Democrats asking for your vote in Michigan’s March 10 presidential primary are proposing health care overhauls that share a common goal: movement toward universal coverage for all Americans.
But how they get there —and pay for it — has divided the candidates and fueled heated exchanges in televised debates.
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The dispute is largely centered on whether to upend the entire health care industry by creating a single-payer Medicare for All program, or build on the so-called Affordable Care Act by creating a “public option” insurance plan that would compete with private insurers in an attempt to drive down consumer costs.
Here’s where the candidates stand:
Joe Biden: The former vice president served under President Barack Obama during passage of the Affordable Care Act and wants to build on that 2010 law, primarily by creating a new government-run public option health insurance plan. He would give consumers the choice to purchase a plan “like Medicare” or stay on private insurance. Biden also wants to expand tax credits and lower premiums for families who purchase insurance on the individual marketplace. He’s proposed paying for health care overhauls, eliminating capital gains tax “loopholes” and rolling back recent tax cuts for the wealthiest Americans. Read Biden’s plan
Bernie Sanders: The U.S. senator from Vermont isn’t just a leading proponent of Medicare for All, as he reminded during a July debate: “I wrote the damn bill.” He introduced the latest version, the Medicare for All Act of 2019 last April. At its core, the proposal would replace private health insurance with a “universal entitlement” provided to all residents without premiums, deductibles or copays. Sanders hasn’t specified exactly how he’d pay for the single-payer health care system but has laid out a series of financing “options,” most notably an employer-side payroll tax. Read Sanders’ plan
Elizabeth Warren: The Massachusetts senator is one of 14 co-sponsors on the Senate bill and remains a prominent Medicare for All supporter. In an attempt to avoid middle-class tax increases, she’s outlined a financing system that relies most heavily on an “employer contribution” that would require businesses to pay an annual tax that is roughly equivalent to the amount they now spend on insurance for their employees. While she wants to eliminate private insurance, she’s proposed a multiyear transition plan that would cover children and low-income individuals for free, while allowing others to choose whether to join. The transition plan is essentially an expansive “public option.” Read Warren’s plan
Mike Bloomberg: The former New York City mayor, who won’t qualify for debates because he is fully funding his own campaign, is very much in the “public option” camp. He wants to create a “Medicare-like” public health insurance plan that would be administered by the federal government but paid for by individual premiums. He also wants to expand enrollment options and cap premiums on private plans offered through the Affordable Care Act marketplace. Read Bloomberg’s plan
Pete Buttigieg: The former mayor of South Bend, Indiana, also is proposing a public option insurance plan he calls “Medicare for All who want it.” Like Biden, he aims for universal coverage by creating a new government insurance plan to compete with private insurers and expanding subsidies for private insurance. He’s proposed paying for it, in part, by rolling back recent corporate tax cuts. Read Buttigieg’s plan
Andrew Yang: The New York entrepreneur says he supports “the spirit” of Medicare for All, but he’s also argued that eliminating private insurance is “not a realistic strategy.” His health care plan does not propose Medicare for All or a public option under the Affordable Care Act. Instead, it focuses on goals like prescription drug price controls, investments in medical technology and new curbs on health care industry lobbying. Read Yang’s plan
Amy Klobuchar: The Minnesota senator also wants to create a public option plan that would compete with private insurers. Klobuchar’s plan would allow people to buy into coverage through Medicare or Medicaid. She also supports expanded premium subsidies through the Affordable Care Act. Read Klobuchar’s plan
Tom Steyer: The California hedge fund manager wants to create an “affordable, quality public option” for consumers that will force private health insurers to “compete on cost and quality” or risk losing customers. He also wants to expand financial subsidies offered though the Affordable Care Act. Read Steyer’s plan here
Tulsi Gabbard: The Hawaii congresswoman co-sponsored a House version of the Medicare for All legislation and argues current health care laws are organized “by and for the benefit of big insurance and pharmaceutical companies. An earlier universal health care proposal she supported proposed financing the system by increasing income taxes on the top 5 percent of earners, instituting a progressive tax on payroll and self-employment income and new taxes on unearned income and stock and bond transactions. Read Gabbard’s plan
Michael Bennet: The U.S. senator from Colorado helped develop legislation dubbed “Medicare-x” that would create a public option for health insurance, allowing consumers the choice to buy into the government system rather than private offerings. It’d be phased in over multiple years, starting in areas where there are fewer private insurers or higher costs. Read Bennet’s plan
John Delaney: The former Maryland congressman is touting a proposal he calls “BetterCare” that would enroll every American under the age of 65 into a new government-run health insurance but allow them to purchase supplemental insurance. The plan would swallow Medicaid but he’d continue state and federal Medicaid payments to cover the cost, and he’d end tax subsidies for businesses that sponsor employee health insurance. Read Delaney’s plan
Deval Patrick with Jesse Jackson
Deval Patrick: The former Massachusetts governor, who is still running but did not qualify for the Michigan primary ballot because of faulty signatures, also supports the idea of creating a public option insurance plan through the Affordable Care Act. Read Patrick’s plan
Note: Cory Booker, Julian Castro, Joe Sestak and Marianne Williamson will also appear on Michigan’s Democratic primary ballot but have dropped out of the presidential race.