Democratic presidential candidate Kamala Harris introduced a healthcare proposal Monday that would allow private health insurers to continue doing business, even as it would enroll most people living in the U.S. in a government plan.
Harris had previously gone back and forth about whether private insurance should be allowed. In the Senate, she is a cosponsor of the Medicare for All Act, introduced by Sen. Bernie Sanders of Vermont, which would ban private plans. Monday’s proposal comes just ahead of the next round Democratic debates, set for Tuesday and Wednesday in Detroit.
The largest provision for private health insurance coverage in Harris’ new plan is not through the “supplemental” proposal she had alluded to before. Instead, it would allow people to choose Medicare Advantage plans rather than traditional Medicare, which too would undergo changes in how it operates and would be allowed to cover more services.
“Essentially, we would allow private insurance to offer a plan in the Medicare system, but they will be subject to strict requirements to ensure it lowers costs and expands services,” Harris wrote in a blog post. “If they want to play by our rules, they can be in the system. If not, they have to get out.”
Medicare Advantage covers about a third of the 60 million people who are on Medicare now. It allows private health insurers to contract with Medicare to deliver services. Often, the services are more extensive than the traditional Medicare program, but they limit which providers beneficiaries can see.
Harris’ new plan differs in a few other ways from Sanders’ Medicare for All Act. It would overhaul the healthcare system over the course of 10 years, as opposed to the four-year timeline set up under the Medicare for All Act. Such a timeline would eclipse the duration of a two-term presidency.
The plan would, in its first year, let people buy into Medicare, then it would expand the program to cover newborns and the uninsured. The current Medicare programs covers adults 65 and older and people with disabilities.
“Under my plan, no one will lose access to insurance during a transition. Period,” Harris promised.
As with the Sanders proposal, the plan would extend the current Medicare program so that it covers more medical goods and services than it does now, including prescription drugs, dental, vision, hearing aids, and treatment for addiction. Supplemental coverage would be limited. People would be allowed to buy extra coverage for when they are traveling abroad or for cosmetic surgery, a service that health insurance plans do not currently cover.
Under the current Medicare program, beneficiaries have the option of purchasing supplemental coverage known as Medigap, which helps pay for deductibles, co-pays, and healthcare received when traveling outside the U.S. The healthcare plan that Harris and Sanders have proposed is intended to do away with any out-of-pocket costs to patients.
Last week, former vice president Joe Biden attacked Harris for her support for “Medicare for all,” saying that it was a “fantasy world” to promise that carrying out the Medicare for All Act could be achieved without taxing the middle class. Biden has proposed expanding Obamacare so that more people get subsidies to pay for private coverage, and letting people buy into a government plan that would be similar to, but more expansive than, Medicare.
Harris didn’t specifically vow again on Monday that she would not raise taxes on anyone in the middle class. Instead, she specified that she wouldn’t raise taxes on families making under $100,000 a year, and said the income threshold would be higher for families who live in parts of the U.S. that are more expensive. To pay for her healthcare plan, she floated an income-based premium paid by employers, taxing people whose income was at the top 1% of the population, and taxing capital gains at the same rate as ordinary income.
Harris did not provide an estimate about how much her plan would cost. The proposal would pay doctors and hospitals lower rates than what they make now and the government would have more power to decide how much to pay for prescription drugs.
