Health care has been a difficult topic for Elizabeth Warren. After some wishy-washy answers about it early in her presidential campaign, she committed herself hard to the cause of “Medicare for All,” going so far as to produce a detailed plan answering the nagging question of how she would pay for it without increasing taxes on the middle class. But the effort to simultaneously win over single-payer diehards who’d otherwise support Bernie Sanders while quieting criticism from Democratic moderates worried about cost has not paid off particularly well. Center-left types (myself included) have criticized her budget math for being unrealistic. Some on the left, who’ve long doubted her commitment to the cause, suggested her financing plan was both insufficiently progressive and politically poisonous. And as her campaign was consumed by these conversations, her poll numbers leveled off.
Now, Warren is trying a different tack: admitting that she isn’t really going to pass single payer after all. Not any time early in her presidency, at least. And maybe not ever.
That isn’t quite how Warren is framing things, of course. But I think it’s the fairest reading of the first-term plan for “transitioning” to Medicare for All that her campaign released on Friday. The candidate promises that within her first 100 days as president, she’ll use the executive branch’s regulatory powers to start bringing down health costs, push for fast-track legislation to build on the Affordable Care Act, make traditional Medicare available to everyone over the age of 50, and create a very generous public insurance option with modest premiums that Americans will be able to purchase on Obamacare’s exchanges, which she is branding as the “Medicare for All option.”
Warren argues that these reforms will eventually pave the way to pass a second bill that fully moves the United States to a single-payer system like Sanders has envisioned, by putting all Americans on a single government plan and banning private insurers from selling competing coverage. “No later than my third year in office, I will fight to pass legislation that would complete the transition to full Medicare for All,” her plan states. “By this point, the American people will have experienced the full benefits of a true Medicare for All option, and they can see for themselves how that experience stacks up against high-priced care that requires them to fight tooth-and-nail against their insurance company.”