Democrats Clash Over Health Care

Candidates disagree on maintaining private insurance and employer plans

Stephen Miller, CEBS By Stephen Miller, CEBS August 1, 2019
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​Democratic presidential candidates squared off over whether the U.S. health care system needs a radical overhaul that would do away with private health insurance and employer-sponsored health coverage, or if more moderate reforms would suffice, during two nights of televised debates on July 30 and 31. We've rounded up articles from SHRM Online and other trusted news sources about the Democrats' ideas.

Sanders and Warren Would Eliminate Private Coverage

During the July 30 debate, Sen. Bernie Sanders (I-Vt.) defended his Medicare for all plan, which would eliminate private health care coverage and set up a new government-run, single-payer health system offering care at no cost to consumers, financed by taxes. Sen. Elizabeth Warren, D-Mass., a co-sponsor of Sander's Medicare for All Act, defended the proposal to eliminate private coverage.

"It used to be Republicans that wanted to repeal and replace" the Affordable Care Act (ACA), said Gov. Steve Bullock of Montana. "Now many Democrats do as well."

John Delaney, a former congressman from Maryland, called the Sanders bill reckless and advocated his own plan, which would automatically enroll every American under 65 in a new public health care plan or let them choose to receive a credit to buy private insurance instead.

Beto O'Rourke, the former Texas congressman; Sen. Amy Klobuchar, D-Minn.; and Mayor Pete Buttigieg of South Bend, Ind., also took the middle ground, favoring plans that would allow but not force people to join Medicare or a new government health plan, or public option. Some candidates would require people to pay into those plans, while others would not.

(New York Times)

Medicare Advantage for All?

Days before the July debates, Sen. Kamala Harris, D-Calif., released a health care proposal that would allow a role for private insurers to offer coverage that meets the governments' terms, along the lines of the current Medicare Advantage program, but which would prohibit employer-sponsored health care plans except for supplemental coverage. She would slow the transition to a single-payer system to 10 years from the four Sanders has proposed.

Progressives took issue with Harris for stopping short of the full-scale health care overhaul embodied by the Medicare for All legislation. Her more moderate rivals, meanwhile, said she was trying to have it all without taking a firm position on one of the most animating issues in the primary.

(Associated Press/U.S. News & World Report)

Biden and Harris at Odds

During the second night of Democratic debate on July 31, former vice president Joe Biden and Sen. Harris—two of the highest-polling candidates in the crowded primary—took turns criticizing each other's health care plans. Biden expressed skepticism about Harris's proposal, which he said would take 10 years to accomplish, cost $3 trillion and lead to people losing their private employer-based insurance. Harris responded that Biden's plan to add a government-run public option to compete with private plans on the ACA marketplace was insufficient and would leave almost 10 million Americans uninsured. New York City Mayor Bill de Blasio, who supports a single-payer system without private insurance, said both Biden and Harris' plans were too timid and would leave some people without adequate and affordable health care.

(CBS News)

[SHRM members-only toolkit: Complying with and Leveraging the Affordable Care Act]

Medicare for All Hinges on Elections

Democrats unveiled the Medicare for All Act on Feb. 27, and the legislation now has 117 Democratic co-sponsors in the House and 14 in the Senate. The bill, which would only allow employers to sponsor supplemental health care benefits, has slim chance of being enacted given the Republican-controlled Senate and opposition by President Donald Trump. However, it is expected to be a major point of contention during the 2020 congressional and presidential elections.

(SHRM Online)

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