"I have not been comfortable with Bernie’s plan": Kamala Harris inches away from Medicare for All

Harris is so slippery on this topic that it’s hard to identify true shifts in her position versus “just get me through this moment” rhetorical idling. She co-sponsored Bernie’s Medicare for All bill in the Senate last year, hoping to protect her left flank ahead of a presidential run. When she and the other candidates were asked point-blank at one of the debates this summer whether they’d be comfortable eliminating all private health insurance — which is what Medicare for All means, don’tcha know — she raised her hand in favor. But those poll numbers are stubborn: Although Americans very much like the idea of a public option and are at least curious about MFA, they turn squeamish once you start nudging them about getting rid of private insurance plans.

And so, the day after the debate, she claimed that she’d misheard the question. Until late last month, before she rolled out her new plan, she was also prone to saying in interviews that her vision of Medicare for All *wouldn’t* mean the end of private insurance. Only when badgered by interviewers into explaining what that means would she admit that the only private insurance that would survive under her plan was “supplementary” coverage. Health coverage would in fact be monopolized by the government.

Oh, and unlike Bernie, at times she’s seemed to have no idea for how she’d pay for the program.

Trying to have it both ways has led to more than one awkward moment for her this year so maybe she’s decided not to do that anymore. Her polls are tanking, which seems like an opportune moment for a campaign reset on this issue. Did that moment arrive yesterday?

“I believe in capitalism, but capitalism is not working for most people,” Harris said on the patio steps of the Patricof house, looking out at a peach orchard among flower and herb beds. She said she recognized people who’ve become successful by working hard and following rules, but that the middle class needs help.

Harris again tried to clarify her stance on health care, a topic that tripped her up in the early Democratic debates. “I have not been comfortable with Bernie’s plan,” she said of Sanders’ Medicare for All proposal, and explained how a Harris administration would leave room for private insurance.

Once again: She co-sponsored Bernie’s plan. There’s not much to go on from those barebones quotes, although the explicit nod at capitalism (this was a fundraiser in the Hamptons, to be sure) is notable. But she was more emphatic in a chat with a WaPo reporter last week:

“People want choice.” She’s not wrong.

The way she’s going to “make this circle fit into a square” is — for the moment — with her new health-care plan, which she introduced three weeks ago. It’s Medicare for All but with two key tweaks: Private insurers wouldn’t be eliminated but would be allowed to offer the equivalent of “Medicare Advantage” plans; and, instead of paying for the program with middle-class tax hikes, Harris would somehow do it with taxes on Wall Street or something. The new plan lets her argue that she hasn’t entirely abandoned MFA while also letting her claim that her system will save the private health insurance plans that Americans seem to like so much.

But of course, it can’t. Private health insurers can’t compete with an institution like government that can afford to operate at a loss, especially in a system like Harris’s where the government is able to set the terms of what private insurers need to offer in their plans. Philip Klein:

In her vision, within 10 years, all Americans would transition into a government-run Medicare system. She would allow private companies to administer Medicare plans as they do currently within Medicare Advantage. But the more important question for individuals is not whether, a decade from now, they may be able to purchase a plan that is issued by a private company. The more relevant question is whether they will be able to keep the insurance that they’ve purchased either individually or through their employers, and under the revised Harris plan, the answer is no

Harris pitches a 10-year transition period, but the reality is that Americans are likely to see their employer coverage go away long before that. She would allow all Americans to “buy in” to Medicare immediately and promises that the new plan would, “cover all medically necessary services, including emergency room visits, doctor visits, vision, dental, hearing aids, mental health, and substance use disorder treatment, and comprehensive reproductive health care services.”

But the more generous the new plan promises to be, the faster that the employer-based insurance system will erode, as businesses decide to dump workers on the new government plan. So that means many people happy with their current plan would lose their coverage and have no choice but to enroll in the government plan well before the 10-year period comes up for the elimination of all employer insurance.

Your “choice” would be between a “free” government plan and an expensive private plan that covers all the same stuff, and since that’s not much of a choice, employers aren’t going to bother preserving it. Cheaper catastrophic coverage won’t be an option. And needless to say, Wall Street won’t remotely be able to pay for comprehensive coverage for the entire population by itself; Sanders’s plan at least has the virtue of admitting that the middle class will need to step up. Klein’s verdict on Harris’s plan is perfectly accurate: It’s “unserious.” It’s the sort of thing a candidate proposes when they’re not interested in actually solving a policy problem but very much interested in staying on the right side of all of the different constituencies to which they’re pandering in a primary. Medicare for All and some role for private insurance and a free lunch for the middle class? It checks every box, so that’s the Kamala Harris plan.

Which is in keeping with her primary strategy generally. Say what you need to win, worry about cleaning it up later.

The question raised by the new comments, though, is whether she’s still completely behind her new plan or whether she’s already begun to shift from that. Don’t put it past her: She’s so eager to find a sweet spot on health care, and so willing to keep repositioning to stay on the right side of voters, that she may have already begun to drift towards a public option a la Joe Biden as her endgame. That’s the health-care proposal that polls best among Democratic voters so that’s the one Harris naturally has her eye on. The more it seems like the left is unwinnable to her, the more tempted she’s going to be to drift towards the center and try to elbow past Biden as the centrist alternative to Sanders and Warren. I’d be surprised if her plan for health care hasn’t shifted again by New Year’s.

Here she is last week getting an earful.