Democratic presidential candidates are vying for former President Obama’s mantle on health care, arguing that he would support their stance in the raging debate over “Medicare for All.”
Obama remains enormously popular among Democrats, and his backing in the party’s divisive health care debate would be a one-of-a-kind boost for a candidate.
But Obama is not tipping his hand on the issue, careful not to wade into a crowded and contentious primary contest. His office also declined to comment for this story.
Statements and comments from his former advisers, though, have given fodder to both sides in the debate as the Democratic hopefuls latch on to any clues to argue that the former president is really on their side.
{mosads}“[Obama] is far and away the most popular figure in the Democratic Party,” said Jim Manley, a Democratic strategist who was an aide to then-Senate Majority Leader Harry Reid (D-Nev.) when ObamaCare passed.
“Some are trying to claim that he would support their ideas for health care reform,” Manley said. “I think that’s still an open question, but it’s not stopping people from trying.”
Former Vice President Joe Biden, in particular, has made linking himself to his former boss a centerpiece of his campaign.
He touts Obama’s signature achievement, the Affordable Care Act, and argues it should be improved, not replaced with a Medicare for All system.
“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 last month announcing his health care plan.
“I was very proud the day I stood there with Barack Obama and he signed that legislation,” he added, over images of him standing next to Obama.
Biden’s health care proposal would give people the option of government-run insurance, without mandating it for everyone like in Medicare for All.
But one of Biden’s rivals, Sen. Kamala Harris (D-Calif.), has hit back by pointing to remarks Obama made in a speech last year, where he said Democrats “are running on good new ideas, like Medicare for All.”
“You know who says Medicare for All is a ‘good idea’? Barack Obama,” Harris tweeted last month.
That comment from Obama, made as he kicked off his campaigning in the 2018 midterm elections for congressional Democrats, is at the center of the debate. Some, like Harris, are touting it as close to an endorsement of Medicare for All.
But the comment was just one sentence in a larger speech, and Obama’s team gave no indication that the remark was meant as an endorsement of a Medicare for All plan or even as a change in position.
Obama has praised Medicare for All, or “single-payer” health care for years, dating back even before his presidency, but has always taken a nuanced view of the issue that has stopped short of the more explicit calls for enacting Medicare for All coming from Harris, Sen. Elizabeth Warren (D-Mass.) and its leading champion, Sen. Bernie Sanders (I-Vt.).
Instead, Obama has long said he supports single-payer health care in theory, but that practical considerations and what is possible in Washington need to be taken into account also.
“If I were starting a system from scratch, then I think that the idea of moving towards a single-payer system could very well make sense,” Obama said in 2009.
“The only problem is that we’re not starting from scratch,” he added. “We have historically a tradition of employer-based health care.”
{mossecondads}Another of the practical considerations that Obama has raised is the cost of Medicare for All.
In private remarks to freshman House Democrats earlier this year, Obama said the party shouldn’t be afraid of big ideas, but cautioned that they also needed to think about how to pay for them, a comment that was widely interpreted as referring to Medicare for All.
Some former top Obama advisers are being even more explicit in cautioning against Medicare for All.
“The fact is large numbers of people oppose the Medicare for All proposal if it replaces private insurance,” David Axelrod, Obama’s former senior adviser, said on CNN last month.
“This is what Democrats are asking: Do we move forward with these idealized proposals that are going to beg opposition and make it easier for Donald Trump to make his case and win reelection when the stakes are so high? This is what a lot of Democrats are worried about,” he added.
Denis McDonough, a former Obama chief of staff, warned in a Washington Post op-ed this month that it would be a “grievous mistake for any Democrat” to walk away from ObamaCare.
Instead of Medicare for All, he called for increasing ObamaCare’s subsidies and adding a public option.
Nancy-Ann DeParle, a former top health care adviser to Obama, pointed to improvements to ObamaCare that California has made, such as increasing the subsidies to help people afford coverage, as a better approach than Medicare for All, which she called unrealistic.
DeParle said Harris, the senator from California, should look to her own state’s improvements rather than her more sweeping Medicare for All plan. “From her porch she can see an Affordable Care Act that’s working,” DeParle told The Hill.
On the other side, though, Kathleen Sebelius, Obama’s former secretary of Health and Human Services, has endorsed Harris’s Medicare for All plan.
Ian Sams, a spokesman for Harris, tweeted Sebelius’s praise for the plan over a photo of the former secretary standing next to Obama and Biden.
“I don’t know that anybody’s really talking about scrapping [the ACA],” Sebelius told The Hill, noting that Medicare for All would keep core improvements from ObamaCare, such as mandated coverage of certain benefits and protections for pre-existing conditions, while expanding on them.
She said she was not surprised that Obama praised Medicare for All in his speech last year.
“He wanted to basically do as much as we possibly could with the votes that we had,” Sebelius said. “The fact that he’s saying we really should go further is not a surprise at all.”