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Sen. Bernie Sanders unveiled a universal health-care plan on Wednesday as he tries to set the tone on a pivotal issue in the 2020 Democratic presidential primary.
The Vermont independent introduced a new "Medicare for All" bill that would create a government-run system to provide health insurance for all Americans. While Sanders has proposed legislation to create a single-payer system before, the measure unveiled Wednesday would go further in covering long-term care for people with disabilities, bringing it in line with a bill introduced in the House earlier this year.
Sanders, who helped to vault Medicare for All into the political mainstream, hopes embracing sweeping change will help separate him from a crowded primary field. While four of Sanders' Democratic rivals — Sens. Cory Booker of New Jersey, Kirsten Gillibrand of New York, Kamala Harris of California and Elizabeth Warren of Massachusetts — co-sponsored his legislation, none have as fully embraced the dismantling of the private insurance system as Sanders has.
"The current debate over Medicare for All really has nothing to do with health care," the senator said at a news conference unveiling the legislation. "It has everything to do with greed and profiteering. It is about whether we continue a dysfunctional system."
Sanders' bill, which has 14 Senate co-sponsors, would:
On Wednesday, Sanders' office outlined potential methods to finance the system. Those include income-based premiums paid by employees and employers, hiking the marginal tax rate to up to 70 percent on people making $10 million or more, raising the estate tax and putting a "fee on large financial institutions."
Sanders has argued a single-payer system would reduce costs for consumers. While the government would have to hike taxes to cover a potential price tag in the tens of trillions of dollars, the senator says Americans would see fewer out-of-pocket costs.
Republicans and President Donald Trump's reelection campaign have slammed Medicare for All as a costly government takeover of the insurance market. They have tried to frame the 2020 election as an effort to stop Democratic attempts to create a single-payer system. They have also aimed to move voters' focus away from unpopular GOP attempts to repeal the Affordable Care Act, which helped Democrats take control of the House in November's midterms.
In responding to Sanders' plan, White House press secretary Sarah Huckabee Sanders called it a "government takeover of healthcare plan which confiscates every American's private health insurance." (The senator's bill would replace private plans.)
"Stand with President Trump so America will never be a socialist country!" she wrote.
In this political context, even the senators who co-sponsored Sanders' legislation have tiptoed around calling for the end of private health insurance companies. Sen. Amy Klobuchar — a Minnesota Democrat who has run to the right of many of her Senate colleagues in the early days of the 2020 primary — has instead advocated for an optional government health-care buy-in to reduce costs.
Another 2020 candidate, former Democratic Rep. John Delaney, said in a Wednesday statement that "Americans don't want a health care system that bans private insurance and is solely government based."
Sanders' bill has little shot of getting through the GOP-held Senate. It would even face a tough path to passage in the Democratic-held House, where House Speaker Nancy Pelosi and numerous members from ideologically split districts have criticized Medicare for All.
Despite the concerns within the Democratic caucus, Sanders argued Wednesday that "the American people want and we are going to deliver a Medicare for All, single-payer system."
Support for a single-payer plan has grown. In March, 56% of respondents to a Kaiser Family Foundation survey said they support a national health plan in which all Americans would get insurance from a single government plan, versus 39% who said they oppose it.
However, support for a government-run system drops significantly when voters are told it could require most Americans to pay more in taxes or eliminate private health insurance companies, according to Kaiser polling.