Medicare for All Plan Splits Democrats on Health Insurance
Medicare for All Splits Democrats on Future of Health Insurance
(Bloomberg) -- Democratic candidates split over one of the biggest issues in the race to find a 2020 presidential nominee: whether or not to replace the U.S.’s system of largely private health insurance with government-run health-care known as Medicare for All.
Expanding a Medicare-like program to all Americans is popular with the party’s progressive wing, including Senator Elizabeth Warren and Senator Bernie Sanders. But the questions candidates faced on Wednesday night, and the split among Democrats, reflected the mixed support voters give to the idea when they consider the details.
Sanders’s Medicare for All bill would eliminate most private insurance in four years, instead offering people comprehensive government-run coverage, with small co-pays for drugs. It would set payment rates to doctors and hospitals. It would also almost certainly involve shifting hundreds of billions of dollars in spending, some new taxes, and other significant changes.
Five of the biggest U.S. health insurers gained in New York trading Thursday, with Humana Inc. and Centene Corp. advancing the most, by about 2% each. Warren and New York Mayor Bill de Blasio were the only two candidates who raised their hands when asked who would abolish private insurance companies.
``There is clearly political sensitivity to the risks of disruption from single payer and room for incrementalism in the internal debate on how to achieve the the party’s consensus goal of universal coverage,'' Evercore ISI analyst Michael Newshel said in a note to clients after the debate.
Health-care is a top issue for voters, and Medicare for All enjoys broad support: 56% of Americans said they supported such a plan in a January survey by the Kaiser Family Foundation, a health research group. But backing for the idea gets softer as people hear potential pitfalls. When told Medicare for All would eliminate private health insurance, 37% said they favor it while 58% said they oppose the idea.
Debating Change
Senator Amy Klobuchar and other candidates have said that Sanders’s plan is too much change, too fast. “I’m simply concerned about kicking half of America off their health insurance in four years, which is what this bill says,” she said.
Warren and other supporters argue that the time is right. “There are a lot of politicians who say it’s just not possible,” Warren said. “What they’re really telling you is that they just won’t fight for it. Health care is a basic human right.”
Almost all of the Democrats are for expanding coverage somehow, and at least adding Medicare as an option for more people to buy into enjoys wide support among the candidates. That, too, would likely be disruptive to the current system, upending the mix of people who are in private coverage, causing insurance premiums to change, and giving some employers a reason to rethink the coverage they offer.
At the same time, voter frustration with private insurance and health-care costs continues to simmer -- particularly over its costs. In 2018, workers had to pay an average of $5,547 a year for family coverage, with deductibles that often totaled thousand of dollars.
Do It Again
The split over health care is likely to continue into the second night of the debate on Thursday, when Sanders will face off with former Vice President Joe Biden and other Democrats.
“The vast majority of people are satisfied with their own health-care system today, through your employers,” Biden told reporters last month, saying that he wants to offer “a Medicare-like account that you can buy into. But you’d be able to keep your own insurance if you’re satisfied. If you’re not, you can buy into Medicare.”
The nonpartisan Congressional Budget Office has said that creating a single-payer health system in the U.S. would be a “major undertaking, and “would significantly increase government spending and require substantial additional government resources.”
Other groups have projected that Medicare for All would increase government spending while reducing private expenditures. A 2019 estimate by the Rand Corp., a nonprofit research group, estimated that one version of Medicare for All would more than triple federal spending to $3.499 trillion in 2019, close to the same amount spent on health care in the U.S. now.
Sanders has proposed several options to pay for Medicare for All, including a 7.5% income-based premium paid by employers, a 4% income-based premium paid by households, or eliminating tax breaks.
A competing bill by Senator Michael Bennet would give people the option to buy into a government-run insurance plan while preserving private and employer-based insurance for those who want to keep their plans. That legislation is co-sponsored by Klobuchar.
Some progressive activists have sought to make single payer a litmus test for Democratic contenders -- a measure of how committed they are to progressive values. Polls by the nonpartisan Kaiser Family Foundation indicate that Medicare for All is popular among Americans, but that support falls when respondents are told it’ll largely eliminate private insurance.
--With assistance from John Tozzi.
To contact the reporters on this story: Sahil Kapur in Washington at skapur39@bloomberg.net;Anna Edney in Washington at aedney@bloomberg.net
To contact the editor responsible for this story: Drew Armstrong at darmstrong17@bloomberg.net
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