In an effort to distinguish himself from rival presidential candidate Elizabeth Warren, Bernie Sanders emphasized on Friday that if elected president, he would immediately pursue the complete enactment of a “Medicare for All” single-payer health care system, including the elimination of the vast majority of private health insurance coverage.
Sen. Warren, the Massachusetts Democrat who two weeks ago introduced her own plan to finance Medicare for All without raising middle-class taxes, announced earlier on Friday that she would also pursue implementation of her plan in stages. She said she would move immediately to introduce a public option and lower the Medicare eligibility age to 50 and then, in the third year of her presidency, she would begin phasing out duplicative private health insurance.
Speaking at a campaign rally-cum-press conference in Oakland, California, where he was formally accepting the endorsement of the National Nurses United labor union, Sen. Sanders staked out a contrasting approach.
“With National Nurses United at my side, during the first week of our presidency, we are going to introduce the legislation that will bring Medicare for All to everyone in this country,” the Vermont independent said to a cheering crowd of nurses clad in the union’s signature red T-shirts.
The 150,000-member union, which is especially strong in California, is perhaps the country’s leading institutional proponent of Medicare for All. While it had been considering throwing its weight behind Warren, the union cited Sanders’ decades of consistent support for a single-payer health care system in explaining its endorsement.
Asked at the press conference whether Warren’s plan is a departure from his plan, Sanders answered diplomatically.
“I will let Senator Warren speak for herself, but this is what I believe,” he said before being cut off by the knowing laughs of the nurses assembled before him.
Addressing the laughter, he joked, “See, that’s being very tactical.”
He explained that he does not see any value in deferring a confrontation with the private insurance companies and pharmaceutical companies that will stand in the way of a single-payer system.
“That’s a fight that’s going to have to happen,” Sanders said. “I will engage that struggle on day one of my administration, not put it off for several years.”
Of course, Sanders’ Medicare for All legislation features a four-year phase-in period during which he would gradually lower the Medicare eligibility age before making the program completely universal. But unlike Warren, he has decided not to decouple the plan’s most controversial feature ― the abolition of private insurance for practices covered by the new, expanded Medicare program ― from the expansion of coverage. And by refusing to postpone implementation of the full Medicare for All legislation to the third year of his presidency, he does not risk ― as Warren’s left-wing critics fear of her plan ― facing a more hostile Congress and being forced to defer the policy’s enactment indefinitely.
The gentle tone of Sanders’ remarks about Warren reflect a non-aggression pact that the two candidates struck prior to announcing their plans to run for the White House. Sanders’ campaign aides have shown signs of straying from the terms of that accord, but Sanders himself has rarely, if ever, offered anything more than veiled criticism of Warren.
But Medicare for All is still something of a political obstacle course for Warren, who has scrambled to respond to a monthslong drumbeat of pressure springing from her initial embrace of Sanders’ legislation. She released her plan to finance the single-payer legislation after weeks of questions from journalists and attacks from more moderate rivals demanding to know whether her plan to finance the plan would lead to middle-class tax increases.
Before relenting and producing a plan to pay for Medicare for All that limited the tax increases to the wealthy and corporations, Warren had been reiterating that the vast majority of Americans’ underlying costs would go down under her plan without specifying whether that meant that the elimination of out-of-pocket costs would offset a tax increase. (Sanders has openly stated that his health care plan will raise taxes on middle-income earners, but justified it on the grounds that the tax increases would be lower than overall savings.)
The presidential campaign of South Bend, Indiana, Mayor Pete Buttigieg, a moderate contender who perhaps exerted the most effective pressure on Warren, continued to blast her in a Friday statement. Campaign spokeswoman Lis Smith argued that Warren’s decision to embrace the public option, which Buttigieg has labeled “Medicare for All Who Want It,” was an effort to “paper over a very serious policy problem, which is that she wants to force 150 million people off their private insurance- whether they like it or not.”
“Despite adopting Pete’s language of ‘choice,’ her plan is still a ‘my way or the highway’ approach that would eradicate choice for millions of Americans,” Smith continued.
This story has been updated with additional information about Warren and Sanders’ plans.