South Bend, Indiana, Mayor Pete Buttigieg sees “Medicare for All” as the “long run destination,” but he’s concerned.
He’s raised the concern that under a single-payer system, which would move every American to a government-sponsored insurance program, workers in the private insurance sector would lose their jobs. Buttigieg is concerned about jumping straight to a proposal with a $32 trillion price tag, and mandating everyone move to a government-run program. And he’s concerned that Americans in labor unions with already strong health care benefits could lose out in a single government-run system.
As Buttigieg sees a bump in the early-state polls, the left is calling out the presidential candidate for “concern trolling”: acting like he’s an advocate for progressive causes, but proposing less ambitious programs with rhetoric that undermines his purported goals by suggesting they aren’t really feasible.
“He represents how Democratic elites have controlled the Democratic party for three decades,” said Matt Stoller, a fellow with the Open Markets Institute. “What you do is very simple: You say we want to do the same thing as the progressive with the idea, that there is no difference in values. Then you come up with this pedantic disagreement which basically tells the elites that you won’t do it.”
At the start of his campaign, Buttigieg went on the record supporting sweeping policies that have become increasingly popular with the Democratic base. But in the last few months he has hit the campaign trail questioning hallmark progressive policies around education and health care. In February 2019, Buttigieg called the Affordable Care Act a “conservative proposal” and Medicare for All “a compromise” between the national health care system in the United Kingdom and free market private health insurance. Now, Buttigieg says he could still support single-payer in the long term, but has put forward a “Medicare for All Who Want It” alternative — an expansion of the Affordable Care Act. He has also run an ad warning against the dangers of Medicare for All.
As a result, progressive activists have questioned Buttigieg’s policies at campaign events. When Buttigieg began moderating his platform, the hashtag #RefundPete trended on Twitter after ex-supporters asked for their campaign donations back. Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.) have dismissed similar critiques as “Republican talking points.”
“A lot of Buttigieg’s positioning in the past few months has been really cynical,” said Waleed Shahid, a spokesman for Justice Democrats, the left political action committee that famously backed Rep. Alexandria Ocasio-Cortez. “When he launched his campaign he was running as a progressive. ... There is a new phase in the Buttigieg campaign going negative on Elizabeth Warren and Bernie Sanders. A lot of what you are seeing now is people responding to that.”
Washington Post columnist Helaine Olen called Buttigieg “disingenuous” in his attacks on Medicare for All, addressing the candidate directly in a recent piece: “If your defense against Medicare-for-all is that you prefer our current system of a privatized, costly and highly inefficient jobs program that delivers inferior health-care outcomes, you should be up front about all that.”
Unlike some of the other self-proclaimed pragmatists in the race like Sen. Amy Klobuchar (D-Minn.), who has gone on record outright disagreeing with policies like single-payer, Buttigieg maintains that his values are just as progressive as those of the most left-wing candidates in the race.
Buttigieg’s “Medicare for All Who Want It” plan would give Americans a public option and has an automatic enrollment mechanism. His campaign and surrogates argue his proposal is directly in line with progressive values, but that he just has a different way of getting there.
Early endorser Susan Turnbull, who was a candidate for lieutenant governor in Maryland last year on a ticket with progressive Medicare for All advocate Ben Jealous, told HuffPost she believes “the goal is the same: People get coverage and that they get care.”
“He’s always believed that Medicare for All Who Want would be the best path to a Medicare for All environment,” Buttigieg spokesperson Sean Savett told HuffPost. “He disagrees on the implementation.”
But others who avowedly oppose Medicare for All are drawn to Buttigieg’s plans not for that stated long-term goal, but precisely because his implementation of it makes it much less likely to happen at all.
Iowa state Sen. Bill Dotzler, who endorsed Buttigieg recently, told HuffPost that he was specifically looking for a more “conservative” and “pragmatic” candidate who did not support a fully government-run health care system to endorse. He settled on Buttigieg, who seemed to check those boxes.
Jim Kessler, who directs policy at center-left think tank Third Way and who opposes Medicare for All, doesn’t pay much mind to Buttigieg saying his plan is in line with achieving a single-payer government system. Kessler has not outright expressed support for Buttigieg as a candidate, but sees his health care proposal as a strong policy.
“When people say, well, [Medicare for All] is a long-term vision, I am much more forgiving,” Kessler said. “I say, well, OK, that’s about a time long past when he is going to be president.”
This rhetorical style has come to define many of Buttigieg’s talking points. He has said he supports tuition-free college, but recently raised concerns about implementing a universal tuition-free public college program, claiming it would give rich families too big a financial break. His own college affordability plan would make public colleges and universities tuition-free for households making up to $100,000 and families eligible for federal income-based Pell Grants.
Buttigieg told NBC that he’s “concerned about a narrative emerging, that ignores the fact that not everybody goes to college,” arguing it’s not like K-12 education or Social Security, as Sanders, who popularized tuition-free college on the national stage in the 2016 cycle, puts it.
“As president, I will strengthen paths to college for students from working and middle-class families with historic investments in [historically Black colleges and universities], expanded Pell Grants, and tuition-free public college,” Buttigieg’s campaign tweeted. “Instead of providing free college tuition for the children of millionaires and billionaires, I will open doors of opportunity for Americans who choose not to go to college with massive investments in apprenticeships, workforce training, and lifelong learning programs.”
As HuffPost’s Daniel Marans pointed out, both Sanders’ and Warren’s plans cover trade schools and professional apprenticeships as an alternative to college, whereas Buttigieg’s plan is just for traditional four-year colleges and community colleges.
It’s even how Buttigieg talks about the party as a whole: He bills himself as the unifier, and has pushed back against party infighting around policy on the debate stage.
“This is why presidential debates are becoming unwatchable,” he said during the September debate. “Because this reminds everybody of what they cannot stand about Washington: scoring points against each other, poking at each other and telling each other that ‘My plan, your plan ― look ―’”
Buttigieg, however, has run an ad criticizing single-payer health insurance that names Sanders and Warren.
Why does Buttigieg frustrate the left? “It’s a failure to polarize around policies,” Stoller said.