How Elizabeth Warren's Medicare For All Proposal Works

Grant Boone
November 6, 2019

For months, Elizabeth Warren has refused to say if her health care plan would raise taxes on the middle class, and now we know why: because it does. Instead, she said, it would save American households $11 trillion in current out-of-pocket spending.

The nation's most powerful Democratic lawmaker said she is open to a conversation about Medicare for All and has allowed advocates to speak before various congressional committees.

If the transfers from private businesses to the government do not raise enough money, Ms Warren says she would make up the difference by imposing a supplemental contribution requirement for big companies "with extremely high executive compensation and stock buyback rates".

Warren's detailed proposal, which was published on Medium on Friday and describes how she would pay for Medicare For All, is a reflection of that divide. Doctors, hospitals, and other health care providers would get paid much less than they do now from nongovernment plans. That would raise about 40% of the $20.5 trillion over 10 years the Warren campaign estimates will be needed for Medicare for All. Warren, a senator from MA, is one of 18 Democrats vying for the party's nomination to take on Republican President Donald Trump in the November 2020 election. Under their plans, an expanded Medicare system would fully cover everyone in the country.

The Senator from MA has faced criticism from her Democratic rivals on how she could possibly afford such a sprawling plan. Warren had promised at a recent debate that she would not sign a bill that raises health care costs for the middle class.

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Pete Buttigieg, the mayor of South Bend, Ind., has gained recently in the primary rankings, in part because he favors letting people keep their private insurance if they want to. He feels that in order to pay for a Medicare for All plan, in his view, it would require raising taxes on middle-class families. "Some of the people now working in health insurance will work in other parts of insurance - in life insurance, in auto insurance, in vehicle insurance".

During a panel discussion on rural politics in Iowa Friday, former Iowa Gov. Tom Vilsack said Warren's plan wrongly suggests voters will accept that an increase in her proposed tax on the wealthiest Americans won't affect their own pocketbooks. Passing the law would be hard, even if Democrats control both chambers, given the opposition from some moderate members of the party. An analysis of the plan, compiled by Simon Johnson, the former chief economist of the IMF; Betsy Stevenson, a former chief economist for the Department of Labor; and Mark Zandi, the chief economist of Moody's Analytics, says that Warren's IRS proposals would "would close the overall tax gap by one-third" and "generate an additional $2.3 trillion in revenue after accounting for the increased cost of IRS and other agency enforcement".

"To accomplish this sleight of hand, her proposal dramatically understates its cost, overstates its savings, inflates the revenue, and pretends that an employer payroll tax increase is something else", she added.

"We can generate nearly half of what we need to cover Medicare for All just by asking employers to pay slightly less than what they are projected to pay today, and through existing taxes", she wrote.

As for cutting government spending to help pay for her plans, Warren briefly mentioned one possibility - funding for overseas contingency operations in the Department of Defense budget - before quickly getting back to her 2 percent wealth tax. Senator Warren would place a new tax of almost $9 trillion that will fall on American workers. Instead of billionaires paying 3%, they would pay 6%.

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