"Medicare for All": The Democratic Primary Battle of 2020 is just beginning

In the cauldron of a campaign – under the pressure of skeptical voters, political rivals, donors and other groups of interest – the fragile coalition that had joined Sanders that day in 2017 is widely fractured. Only independent Vermont, who made medicare for all the central theme of his second presidential candidacy, and Warren remain committed to the bill.

New plans and new debate

The California Democrat recently confessed what had become clear from the beginning of her campaign.

"I support Medicare for all but as you may have noticed, over these many months, I have not been comfortable with the plan Bernie, the Medicare plan for all, "said Harris during a speech at a fundraiser in Hamptons. "And I'll tell you why, and again it's like listening."

In August 2018, Harris was touted to be "the first Democratic senator to rule in favor of Bernie Sanders' Medicare for All bill." But since then, as she entered the presidential race and was starting to campaign, she told voters that she had met on the trail and, more specifically, to union members who had voiced their own apprehensions. So Harris took into account and traced a different path from Medicare for All.

His proposal was looted from the left and center. The team of former Vice President Joe Biden – who has taken a more moderate stance in favor of the extension of the Affordable Care Act – has described it as one of the world's best. "approach to do everything" because Harris gave up a tax hike the middle class. paying for it, meant that she was not "direct" with the voters.

A month later, Ian Sams, spokesman for Harris, told CNN that the campaign bet that while the Democrats deepened their policy, they would find both comfort and ambition in his vision.

"She is focused on getting the right plan for people, not on pursuing an ideology," Sams said. "Then let the chips fall where they can, we think we have the best plan, and when we send it to the message and we talk about it and we get into the thick of the subject of this campaign, if people really do take to those candidates, that voters will agree with that. "

The challenges the Sanders Campaign faces are different, but are rooted in a similar and vexing question: what exactly do Democratic voters want?

There is a clear consensus within the party base to support efforts to expand coverage and care – even Biden, an unconditional opponent of Medicare for All, wants to rely on Obamacare with a public option backed by the government. However, the survey varies depending on how the questions are asked and the respondents' understanding of the policies.

Sanders' response has been to broaden the issue – and sharpen the conflict. His campaign sees Medicare for all as a moral imperative, likening it to past struggles like the civil rights movement. Any "half measure", as Sanders so often says – especially a measure that would preserve the private insurance sector – is tantamount to capitulation.

"It's really a statement of value about who you are in this political and economic system, do you stand alongside ordinary people or are you with people at the highest level? is, rightly so, in many people think of a substitute for this because you are in this larger battle, "said Jeff Weaver, senior advisor to Sanders.

Drilling

Biden has grasped these concerns.

"You have negotiated very hard for your benefits with your union with the employer, in my plan you have to keep it, you do not have to give up," he said. at the AFL-CIO of Iowa last week.

The new detail was presented as a half-turn or a rollback of Sanders by some rival campaigns. In fact, as quickly pointed out his campaign, the wording of the bill had not changed. But this additional incentive, forged in order to gain wider support from the unions, has highlighted the delicate policy ahead.

Warren, the only other leading candidate to be a member of Medicare for All, has often said that unions would play a key role in defining the details of her own transition. The goal, she said in July, was to guarantee "that they are fully recovered" in the market.

Although she has not yet unveiled a specific mechanism to achieve this, a Warren assistant told CNN this week that the campaign was discussing with union leaders how unions with care plans Negotiated health care would have the opportunity to rework their agreements during a Medicare for All program. transition.

Biden, on the other hand, seems to content himself with digging holes in the nobler proposals while touting his as the most feasible. His spokesman, Andrew Bates, called Obamacare "one of the most monumental progressive victories of his generation" and said Biden was determined to "protect and strengthen him."

"Whether they come from Republicans or Democrats, it will oppose any effort to get rid of ACA – and unfortunately, that's exactly what Medicare for All would mean for the world. country, "said Bates.

Roadblocks

Even if the projects of the Democratic candidates differ, a Senate controlled by the Republicans led by the leader of the majority, Mitch McConnell, would pose the same challenge.

The Kentucky Republicans stand out for their ability to stifle progressive legislation and will likely see Biden's plan in the same way as Medicare for All – as a bill with no future in the room that it controls.

Even if Democrats reclaim the Senate and the Presidency in 2021 while maintaining their majority in the House, the prospects for a major new health care legislation remain complicated – especially if legislative obstruction, which actually requires 60 votes to introduce a bill, remains in place. It would also be difficult to get 50 votes, given the number of Democratic senators opposed to Medicare for all or currently uncommitted.

This is another debate that will certainly intensify in the coming months – a debate that could ultimately represent as much as the legislation currently defining this primary.