Elizbeth Warren's health care plan met with lots of skepticism.

Even from left-leaning pundits, the plan took some heat.
Isaac Saul Nov 4, 2019

This is an excerpt from Tangle, an independent, ad-free, non-partisan, daily politics newsletter where I answer reader questions from across the country. If you found Tangle online, you can subscribe below.

Sign up now

Last week, Elizabeth Warren released her much-anticipated plan explaining how she’d pay for Medicare for All. So far, the plan has been received with unending skepticism and lots of questions.

Warren, whose campaign tagline is “I have a plan for that,” had come under increased scrutiny for not actually having a plan for her signature issue. During debates, she was evasive about whether the middle class would have to pay more in taxes. Her new plan says definitively that they wouldn’t. Warren says her plan would cost $20.5 trillion over a decade, about $14 trillion less than experts have estimated Medicare for All would cost. It would eliminate private insurance entirely, increase the burden on states, employers, Wall Street and the wealthy, and not raise taxes “a single penny” on the middle class. For a refresher on what Medicare for All is, you can read this August edition of Tangle: click.

Photo credit: Gage Skidmore / Flickr

Predictably, conservatives reacted to the plan with ire. The Wall Street Journal editorial board covered pretty much all the bases, saying her plans “bear no relation to reality” and that “Donald Trump’s boast that Mexico would pay for the wall was more believable.” The editorial was one of the most generous takes on Warren’s plan from the right, and it was still seething with indignation. The Journal notes that Warren has already proposed huge tax increases on the wealthy and corporations to cover education, child-care and college debt forgiveness, and none of those increases — or the ones in this plan — take into account tax avoidance or the cost of collecting those taxes, which would require expanding the government. She says she’d raise corporate taxes and pull in $1.75 trillion over 10 years, but that’s assuming none of those companies relocate overseas. She says she’d cut funding for the military, a “hyper-fantasy” that would never pass the Senate even if it were controlled by Democrats. The Journal also laughs off Warren’s claim that this plan would “restore health care competition” by saying that the government will control and prices and reimbursements, so what incentive is there for health insurance companies to compete? Finally, the editorial says many of her plans have been attempted — and failed — under Obamacare. Closing the “tax gap” between what people owe and what they pay has never worked, nor have “bundled payments” or Obamacare’s Independent Payment Advisory board that were proposed in previous insurance laws. In total, Warren’s plan shoves aside consensus estimates on the cost of Medicare for All ($31-34 trillion) only to introduce her own estimate — $20 trillion — and still come up short of covering it.

More surprisingly, liberals weren’t nearly as receptive to the plan as Warren’s team may have expected. This is the starkest difference we’ve seen between Sen. Bernie Sanders and Sen. Warren yet. Sanders has been open that his plan would be funded by a tax hike on everyone, including the middle class, and estimates it’d cost about $30 trillion over 10 years. Warren’s plan draws funds from employers, asking them to pay $9 trillion to the government, a slightly smaller percentage of what they currently pay to cover their employers’ health insurance. She calls this an “employer Medicare contribution.” Sanders says that plan would have a negative impact on job creation and wages and has instead suggested a 7.5 percent payroll tax, which he says will impact upper-income people more instead of low-wage workers. Warren responded to that criticism by saying employers would end up paying less to the government than they currently pay to insurance companies, and they wouldn’t need HR departments to “wrestle” with insurance companies.

Sen. Joe Biden, who has been a staunch critic of Medicare for All, called the plan “mathematical gymnastics.” The Atlantic, generally a left-leaning news outlet, said her plan “makes big assumptions about how much money she’ll be able to squeeze from the health-care system.” Ezra Klein, the founder of Vox and one of the most authoritative health care voices on the left, said “there are places where I find Warren’s math or ideas a bit optimistic” and added that there needs to be more thought put into how we will increase supply to match the inevitable increased demand of cheaper health care. But Klein also notes that, if enough people hold on through the disruptive transition, there is no doubt “we could have a system that covered everyone for less than we pay now.” Sen. Michael Bennet of Colorado said, “She accepted Bernie Sanders’s Medicare-for-all program and then had to reverse engineer how to pay for some of it. But it’s not terribly persuasive.” The New York Times and The Washington Post both ran editorials questioning how realistic implementing her plan was. Pretty much the only full-throated endorsement of the plan came from Ady Barkan, a health care advocate battling ALS who I’ve interviewed and have a tremendous amount of respect for. Barkan wrote a passionate op-ed in The Intercept making the case that Warren’s plan would permanently change the country for the better.

On the surface, there’s plenty I like about Warren’s plan. I’m a middle-class worker, so of course I don’t want to pay more in taxes. My employer-provided health insurance is expensive, so of course I want to reduce its cost. Like most Democrats and 45 percent of Republicans, I also believe the rich aren’t paying their fair share of taxes in America. So Warren’s goal to close loopholes, enforce tax laws and increase taxes on billionaires is easy to get behind. She also proposed that 5 percent of the funds would come from achieving immigration reform and reducing defense spending. On both ideas, I could practically leap out of my seat clapping: our extraordinarily well-funded military should continue to be well-funded, but it’s also unthinkably wasteful and has little incentive to stop wasting money when we always double-down on increasing our defense spending. Similarly, our immigration system blows billions of dollars on practices that have not reduced illegal immigration, the cruelty in the system or the wait times for people who want to gain permanent status legally. Calling for reform in those areas to help insure more Americans is about as admirable of a goal as I can think of, legislatively.

But the flaws the Journal points out aren’t easy to sweep under the rug. Warren does seem to wave a magic wand and make some wildly optimistic assumptions about how costs will go down during a tumultuous overhaul like this. I’m appreciative of the fact her plan tries to slow down the transition into Medicare for All, but it’s also fair to note that it will only give employers time to reduce their own spending, wages, coverage, and so on. Even though his plan is far less detailed, the central premise of Sen. Sanders’ plan is that it will require a middle-class tax hike along with some of the reforms Warren calls for. His argument is that the increase in taxes will be smaller than the increase in savings, and it strikes me as a much more genuine argument to make than Warren’s, which is that she’s going to pull off the biggest government overhaul in American history without increasing middle-class taxes a single penny.

This is an excerpt from Tangle, an independent, ad-free, non-partisan, daily politics newsletter where I answer reader questions from across the country. If you found Tangle online, you can subscribe below.

Sign up now


Only paid subscribers can comment.
Please subscribe or sign in to join the conversation.

Isaac Saul

I'm a politics reporter who grew up in Buck County, PA — one of the most politically divisive counties in America. I'm trying to fix the way we consume political news.

Great! You've successfully subscribed.
Great! Next, complete checkout for full access.
Welcome back! You've successfully signed in.
Success! Your account is fully activated, you now have access to all content.