WASHINGTON — Kamala Harris insists she still backs “Medicare for All,” but the health care proposal she released on Monday stops short of the full scale health care system overhaul that’s being advocated by her more liberal 2020 Democratic presidential rivals.
In a split with Bernie Sanders, Medicare for All’s chief architect and a fellow White House hopeful, Harris said she envisions a role for private insurers as long as they follow the government’s rules. She would slow the transition to a so-called single-payer system to 10 years from the four Sanders has proposed. And she ruled out tax increases on middle income Americans, an idea to which Sanders has expressed openness in exchange for lowering the price of health coverage.
Medicare for All has become a defining issue in the Democratic primary, with the most progressive candidates calling for a revolutionary approach to providing insurance coverage for all Americans at a lower price. Harris’ proposal, released a day before highly anticipated presidential debates begin, essentially seeks to thread the Democratic Party’s disparate camps, nodding to the demands of the progressive base while acknowledging that some voters are nervous at the prospect of losing private coverage provided by their employers.
But it also could open the California senator to criticism that she’s trying to appease all corners while doing little to stake out a position of her own. She’s already had to repeatedly clarify her positions on fundamental questions including the role of private insurers.
In a Medium post published on Monday, Harris said her focus was on finding a way to lower health care costs.
“Right now, the American health care system is a patchwork of plans, providers and costs that have left people frustrated, powerless and insurance companies in charge,” Harris said in the post. “And the bottom line is that health care just costs too much.”
Medicare for All advocates were quick to criticize the approach. Adam Gaffney, the president of Physicians for a National Health Program, which supports a single-payer system, said Harris’ plan has “several major shortcomings,” including the continuation of private insurance and the longer transition period.
“This plan continues to give private insurance a very central role in the health care system,” he said. “We have seen for decades that that does not work.”
Sanders campaign manager Faiz Shakir said Harris was “continuing her gradual backdown from Medicare for All” and suggested that she had been inconsistent on the issue of health care.
Harris has repeatedly been forced to clear up her stance on Medicare for All. During the first set of presidential debates she appeared to suggest that she supported abolishing private insurance, later clarifying that she does not. And before releasing her own health care plan, she was criticized for saying that she opposes a middle class tax hike to pay for Medicare for All without making clear how she would pay for it.
Sanders, a Vermont senator, and Harris will debate on different nights, so they won’t clash directly on health care. But liberals who will share the stage with Harris on Wednesday, including New York Mayor Bill de Blasio, could press the issue.
And Joe Biden, with whom Harris memorably clashed during the first debate, has opposed Medicare for All and could blast the senator for going too far. The former vice president also has seized on Harris’ recent comments, in an interview with CNN, that she opposes a middle class tax hike to pay for Medicare for All. Biden said Harris was not being realistic about what it would take to pay for it.
Sanders has said as recently as this month that the sweeping overhaul of the U.S. health system he envisions could cost up to $40 trillion over a decade, and he has said that one option for paying for it would be a 4% tax hike on families making more than $29,000 each year.
Harris said that “hits the middle class too hard,” and she is calling for exempting households making less than $100,000 each year from that 4% tax, with “a higher income threshold for middle-class families living in high-cost areas.”
Sanders estimated that the tax increase he proposed would raise $3.5 trillion over 10 years. Harris did not specify how much revenue would be raised in the scenario she’s proposing.
To pay for the difference, Harris wants to tax stock trades at 0.2% of the value of the transaction, 0.1% for bonds and 0.002% for derivatives.
Harris also argues that by making the transition period from current policy to Medicare for All 10 years instead of four, the overall cost of Medicare for All will be lower than in Sanders’ bill.
