Warren Says She’ll Explain How to Pay for Medicare for All

by Michael Rainey: Under pressure from competitors and journalists covering the Democratic presidential nomination race, Elizabeth Warren said Sunday that she would release details “over the next few weeks” to explain how she intends to finance her Medicare-for-All proposal.

“Every single person who is running for president of the United States on the Democratic side right now knows that families are getting crushed by the cost of health care,” Warren said Sunday at a campaign event in Iowa. “They also know that the cheapest possible way to make sure that everyone gets the health care that they need is Medicare for All. … What I see, though, is that we need to talk about the cost. And I plan over the next few weeks to put out a plan that talks about, specifically, the cost of Medicare for All and, specifically, how we pay for it."

Warren has endorsed Bernie Sanders’ sweeping proposal for Medicare for All, but unlike the senator from Vermont, she has avoided talking about how she’d pay for it. Instead, she has argued that middle-class households would be better off in the end due to the elimination of health care premiums and other medical expenses. “I will not sign a bill into law that does not lower costs for middle-class families,” Warren vowed at the Democratic debate last week.

Critics keep up the pressure: Even as Warren announced her plans, the Biden campaign continued to hammer away at her avoidance of the issue thus far, echoing complaints from other candidates. "It's mystifying that for someone who has put having a plan for everything at the center of her pitch to voters, Senator Warren has decided to release a health care plan only after enduring immense public pressure for refusing to do so,” said T.J. Ducklo, a spokesman for Joe Biden. "We hope her plan will be straight with the American people about how much middle class taxes will go up to pay for the $30+ trillion it will take to fund Medicare for All."

But money isn’t the only issue: Ernie Tedeschi of Evercore ISI said that while the debate over how to pay for Medicare for All is critical, the more fundamental problem is how to shift funds currently flowing through the health care system from a variety of sources onto the federal government’s budget. “Paying for M4A is a challenge of mechanics (shifting a large share of the money the US economy currently devotes to health care from one pocket to another), not capacity,” he wrote Sunday. “It's an important debate to have but not nearly the only or most important one.”

Tedeschi provided this illuminating chart that shows what a Medicare for All budget would have looked like in 2019, according to estimates from the RAND Corporation. Overall national health care spending is roughly similar, but the sources of the spending are quite different, with the federal budget carrying most of the load. “In some ways, the sheer size of [Medicare for All] makes the financing debate a bit... uncreative,” Tedeschi wrote. “Basically, the federal government has to raise $1.8-2.4T a year. Even with higher household income from no premiums and lower [out of pocket] costs, there are only so many ways it's possible to do that.”

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Michael Rainey is managing editor for The Fiscal Times (@TheFiscalTimes)

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