WASHINGTON — Senator Elizabeth Warren has spent weeks dodging a simple question about how she would finance a pillar of her presidential campaign — a universal health care plan dubbed Medicare for All. This week, that tactic appeared to hit a wall.
On the debate stage in Ohio Tuesday, Warren faced fierce criticism from her Democratic rivals over why the candidate who has a detailed plan for everything won’t spell out how she will pay for a transformation to a fully government-run health insurance system that would eliminate private insurance. She batted away a question about whether Medicare for All would require higher taxes on middle-class families, arguing that overall costs would go down because those families won’t have to pay medical bills and premiums anymore.
“I will not sign a bill into law that does not lower costs for middle-class families,” Warren promised.
But her rivals jumped all over the evasion, suggesting that Warren — who for months has gotten away with saying, “I’m with Bernie” on Medicare for All while staying vague on the details — may need to shake up her approach as she faces increasing scrutiny as a front-runner in the Democratic race.
“We heard it tonight — a yes or no question that didn’t get a yes or no answer,” said Pete Buttigieg, mayor of South Bend., Ind. “Your signature, senator, is to have a plan for everything. Except this.”
By refusing to concede that taxes will go up to finance the plan, Warren is denying Republicans a video clip that could be used to vilify Medicare for All — and her candidacy — in attack ads should she become the nominee. But by spending weeks running away from the question, Warren has also opened herself up to charges of evasion and even dishonesty from her Democratic rivals, and entangled herself in health policy debates that have eclipsed her signature issues like campaign finance and trade.
Warren has never released her own health care plan, but that could change soon. Her campaign has been consulting with an economist on the issue, and an aide said Wednesday that she is reviewing options for funding Medicare for All, including those suggested by Vermont Senator Bernie Sanders in his 2016 presidential race. The Warren campaign reiterated that whatever plan she lands upon, costs will go up for wealthier Americans and big corporations, while they will go down for middle-class families.
Warren’s allies argue that her tactic of refusing to talk about taxes is smart.
“While some pundits may be frustrated that she’s not repeating insurance industry talking points, Democratic voters who care about electability are very happy that she’s standing her ground and not giving Republicans rope to hang Democrats with,” said Adam Green, cofounder of the Progressive Change Campaign Committee.
Green added that Warren’s opponents would use any admission she makes on taxes to give the false impression that Medicare for All would be more expensive for middle-class Americans on average.
But Tuesday’s debate showed the pitfalls of that strategy. Even Sanders, who wrote the bill Warren supports, did not come to her defense on the debate stage.
“I do think it is appropriate to acknowledge that taxes will go up,” he said. Senator Amy Klobuchar praised Sanders for being “honest” about his plan, pointedly telling Warren, “We owe it to the American people to tell them where we’re going to send the invoice.”
The pile on continued on Wednesday, as former vice president Joe Biden told reporters that Warren is “going to have to tell the truth” about Medicare for All, and suggested her evasion cut into her image as a straight-talking populist who can break down complicated policies for regular people. “The person with a plan for everything has no plan for the single most consequential issue in this election in the minds of the American people, across the board,” Biden told reporters in Ohio. “And you know, credibility matters.”
Sanders has introduced two different Medicare for All bills, with independent 10-year cost estimates varying from $13 trillion to $32 trillion.
Warren’s policy team has examined at least one plan to pay for Medicare for All conceived by Robert Pollin, an economics professor at the University of Massachusetts Amherst, who said he’s been consulting with the campaign for weeks. Pollin’s plan uses a wealth tax on assets over $1 million, a sales tax on nonessential goods, and a tax on businesses with annual revenues of over $1 million.
He defended Warren’s focus on overall costs in the debate, explaining that under his proposal, a family that makes $60,000 a year and now spends $9,000 on health insurance would, under Medicare for All, pay $900 in additional sales tax and spend no money on health insurance. “Do you really think people care if it’s taxes or copays?” he asked. “I mean, they’re saving $8,000.”
“I think there are people who want to have the story told in this way because the word ‘taxes’ is scary,” Pollin added. “If you say taxes, then people are going to freak out.”
But Warren’s unwillingness to discuss how to finance a major proposal is out of character for a candidate with a reputation as a policy heavyweight. Her sweeping portfolio of plans that helped her surge to the top of the crowded field was built on the back of an unusual and bold revenue generator. Warren’s “wealth tax” would claw back 2 cents for every dollar over $50 million in assets owned by the nation’s wealthiest people, and has become a rallying cry among her supporters. The tax proposal paved the way for Warren to promise universal affordable child care and other new domestic programs without having to face criticism of financial irresponsibility.
But with Medicare for All, Warren has displayed less creativity or enthusiasm for the details. At the beginning of her campaign, she appeared to hesitate on whether she supported a quick transition to a nationalized health care system with no private insurance, before declaring unequivocally at the first Democratic debate in June that she was “with Bernie.” The move has shored up support for Warren among the progressive activist wing of the party, but is seen by some political operatives as risky.
Only 42 percent of Democrats strongly favor a Medicare for All system, according to a recent Kaiser Family Foundation poll.
That’s compared with 63 percent of Democrats who strongly favor a “public option” — a government insurance plan that would coexist with and compete with private plans.
“Most Democratic primary voters agree that fixing the Affordable Care Act is the right thing to do,” argued Antjuan Seawright, a South Carolina-based Democratic strategist. “In 2018 we ran on strengthening the ACA, fixing the bugs, and making it work — not dismantling it and going to another form of health care system.”
But Mary Anne Marsh, a Boston-based Democratic strategist, argued that Warren needed to enthusiastically back Medicare for All in order to clear a path to the nomination.
“It helps her consolidate the progressives and avoid the kind of tortured experience that Sanders’ folks gave Hillary Clinton all the way through to the end,” Marsh said. She pointed out that Warren’s equivocation on the details has left herself room to maneuver on Medicare for All should she win the nomination.
“I think you’ll start to hear what her view of that would be,” she said.