Canada and other industrialized countries. To reduce costs, the Vermont senator wants to peg medication prices to the median drug price in Canada, the United Kingdom, France, Germany and Japan.
He has taken a tough line on drug manufacturers, introducing legislation to prohibit illegal marketing and distribution of opioids and calling for criminal liability for drug company executives and for manufacturers to reimburse the country for the negative effects of their products.
To address shortages of healthcare providers, especially in the mental health fields, he wants to increase funding for the National Health Service Corps.
Elizabeth Warren
Warren supports Medicare for all, but unlike Sanders, she has called for a two-year transition to a new government-run healthcare system.
The Massachusetts senator said she would aim to pass a Medicare public option, which would automatically cover all children and low-income Americans, within the first 100 days of her presidency. Other people could opt into the program in its early stages or stay with private insurance companies. In her third year, she would pursue a full Medicare-for-all plan, which would cover everyone in the country with no out-ofpocket costs. The complete plan would cost $20 trillion, funded by new taxes on the rich and contributions from employers, her blueprint says.
Warren has also outlined a slew of executive actions she would take in her first months as president, including reversing Trump administration efforts to undermine the Affordable Care Act and using existing government powers to revoke a medication’s patent if there is public need, which would pave the way for lower-priced versions of that drug.
Warren would allow the federal government to manufacture generic drugs in certain circumstances, such as when there is a drug shortage or when no company is manufacturing the drug, and she supports allowing Medicare to negotiate with companies to lower drug prices.
To deal with the opioid crisis, she has proposed a $100-billion plan that includes targeted funds for areas with the highest levels of overdoses and expanded access to naloxone, the anti-overdose drug. She would impose criminal penalties on executives of companies if they’re found to have acted negligently in distributing drugs.
Warren would address the country’s high maternal mortality rate by tracking health outcomes for mothers and infants at hospitals and would give bonuses or penalties based on the results.