Senators Bernie Sanders and Elizabeth Warren are often mentioned in the same breath when talking about their healthcare policy proposals. Both are suggesting that a Medicare For All system, which would expand the federal health insurance program to encompass all Americans, is the best path to achieving universal healthcare coverage.
But on New Year's Eve, Sanders told NBC News that his plan has one key difference: the speed of its rollout.
Sanders said Tuesday he would introduce a Medicare For All, single-payer program in his first week in office, while Warren's rollout plan is more gradual.
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Warren has said that, in order to gradually transition to universal coverage, she would first offer an optional government-run insurance plan, with full scale Medicare For All being fully implemented in her third year in office.
The concept of choice is one that Warren has been leaning into as of late, as polling suggests that public support for such an approach largely hinges on whether it's optional or mandatory. New surveys show a Medicare For All option -- such as the one proposed by candidate Mayor Pete Buttigieg -- enjoys a 2:1 preference against the mandatory programs proposed by Warren and Sanders. Voting age Americans would prefer no change at all to the current private health system over mandatory Medicare for All.
Optional Medicare for All was the most popular policy among respondents to the poll, at 45.4%. Keeping the current private system intact came in second at 33.3%, while a mandatory Medicare for All system garnered the least support at 21.2%.
This suggests that, while there's public support for a shift to some form of universal healthcare, voting age Americans are wary of a complete break from the current system. In short, a majority of voters reject mandatory Medicare for All, while a majority supports a Medicare for All option.
WHAT'S THE IMPACT
Sanders' plan would effectively abolish private health insurance in favor of a government-run program. He has promised no networks, no premiums, no deductibles, no copays and no surprise bills, and said no American would pay more than $200 a year for their prescription medications. Prescription drug prices would be cut in half, he said, by pegging prices to the median drug prices in countries such as Canada, France, the United Kingdom, Germany and Japan.
The proposal would expand the Medicare program to include dental, hearing and vision. Eligibility would be lowered to age 55 within the first year of a four-year transition plan. Investment would be focused on the healthcare workforce, such as doctors, nurses, mental health specialists and dentists, as well as the development of new drugs and technologies.
Sanders did say however, at a campaign stop in New Hampshire last week, that the transition to Medicare For All would result in some job loss, suggesting a re-training program as a potential end-around -- one in which those working in the industry would retain their income and receive skills training to compete for other industry jobs.
THE LARGER TREND
Politically, Sanders' plan places him to the left of Democratic rivals Mayor Pete Buttigieg and former Vice President Joe Biden. Buttigieg and Biden have both called for public options that would compete with the private insurance industry, with Biden in particular citing the need for strengthening the Affordable Care Act, which recently turned 10 years old.
Candidate and entrepreneur Andrew Yang, by contrast, eschews Medicare For All in favor of a plan that focuses more on lowering costs and expanding coverage.
In the above polling on voter preferences, no demographic segment of the population -- by age, sex or region -- preferred the mandatory Medicare for All policy over the Medicare for All option. Medicare-based healthcare reform moves from majority support to majority opposition based on whether its implementation is optional or mandatory, respectively.
Given a choice between single-payer Medicare or the existing private health system, voting age Americans choose the existing system. And compared to a public option or no change at all, Medicare for All is extremely unpopular.