Kamala Harris released a plan Monday for a single-payer health care system that is designed to address some Democratic moderates’ concerns with the sweeping Medicare for All bill championed by Sen. Bernie Sanders.
Harris’s version of Medicare for All — which the California senator is also calling Medicare for All — is light on many details. But what it does, effectively, is transform Sanders’ bill into something that could be more palatable for many party moderates who have been hesitant to embrace a dramatic remaking of the US health care system. The Sanders bill has become a litmus test of sorts for progressive Democrats in the presidential race.
Harris said she would give the country a longer period, 10 years, to transition over to a single-payer system, and her bill would still allow private insurance companies to offer health care plans — though within a highly regulated Medicare system modeled after the one that allows private insurers to offer Medicare plans to seniors.
During the 10-year transition period, Harris would immediately create a so-called public option, the ability to buy into Medicare — an idea favored by more moderate Democrats who worry about the political risks of forcing people off of their current health care plans.
Harris’s release of her own version of Medicare for All is likely to cause friction between her and Sanders. The Vermont senator has opposed anything that falls short of his 2016 bill, which would all but eliminate private health insurance in the US within four years. Harris cosponsored Sanders’ bill.
“I am clear-eyed about the challenge of achieving this goal,” Harris wrote of a single-payer health care system in a Medium post. “It will not be easy, and it will not happen overnight. So here is my plan to get us there.”
Harris has often appeared to try to strike a balance between the moderate and progressive wings of her party, a struggle that has never been more obvious than over the issue of health care.
Harris has made conflicting statements several times during her campaign about the role of private insurance companies in a single-payer system, forcing her to clarify her stances.
As part of a press release, Harris’s campaign showed that it had support from many Democrats seen as health care moderates, like former health and human services secretary Kathleen Sebelius, one of the architects of Obamacare.
Andy Slavitt, the former administrator of the Centers for Medicare and Medicaid Services, praised Harris’s plan for “balancing idealism and pragmatism,” the campaign said.
Harris also said that her version of Medicare for All would not raise taxes on families making less than $100,000 a year, instead using a tax on Wall Street transactions to pay for the gap created between her plan and Sanders’, which raises taxes for those making more than $29,000. Sanders has said that increase would be offset by the elimination of health care premiums and other costs.
Harris's plan was quickly criticized from both ends of the Democratic political spectrum. Former Vice President Joe Biden put out a harsh statement that said Harris's version of Medicare for All "both backtracks on her long-promised — but then hedged — support of Bernie Sanders' Medicare for All legislation while at the same time committing to unravelling the hard-won Affordable Care Act."
Faiz Shakir, Sanders' campaign manager, wrote on Twitter of Harris's plan: "Let's take a popular, good government-run program. Add a lot more privatization and profit-seeking into it. What could go wrong?"
By putting forward her own version of Medicare for All, Harris is seizing on a political reality: that voters, especially Democrats and independents, overwhelmingly like the sound of the idea but underestimate the scope of how Sanders’ plan would remake the health care system.
Many voters conflate the term “Medicare for All” with the creation of a public option, not a single-payer, government-run system.
Democratic critics of Medicare for All have pointed to the muddy waters around the term to claim that the issue is a vulnerability for the party. People are less likely to support Medicare for All, for example, if they are told their taxes will increase.
In her post Monday, Harris took direct aim at that part of Sanders’ bill.
“One of Senator Sanders’ options is to tax households making above $29,000 an additional 4% income-based premium,” Harris wrote. “I believe this hits the middle class too hard.”