The 2020 Democratic presidential primary has begun with a debate over abolishing (most) private health insurance.
Sen. Bernie Sanders’s (I-VT) Medicare-for-all proposal holds that private health insurance has to be eliminated for almost all medical care. In a CNN town hall, Sen. Kamala Harris (D-CA) emphatically agreed with the idea, saying it’s time we “eliminate all of that,” though she’s expressed openness to more incremental proposals as well.
But other top Democrats have been more cautious. Sen. Michael Bennet (D-CO), who’s weighing a presidential campaign and is a lead sponsor on a public option bill — Medicare X — with Sen. Tim Kaine (D-VA), has called Sanders’s plan “a bad opening offer.” Interviewed on Meet the Press, Bennet warned, “Remember when President Obama said, ‘If you like your insurance, you can keep your insurance.’ And then a few people in America actually lost their insurance because of the way that the plan worked. Now what the Democrats are saying is, ‘If you like your insurance, we’re going to take it away from you.’”
Even Sen. Cory Booker (D-NJ), who co-sponsored Sanders’s bill, sees some role for private insurance companies. “Even countries that have vast access to publicly offered health care still have private health care, so no.” he said.
Behind the caution lie the polls. Medicare-for-all polls well, but according to the Kaiser Family Foundation, 58 percent of Americans oppose the idea if it includes eliminating private insurance.
Though presidential campaigns obscure this fact, it’s Congress, not the president, that writes and passes health care legislation. So I asked nine Democratic senators, none of whom are running for president, if they could support eliminating private health insurance.
“No,” Sen. Mark Warner (D-VA) said, point blank.
He’s not alone. “I think there is a role for private insurance as well as public insurance,” Sen. Debbie Stabenow (D-MI), who has a bill lowering the Medicare age to 50, said.
Even the senators most open to the idea said they could maybe see public insurance overtake private companies — as long as the market decides. But not one of the Democratic senators I talked to embraced passing legislation outlawing most private insurance.
Here are those exchanges, lightly edited for style and length.
Sen. Dick Durbin (D-IL): “I can see a transition that might work”
Tara Golshan
Do you think in the Democratic debate around health care that a universal health care plan should move toward getting rid of private insurance?
Dick Durbin
I tell you, if we are moving in that direction — which even the Affordable Care Act did, it’s not going to be overnight. It can’t be and it shouldn’t be. It should be done in a thoughtful and gradual way. I’ve supported Medicare at 50 because I think that is a good way to allow those 50 to 64 to qualify for a Medicare-type protection, and we can see if the private insurance companies offer something like Medicare Advantage to this group, [and] how this transition may take place.
Tara Golshan
Do you support allowing people with employer-based health care to buy into a federal insurance program?
Dick Durbin
It’s interesting. Because currently, a high percentage of those receiving Medicare are receiving it through private insurance companies. So I can see a transition that might work, as long as we write the rules on what Medicare coverage means.
Tara Golshan
So you support going in this direction?
Dick Durbin
Oh, I do. I do.
Sen. Debbie Stabenow (D-MI): “I think there is a role for private insurance as well as public insurance.”
Tara Golshan
In the Democratic debate around universal health care, do you support moving in the direction of getting rid of private insurance?
Debbie Stabenow
I think there is a role for private insurance as well as public insurance.
Tara Golshan
What is the importance of having private insurance for you?
Debbie Stabenow
Well I just think people should have a choice. And that’s where I support the option of buying Medicare, or the option of buying it at 50, which is my bill. Because I think each circumstance is different and people should have a choice.
Tara Golshan
Would you support allowing people who are covered with employer-based health insurance to buy into a federal program?
Debbie Stabenow
That’s something we are looking at. I want to see how that works. But it’s something that’s definitely worth looking at.
Sen. Chris Murphy (D-CT): “Let [private insurance] compete against Medicare and see who wins in the marketplace.”
Tara Golshan
In the Democratic debate around universal health care, do you support moving in the direction of getting rid of private insurance?
Chris Murphy
Getting rid of private insurance? So, Sen. [Jeff] Merkley and I have a bill allowing everyone to buy into Medicare, every individual and every business. And so, our position is that we should give consumers the choice to get on Medicare or stay on private insurance. I’m not a sponsor of Sen. Sanders’s legislation.
Tara Golshan
What’s the importance of having private insurance?
Chris Murphy
Ultimately there might not be. But I think it’s better for consumers to make that choice. My guess is that if consumers have the choice between Medicare and private insurance, they will choose Medicare. But I think it’s probably more efficient to allow them to make that choice.
