Health care moves to center stage in Democratic primary fight

The battle over health care has moved to center stage in the Democratic primary, as Sen. Bernie Sanders (I-Vt.) ratchets up his fight with former Vice President Joe Biden over “Medicare for All.” 

Democrats successfully took control of the House by running on protecting ObamaCare during the 2018 midterm election, but are now struggling with internal divisions over whether to move beyond the health law and dramatically expand the government’s role in providing care. 

In the past week, Biden and Sanders have taken aim at each other over the Vermont senator’s proposal to eliminate private insurance and replace it with Medicare for All.{mosads} 

Biden has pushed a more incremental plan of keeping ObamaCare while expanding its subsidies and offering a government-run “public option.” He has sought to draw a contrast with Sanders by highlighting that under his plan, people can keep their private insurance. 

When he announced his health plan this week, Biden equated Medicare for All with the GOP’s ObamaCare repeal attempts. 

“I understand the appeal of Medicare for All, but folks supporting it should be clear that it means getting rid of ObamaCare, and I’m not for that,” Biden said in a video announcing his plan. 

“I knew the Republicans would do everything in their power to repeal ObamaCare. They still are. But I’m surprised that so many Democrats are running on getting rid of it,” Biden said.

Biden is running as the protector of ObamaCare, banking that the law’s popularity will convince voters that his plan is a better approach than Medicare for All. 

As vice president, Biden helped sell a skeptical public on the benefits of ObamaCare, and his campaign messaging focuses on how he helped usher the bill through Congress before it was ultimately signed into law. 

“I was very proud the day I stood there with Barack Obama and he signed that legislation … I know how hard it is to get that passed. I watched it. Starting over makes no sense to me at all,” Biden said. 

Biden and Sanders have escalated their attacks in recent days, with the fight over Medicare for All highlighting a broader debate over whether the party is shifting too far left, with the risk of alienating moderate voters in the general election.

Politically, health care was a winning issue for Democrats in 2018, and could be again in 2020. Polls regularly show health care as a top priority, and voters say they trust Democrats on the issue more than Republicans. 

But centrists worry about jeopardizing that advantage.

Presidential contender Sen. Michael Bennet (D-Colo.) has warned that Medicare for All would be a gift to President Trump.

“Colorado would be at risk if Bernie Sanders is the nominee,” Bennet said in Iowa this week. “[Medicare for All is] a tough burden to carry in a state like Colorado.”

Bennet is the co-sponsor of legislation called “Medicare X” that would create a public option similar to what Biden proposed.

“There’s nothing nuanced about almost 200 million people having to go on a government plan just because Bernie Sanders says it’s what everybody should have,” Bennet said. 

Some Democrats have tried to downplay the rift. Sen. Tim Kaine (D-Va.), who is the other co-sponsor of Bennet’s legislation, said he doesn’t think the Democratic proposals are as different as Sanders and Biden and other Democratic candidates are making them seem. 

“I’m not troubled by the difference between the Democratic proposals, because I think it’s a minor difference compared to where we are and where [Republicans] are,” Kaine said.

When asked about Biden comparing Medicare for All to ObamaCare repeal, Kaine said they are not the same.

“It’s quite different than Republicans. Republicans’ proposal is to repeal the ACA [Affordable Care Act], and leave tons of people with no insurance,” Kaine added. 

Still other Democrats are expressing concern that the sniping between Sanders and Biden could distract from Republican attempts to unravel ObamaCare. 

“My hope is that we don’t lose focus of the here and now,” said Sen. Chris Murphy (D-Conn.).  

“Frankly, my constituents are focused on making sure that they don’t lose their health care in the next year. They’re not as concerned with the debate within the Democratic presidential field about, you know, what the 10 to 20 year future of American health care looks like,” Murphy said.

For now, there is no sign either Biden and Sanders are stepping back from the fight.

On the campaign trail, Sanders has accused Biden of “fearmongering” and spreading “misinformation” about Medicare for All. 

In Iowa on Monday, Biden told an audience of seniors at an AARP event that under Medicare for All, “Medicare goes away as you know it. All the Medicare you have is gone.”

“All the Medicare you have is gone, it’s a new Medicare system,” Biden said. “It may be as good, you may like it as well, but the transition of dropping 300 million on a new plan, I think kind of is a little risky at this point.”

During an interview with The New York Times on Wednesday, Sanders fired back, saying that Biden “is sounding like Donald Trump.” 

“I am disappointed, I have to say, in Joe, who is a friend of mine, really distorting what Medicare for All is about,” Sanders said. “And unfortunately, he is sounding like Donald Trump. He is sounding like the health care industry in that regard.”