vision 2020

Did Elizabeth Warren Solve Her Health-Care Problem?

Photo: Sean Rayford/Getty Images

This week, Elizabeth Warren attempted to cut the Medicare for All baby in half. Will it work? Political columnist Ed Kilgore joined me to discuss the merits of political incrementalism.

Ben: On Friday, Elizabeth Warren released a health-care proposal that seemed to acknowledge that she had put herself in a difficult position by previously adopting a Medicare for All–or-bust approach. In her new plan, her administration would quickly work to pass a Medicare public option — similar to but more generous than the ones being floated by the likes of Joe Biden and Pete Buttigieg. Only in year three of her tenure would Warren turn to shifting the entire system to Medicare, doing away with private insurance. Does this strike you as a well-thought-out proposal? And do you think it’s smart politically?

Ed: Sort-of yes, and definitely yes. Not sure I’d treat this as some sort of flip-flop, though; I don’t remember her clearly saying she was adopting Bernie’s all-or-nothing timetable, though she has refused — and is still refusing — to make the whole enchilada a matter for mañana. Under this new plan, the final push would supposedly happen by her third year in office. But for those of us who, you know, live on planet Earth, the idea that Congress was going to enact a full M4A proposal in 2021 was always hallucinatory.

Ben: Is it much less hallucinatory to think that they’d do so in 2023?

Ed: Well, the idea is that Americans would finally get to see the contrast between the old and new systems, which would dispel their fears about losing private coverage. I don’t think it will happen that fast, if it happens at all. And there’s another problem with this timetable: She’s talking about the second, whole-enchilada bill passing by year three, which could mean right after a first midterm in which all but one president since FDR has lost strength in Congress.

Still, her plan would leave something pretty big and valuable in place. Not that the first bill will be a piece of cake, particularly if Democrats don’t win the Senate next year. Bernie’s plan implicitly says we’re stuck with the status quo (aside, I suppose, for whatever he can do administratively) until Medicare for All passes, though he has co-sponsored all sorts of incremental proposals in the past.

Ben: Pete Buttigieg’s campaign put out a statement attacking Warren’s proposal. An excerpt: “Senator Warren’s new health-care ‘plan’ is a transparently political attempt to paper over a very serious policy problem, which is that she wants to force 150 million people off their private insurance — whether they like it or not.” Buttigieg and others have gotten mileage out of contrasting themselves with Warren on health care, since most Americans prefer the idea of a public option over full-on Medicare for All right now. But will their jabs be less effective now that Warren has pivoted to the center a bit?

Ed: Well, Pete has shifted over time from the default position of many progressives treating M4A as the ultimate goal — which he once embraced — to a fairly hard-core defense of individual choice. Doesn’t sound like he thinks M4A in any form will ever be a good idea. But yes, to the extent Warren isn’t talking about abolishing private insurance until this sort of trial period of, well, “Medicare if you want it,” makes his attacks less effective. Pete, of course, is denying that Warren has “pivoted to the center.” Bernie Twitter sure is treating her as having moved into Satanic centrist territory, but I don’t believe Bernie himself has said anything just yet.

Ben: Haha. Does it matter much that it’s taken her a while to get to this point? Do you think voters who were hesitant to get onboard with her because of her previous health-care posture might give her a second look now?

Ed: It’s never been clear to me how much actual voters have been paying attention to this particular sub-debate. But in my mind it reinforces Warren’s claims to be hardheaded about political realities. She favors abolishing the filibuster — which is likely the only way a full M4A could ever be enacted — and is trying to design a first bill that can pass via budget reconciliation, which means 50 votes plus a veep. Bernie opposes killing the filibuster, and is still arguing that some sort of pixie-dust “political revolution” will make it happen.

Ben: Do you imagine that if the Democrats manage to win the Senate (which is an uphill battle) and the pivotal votes are then true moderates like Joe Manchin and Kyrsten Sinema, that they’ll even give the green light to a public option in the face of what would be enormous pressure from the Democratic base? In other words, does even this incremental change have a good chance of happening?

Ed: It has a chance; not 100 percent how “good” that chance is. You could theoretically flip a Republican or two on an incremental bill, which would probably poll well. Most likely, a President Warren would have to compromise (like Obama did), and accept half of her half-a-loaf bill. That could, of course, be great news for many millions of Americans, and as she suggests, increase support for going the whole hog. If I’m not mistaken, Warren’s argument all along has been “you don’t get anything unless you demand exactly what you want.” That implies that once you’ve fought for your plan, you will eventually accept less if that’s all you can get. Nice to see her articulate a proposal that reflects that reality. This won’t, of course, keep Joe Biden from saying that she’s disrespecting Barack Obama’s legacy. I’m pretty sure the only reason Biden’s plan builds on Obamacare is so that he can say the word “Obama” a few more times a minute.

Did Elizabeth Warren Solve Her Health-Care Problem?