Tara Golshan
So eventually you see that there might not be a role for private insurance?
Chris Murphy
Yeah, but let it compete against Medicare and see who wins in the marketplace.
Sen. Jeanne Shaheen (D-NH): “I don’t think we are in a position yet where we can get rid of private insurance.”
Tara Golshan
In the Democratic debate around universal health care, would you support going toward eliminating private insurance?
Jeanne Shaheen
I don’t think we are in a position yet where we can get rid of private insurance. I think there are lots of ways in which we can expand coverage to people. But I don’t think right now getting rid of private insurance is the way to do that.
Tara Golshan
So when you say right now, is it something that you could support moving in the direction of, or do you see an importance of having private health insurance in the market?
Jeanne Shaheen
I do.
Tara Golshan
You do? So what is that importance?
Jeanne Shaheen
Well, most of the people who are covered in this country are covered by private insurance. Certainly that is true in my home state of New Hampshire. Especially at a time when the administration is trying to reduce access to health care through the Affordable Care Act … they have withdrawn legal support for it, there needs to be some assurances to people that they are going to be able to get health care coverage.
Tara Golshan
Would you support allowing people who are covered with employer-based health insurance to buy into a federal program?
Jeanne Shaheen
I’m on Sen. [Brian] Schatz’s bill that would allow people to buy Medicaid. I’m on Sen. Stabenow’s bill that would allow people to buy Medicare starting at age 50.
Sen. Tim Kaine (D-VA): “Moving the single-payer direction requires a lot of people to go out into a world that they don’t necessarily know.”
Tara Golshan
In Democrats’ debate around universal health care, would you support going toward getting rid of private insurance?
Tim Kaine
I actually have a proposal that I’m really wedded to because I think it’s so good.
Tara Golshan
Right. Medicare X.
Tim Kaine
Medicare X. Which is putting a really powerful nonprofit option on the exchanges. So that wouldn’t eliminate private insurance, you could go buy private insurance if you wanted to. But you would give them a nonprofit option that I think many people would find very attractive.
Tara Golshan
What’s the importance of having private insurance in the system?
Tim Kaine
Well I think I like my system because with anything like this, we want to preserve coverage and then expand. And I think it’s a little bit easier to do that. If you take advantage of the existing system that you know and then you add an additional element to it, that expands. Moving the single-payer direction requires a lot of people to go out into a world that they don’t necessarily know. So that’s why I like my approach, using the advantages of the existing system and adding one more element to it.
Tara Golshan
Would you support allowing people who are covered with employer-based health insurance to buy into [a federal program]?
Tim Kaine
The current proposal that we have, Medicare X, which we will reintroduce, is for the individual market, and the shop market — which is for small businesses — to be able to buy small business policies through Medicare X.
Sen. Chris Van Hollen (D-MD): “Oh goodness.”
Tara Golshan
In Democrats’ debate around universal health care, would you support going in the direction of getting rid of private insurance?
Chris Van Hollen
Oh goodness. As you know, there are lots of bills out there.
Tara Golshan
Yes, I do know.
Chris Van Hollen
I have supported a number of them, starting with buying in a public option through the Affordable Care Act, to buying into Medicare. I support a kind of Medicare-for-all, but I’m not on the bill that would eliminate.
[Gets into elevator]
Sen. Mark Warner (D-VA): “No.”
Tara Golshan
In the Democratic debate around universal health care, do you support moving in the direction of getting rid of private insurance?
Mark Warner
No.
Tara Golshan
And what’s the importance of —
Mark Warner
— Well I think, you know, we need to move toward greater coverage. But more cost-contained.
Tara Golshan
Would you support allowing people —
[Gets into elevator]
Sen. Catherine Cortez Masto (D-NV): “I’ve supported opt-in and public option”
Tara Golshan
In the Democratic debate around universal health care, would you support going toward eliminating private insurance?
Cortez Masto
I’ve never said that.
Tara Golshan
No, I’m asking you.
Cortez Masto
I’ve supported opt-in and public option. And I think that’s the way we ought to shore up the Affordable Care Act. [Gets into elevator]
Tara Golshan
Can I hop in with you?
Cortez Masto
No, actually. I’m late to a vote.
Sen. Jon Tester (D-MT): “I’ve got to see what the proposal is.”
Tara Golshan
In the Democratic debate around universal health care, would you support moving in the direction of getting rid of private insurance?
Jon Tester
Would I support? Look, I think I’ve got to see what the proposal is. We have got to make health care more affordable, bring down costs. I’d look at any proposal that does that.
Sourse: vox.com
