Following months of inconsistency and ambiguity about where exactly she stands on Medicare For All, Kamala Harris has finally laid out her campaign’s official health care policy. Since a clearly defined position is easier to discern than a constantly shifting one — and to say Harris has been inconsistent is putting it mildly — that’s good news.
Nevertheless, the plan ultimately raises some of the very questions Harris’s campaign is hoping it will put to rest.
Mere months ago, Harris was co-sponsoring Bernie Sanders’s sweeping single-payer legislation in the Senate. During a CNN town hall event in January, she then declared her willingness to eliminate for-profit private insurance before walking the statement back less than twenty-four hours later. During the first round of Democratic debates last month, Harris muddied things further by answering in the affirmative when asked if she would eliminate private insurance — later stating she had misinterpreted the question.
Despite having now staked out a more clearly defined position, Harris seems to be continuing much the same pattern: offering a rhetorical endorsement of Medicare for All while in practice proposing something decidedly less sweeping. True to form, her newly released proposal makes use of language almost identical in tone to that popularized by Bernie Sanders — right down to its chosen title: “Medicare for All.” From Harris’s website:
In America, health care should be a right, not a privilege. Families with pre-existing conditions should not fear that they will be denied care. It’s why we need Medicare for All. Imagine changing a job and not having to worry about your health care coverage. Imagine going to the pharmacy and not having to worry about an outrageous price increase on the prescription drug you need. Imagine walking through those sliding glass doors at the emergency room knowing that you have a Medicare card that will ensure you get the treatment you need without a bill you can’t pay.
These are laudable sentiments, but they aren’t matched by what Harris’s plan actually proposes to do. Far from removing them from the equation, the proposal would actually expand the role of private insurers in providing Medicare. As Splinter’s Libby Watson explains, it also keeps the door open to out-of-pocket costs and promises only to “empower the Secretary of Health to negotiate for lower prescription drug prices” and “seriously audit” the cost of prescription drugs (the Sanders plan would cap individual drug cost-sharing at $17 a month, full stop). Under the proposal, the United States would also spend a full decade transitioning to the new regime — ample time for gutting by any future Congress.
On its face, it’s difficult to interpret Harris’s plan as anything other than an act of political triangulation: a calculated effort to appease the lobbying industrial complex that favors retention of private health insurance while preserving her ostensible progressive bona fides by claiming “Medicare for All” as a slogan.
Some of yesterday’s media coverage of the announcement more or less conceded as much, while framing this triangulation in largely positive terms.
Experts say that Harris’s approach enables her to continue supporting universal coverage — a major priority for progressives — while also making the plan a bit more politically palatable to folks who are concerned by how disruptive it could be. With a longer transition period and an ongoing role for private insurers, it means more time for people to adjust and the appearance of greater choice.
Harris’ offering maintains her commitment to universal health care coverage — demanded by her party’s base — while lowering the temperature among the guardians of Obamacare who fear that overreaching would wipe out their hard-fought gains.
Note that all of these takes frame Harris’s political calculation in terms of reassuring ordinary voters and idealistic policy advocates, rather than placating the health care lobby. Politico’s write-up, for example, quoted effusive praise of the plan from former Obama administration official Andy Slavitt, who said: “Sen. Harris’ plan is an effort to balance idealism and pragmatism. If she explains it right, there’s something here for Bernie supporters and Biden supporters and definitely people who voted for Trump.”