It’s not just that Biden’s health care platform is less progressive than those of his rivals, especially Sen. Bernie Sanders (I-Vt.), nor is it simply that Biden holds centrist views about the value of competition and choice in the insurance market.
First, Biden promoted his plan, which also would significantly increase the government’s role in health coverage by creating a public option to compete with private insurers and would provide much more generous financial assistance to people covered by policies from the Affordable Care Act’s health insurance exchanges. Unlike Sanders’ Medicare for All plan, however, Biden’s would leave the private health insurance market intact.
Then Biden began to make the case against Medicare for All. It rested largely on trying to scare old people, a tactic Republicans frequently use to whip up anxiety about any Democratic plan to reform the health care system.
“Medicare goes away as you know it. All the Medicare you have is gone,” Biden said as he leaned down toward moderator Kathie Obradovich from the Des Moines Register for effect. “The transition of dropping 300 million people on a new plan ― totally new ― is, I think, kind of a little risky at this point.”
“Medicare goes away as you know it. All the Medicare you have is gone.”
As a point of fact, the “Medicare” program envisioned under Medicare for All is not the program as it exists today. Unlike what Biden insinuated, however, it would have more generous benefits and little to no out-of-pocket spending. Senior citizens, like everyone else, would be enrolled in a single-payer, national health care program.
This attack utilizes classic Republican “Mediscare” tactics designed to foment discontent among older Americans that anyone else’s gains come at their expense.
Trump himself published an op-ed last October in USA Today under the headline “Donald Trump: Democrats ‘Medicare for All’ plan will demolish promises to seniors.” In the op-ed, Trump makes a number of false and exaggerated claims about Medicare for All. But it’s this line that’s most in sync with Biden’s rhetoric: “The Democratic Party’s so-called Medicare for All would really be Medicare for None.”
“Medicare for None” has become a favored talking point in recent months for Republicans like Trump and Senate Majority Leader Mitch McConnell (R-Ky.).
Biden should recognize this fear-mongering strategy because McConnell and others used it extensively when President Barack Obama was working to enact the Affordable Care Act in 2009 and 2010 and continued to use it to criticize the law. For a candidate so fixated on protecting Obamacare and an ex-vice president who claims partial credit for Obama’s legislative success on health care reform, it’s jarring to hear him parrot those attacks now.
Perhaps worse still was Biden’s suggestion that sick people could be hurt during the four-year transition from the current health coverage system to a new, Medicare for All program.
Biden asked members of the audience to raise their hands if they’d ever lost a loved one to a terminal illness. “Every second counts. It’s not about a year, it’s about the day, the week, the month, the next six months,” he said. “The truth of the matter is, it’s likely to be a bumpy ride getting to where we’re going.”
“The Democratic Party’s so-called Medicare for All would really be Medicare for None.”
Biden has been using variations of this line at public events and during press interviews in recent weeks, and the subtext is pretty obvious: Be afraid of Medicare for All because you might die from it. It’s an aspersion straight out of 2008 Republican vice presidential nominee Sarah Palin’s heinous “death panels” playbook.
Biden’s political nature is more centrist and cautious than that of his most progressive presidential rivals like Sanders and Sen. Elizabeth Warren (D-Mass.). And he’s angling to win by appealing to Democratic voters who are uneasy with the progressive turn the party has taken since losing the 2016 presidential election, which includes older voters.
But Trump and McConnell already have the scaring-old-people market covered. And in a crowded field of candidates seeking the votes of an increasingly progressive Democratic electorate, it’s not even clear the tactic will really help Biden.
CORRECTION: An earlier version incorrectly reported the year of Sarah Palin’s vice presidential nomination. It was 2008.