Kamala Harris and Bernie Sanders’s fight on health care is really about the wealthy

Sen. Kamala Harris (D-CA) went house-hopping in the Hamptons over the weekend, telling high-dollar donors something that’s been fairly obvious since she announced her bid for the White House: that she’s “not been comfortable with Bernie’s plan” on health care.

“As you may have noticed, over the course of many months, I’ve not been comfortable with Bernie’s plan, the Medicare For All Plan,” Harris said at a fundraiser, according to a report from Bloomberg.

Harris is a co-sponsor of Sanders’s Medicare-for-all single-payer bill in the Senate. But she’s been all over the map on one of the legislation’s major features: the elimination of private insurance. In late July, she finally released her own version of a “Medicare-for-all” bill, which, in a departure from Sanders’s proposal, would maintain a role for private insurance within a universal public system.

Sanders’s team has panned Harris’s plan for that alone; they see eliminating for-profit insurance as a key part of their vision for health insurance. Harris’s latest critique, and especially that she made this admission at a fundraiser with donors who paid between $100 and $2,800 to attend, only escalated criticism from Sanders and his allies.

Sanders tweeted that his campaign isn’t raising money in the Hamptons, and that if he were, he would make the case for single-payer:

“Harris and many other 2020 Democrats have spent the past few weeks trying to short circuit Medicare for All and preserve the private insurance industry whose premiums, deductibles and co-pays now cost $28,000 a year for the average family of four,” David Sirota, a Sanders campaign adviser, wrote in his newly minted newsletter, Bern Notice. “The Harris flip flop is a reminder that while Medicare for All received an enthusiastic response at Bernie’s Fox News townhall in Bethlehem, Pennsylvania — it doesn’t get that kind of response on the big dollar fundraising circuit in the Hamptons.”

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Harris’s press secretary Ian Sams shot back, arguing that Sanders has indeed gone to these ritzy billionaire fundraisers as a senator for the Democratic Senatorial Campaign Committee and pointing out that Harris’s plan also eliminates premiums, deductibles, and copays.

The debate is partly about a difference between Sanders’s proposal, which would eliminate private insurance, and Harris’s, which would preserve a role for insurers in the health care system. But by seizing on Harris’s remarks — and the venue where she made them — the Sanders campaign is connecting their health care plan to their candidate’s larger argument on corporate greed.

Harris is admitting she was all over the map on health care

Harris’s health care proposal, which her campaign unveiled in late July, would expand Medicare to all Americans but still allow private insurers to play a role. She proposes that over a 10-year period, everyone would transition to an expanded Medicare; she would allow for private insurance to participate in a program structured like Medicare Advantage, which currently gives Medicare-eligible seniors the option to choose from a slate of private insurance options. All plans would cap out-of-pocket costs at $200.

Before she released her plan, it was hard to pin down Harris on health care. She signed on to Sanders’s single-payer Medicare-for-all bill. She publicly backed abolishing private insurance, saying “let’s eliminate all of that. Let’s move on,” at a CNN town hall in January. She then clarified that she meant getting rid of “bureaucracy.”

In April, at another CNN town hall, she emphasized that there would be some role for private insurance under Sanders’s bill, even though the Sanders Medicare for All Act would reduce private insurance’s role to things like cosmetic surgery or premium hospital rooms.

During the Democratic debate in June, Harris raised her hand when NBC’s Lester Holt asked, “Who here would abolish their private health insurance in favorite of a government-run plan?” She walked it back to say she misunderstood the question, saying she personally would prefer to enroll in public insurance.

It’s not surprising that Harris said she has not fully bought into Sanders’s Medicare-for-all single-payer proposal.

Every time she seemingly endorsed the actual bill she co-sponsored, she’s eventually walked it back.

The big money debate

Harris says her plan is responding to a real discomfort among American people. Sanders’s single-payer proposal has increased in popularity — albeit modestly — over time, but the prospect of eliminating private insurance altogether is less popular.

For example, in a July Kaiser Family Foundation poll, 58 percent opposed eliminating private health insurance companies, despite 51 percent approving of a single government-run health insurance program.

Virtually every country with universal health coverage has some role for private insurers in the system to complement or support the public system. But Harris’s proposal would still majorly change how private insurance operates in the American health care system.

The medical industry is actively lobbying against Medicare-for-all, but as Vox’s Dylan Scott reported, doctors, hospitals, insurers, and pharmaceuticals have pushed back against everything from single-payer to public option proposals to even lowering the age for buying into Medicare to 55.

Sanders, meanwhile, sees a for-profit health care system as fundamentally broken. His campaign platform is centered on fighting the greed of major corporate interests, whether pharmaceutical companies, the fossil fuel industry, or private insurance industry.

In a speech about Medicare-for-all in June, he pledged to reject money from the insurance and drug companies, and called on other presidential candidates to do the same. He has raised more money than any other candidate and has the highest number of individual donors, and the vast majority of his donors are making small-dollar contributions. Harris has pledged to reject funds from corporate PACs, the fossil fuel industry, and federal lobbyists.

Sanders’s campaign is making this about the influence of the wealthy.

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