As Opponents Tout Medicare for All, Biden Leans Into Obamacare

(Bloomberg) -- Democratic presidential front-runner Joe Biden wants to add a public option to the existing U.S. health insurance system and work to make coverage more affordable, according to a plan his campaign released Monday.

Biden’s health care proposals rely on keeping the Affordable Care Act in place while other Democratic presidential candidates are looking past the 2010 law to campaign on versions of a Medicare for All plan first proposed by Vermont Senator Bernie Sanders.

The former vice president argued that the hard-fought gains of Obamacare shouldn’t be scrapped in favor of an even larger overhaul of the health-care system and tax increases on the middle class.

His proposal, which would cost $750 billion over its first decade, would increase tax credits for health insurance premiums and lower the cap on coverage as a percentage of income.

It would give low-income Americans who live in states that haven’t opted into the ACA’s Medicaid expansion access to a public option plan with the same benefits as Medicaid. These and other measures would be paid for by eliminating capital gains loopholes for people making more than $1 million, Biden’s campaign said. The policy and tax law changes would require congressional approval.

Highlighting Obamacare

Biden rolled out his health-care plan -- unambiguously entitled “The Biden Plan to Protect and Build on the Affordable Care Act” – after spending the past few weeks defending Obamacare by noting that it has provided coverage to millions of uninsured Americans and offered protections to people with pre-existing conditions.

He’s warned voters that Medicare for All, which is supported not only by Sanders but also by Senators Kamala Harris and Elizabeth Warren, among other Democratic candidates, would be expensive and hard to achieve.

As he rolls out his plan in Iowa this week, including at a Monday forum hosted by AARP, Biden will continue to emphasize that contrast and the urgency of improving the health insurance system quickly after the 2020 election, a campaign official said on the condition of anonymity to preview the plan.

Building on Success

“I understand the appeal of Medicare for All,” Biden said in a campaign video released Monday. “But folks supporting it should be clear that it means getting rid of Obamacare. And I’m not for that.” It includes footage of Sanders and Harris raising their hands when a moderator at the first Democratic debate in June asked candidates if they support eliminating private insurance.

Sanders responded to Biden’s rollout in a pair of tweets noting that he also fought for the passage of the Affordable Care Act but that he is determined to end “the corporate greed that creates dysfunction in our health care system” by passing Medicare for All.

Sanders also went right at a central figure in Biden’s campaign and the Affordable Care Act: Barack Obama. The former president has spoken positively about Medicare for All, calling it one of the “good new ideas” on which Democrats are running in a video embedded in a Sanders tweet. “I appreciate that President Obama has said recently that Medicare for All is a good idea,” Sanders said.

Biden’s plan would increase subsidies for Americans who obtain coverage through the individual marketplace by basing the value of tax credits on more the generous Gold plan, rather than on Silver plans.

The credits are currently limited to Americans who earn between 100% and 400% of the federal poverty level -- roughly $50,000 for a single person and $100,000 for a family of four. Biden’s plan would eliminate that cap. It would also lower the maximum cost of coverage to 8.5% of income from 9.86%. A family of four making $110,000 a year would save an estimated $750 a month with the lowered limit, the Biden campaign estimated.

Public Option

Under Biden’s plan, an estimated 4.9 million low-income Americans living in states that haven’t expanded Medicaid would have access to a no-premium public option. States that have expanded Medicaid -- typically, those governed by Republicans -- would also have the option of moving to the new public option if they continue paying their current share of the cost of covering those benefiting from the expansion.

The plan also includes a string of proposals that Democrats generally support, including repealing the law that bars Medicare from negotiating lower drug prices, allowing consumers to buy prescription drugs from other countries, and eliminating “surprise billing” when a patient doesn’t have control over which provider he or she sees. Biden would also favor doubling federal funding for community health centers.

Biden’s public option would cover contraception and abortion, and he would push to restore federal funding for Planned Parenthood, the women’s health clinics. He would also reissue guidance requiring states to accept Medicaid funding for Planned Parenthood and other abortion providers, reversing a Trump administration rule.

To contact the reporter on this story: Jennifer Epstein in Washington at jepstein32@bloomberg.net

To contact the editors responsible for this story: Alex Wayne at awayne3@bloomberg.net, Ros Krasny, Steve Geimann

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