Sen. Elizabeth Warren has a plan for everything - but on the crucial 2020 issue of health care, she’s borrowing from a rival and fellow progressive -- Bernie Sanders.
The presidential candidate who made a mark with her signature “I have a plan for that!” is the only one of the five top-polling Democrats without a sweeping proposal of her own to remake the health care system. She has instead championed Sanders’ legislation to replace private insurance by putting every American in an expanded Medicare program.
“I’m with Bernie on Medicare for All,” Warren said recently in New Hampshire when asked if she’d devise a blueprint of her own. “Health care is a basic human right. We need to make sure that everybody is covered at the lowest possible cost, and draining money out for health insurance companies to make a lot of profits, by saying no.”
Warren’s deference to a rival is unusual for a candidate who has styled herself as the policy wonk with a program for everything from cradle to grave. It has allowed her to attract many liberal voters who supported Sanders in 2016, leading her to a dead heat with former vice president Joe Biden for the top spot in the Democratic field. And if Sanders were to eventually drop out of the race before Warren, her embrace of his most popular plan could keep his supporters in her camp.
Sean McElwee, a left-wing activist and researcher with Data For Progress, said that Warren cannot afford to go soft on Medicare for All.
“It’s the best option for the campaign to stay in alignment with Sanders on health care through the general election,” he said. “These Sanders voters have the highest risk of voting third party or staying home, and you have to keep them mobilized.”
Weeks before Warren, a Massachusetts senator, announced that she was exploring a presidential run last December, she sounded less wedded to the Sanders proposal, describing a three-step approach to health care.
“Our first job is to defend the Affordable Care Act. Our second is to improve it and make changes, for example to families’ vulnerability to the impact of high-priced drugs,” she told Bloomberg News. “And the third is to find a system of Medicare available to all that will increase the qualify of care while it decreases the cost of all of us.”
As Warren was rising in the polls, her allies began to pick up signals that Sanders supporters were questioning her commitment to progressive ideas. Since June, Warren has given them little ammunition to claim she’s going soft on Medicare for All, a defining issue for many left-wing voters.
“The biggest concern Warren has from the left is this idea that, at the end of the day, Sanders is the one true progressive,” McElwee said. “If your main issue is Medicare for All, and that’s a central tenet of your politics, Warren probably can’t win you. But she doesn’t want you to hate her. She wants to be your fallback option.”
At the same time, Warren faces attacks from Biden for supporting a plan that would replace Obamacare, which Democrats bitterly fought for in 2009 and 2010. “The senator says she’s for Bernie. Well I’m for Barack,” the former vice president said in the third Democratic debate in September. “I think Obamacare worked.”
Biden’s plan would build out Obamacare and have a public option for those who want it.
Health care consistently ranks as the top issue for Democratic voters. Government-run health care is popular among Democrats and Americans overall, but that support dips once voters are given the arguments against it, including that it would require higher middle-class taxes and abolish employer-sponsored coverage.
Medicare for All, which lay at the heart of Sanders’ stronger-than-expected 2016 campaign, has become a litmus test for some progressive activists and voters. To them, it indicates a candidate’s belief in universal health care and willingness to take on private insurers who they say are gouging consumers for profit.
In Los Angeles on Friday, Warren was asked if her health care vision would raise middle-class taxes. She evaded the question and said working families would see their overall medical costs reduced, referring to the end of premiums and out-of-pocket expenses. “The very wealthy and big corporations will see their costs go up, but middle-class families will see their costs go down,” she said.
Surveys show that Sanders voters clearly prefer Warren as their second choice. But it doesn’t cut both ways - Warren’s supporters are more split among Sanders, Biden and Kamala Harris as their second choice.
Mary Anne Marsh, a Democratic consultant based in Boston, said that if Warren believes Sanders has the best plan, she has to “be all in on it - and if she’s got elements of her own to put in it, she needs to do that.”
The Sanders health care plan tracks with the “big structural change” Warren has called for, a message that also appeals to mainstream Democrats who backed Hillary Clinton in 2016. Maintaining that cross-section of support is critical to Warren’s path to the nomination. Biden is dominating with moderate and conservative Democrats, some of whom worry that running on Medicare for All will cost Democrats the general election.
“By supporting Bernie Sanders’ health care plan, Elizabeth Warren improves the chances of Bernie Sanders voters supporting her if she’s the nominee, thereby avoiding some for the heartburn Bernie gave Clinton and her supporters all the way through Election Day,” Marsh said.
A voter at her event in Keene, New Hampshire, asked Warren how she would handle the transition from private insurance to a government-run system.
“What we’ve got on Medicare for All is a framework,” she said. “And it doesn’t have the details, and you’re right to be antsy.”