- Medicare for All vs. Public Option Proposals
- How many people will be left uninsured?
- What would you have to spend on premiums?
- What would you have to spend on care after you pay premiums?
- Does this plan raise middle class taxes?
- Does the plan lift the burden of health care costs off families with employer coverage?
- What benefits will be covered?
- How long would it take to transition to their plan?
- Will people still need to launch crowdfunding campaigns to pay for medical bills?
- Warren vs. Sanders on Medicare-for-all: How do their plans compare?
- The Sanders-Warren dispute about how to pay for Medicare-for-all, explained
- Bernie Sanders’s payroll tax proposal, explained
- Elizabeth Warren’s employer contribution idea is designed to be simple
- Bernie the technocrat vs. Warren the populist
Medicare for All vs. Public Option Proposals
See how the leading 2020 Democratic candidates’ health care plans compare.
How many people will be left uninsured?
Warren: 0 people uninsured
Sanders: 0 people uninsured
Buttigieg: 6 million people uninsured
Biden: 10 million people uninsured
What would you have to spend on premiums?
Sanders: Workers would be required to pay a 4% premium on every dollar of income above $29,000 (for a family of four).
Buttigieg: In employer coverage, about what you pay now. For a family of four, that’s nearly $8,000 a year. People with ACA exchange plans will save some money, but plans could cost up to 8.5% of income.
Biden: In employer coverage, about what you pay now. For a family of four, that’s nearly $8,000 a year. People with ACA exchange plans will save some money, but plans could cost up to 8.5% of income.
Bloomberg: In employer coverage, about what you pay now. For a family of four, that’s nearly $8,000 a year. People with ACA exchange plans will save some money, but plans could cost up to 8.5% of income.
Klobuchar: In employer coverage, about what you pay now. For a family of four, that’s nearly $8,000 a year. People with ACA exchange plans will save some money.
What would you have to spend on care after you pay premiums?
Buttigieg: Families could still pay up to $16,400 pocket after premiums each year.
Biden: Families could still pay up to $16,400 pocket after premiums each year.
Bloomberg: Families could still pay up to $16,400 pocket after premiums each year.
Klobuchar: Families could still pay up to $16,400 pocket after premiums each year.
Does this plan raise middle class taxes?
Warren: No — not only does Elizabeth Warren’s plan not raise taxes on the middle class, it puts $11 trillion back into the pockets of American families.
Sanders: Yes — Bernie’s Medicare for All plan increases payroll and income taxes on workers by as much as 26% to cover the cost.
Does the plan lift the burden of health care costs off families with employer coverage?
Warren: Yes. Elizabeth’s Medicare for All plan would bring families’ health costs down nearly to zero.
Sanders: Somewhat. Bernie’s Medicare for All plan would bring families’ pocket costs down to nearly zero, but it still charges premiums.
Buttigieg: Somewhat. Buttigieg’s public option is more expensive than most employer coverage, but does ban surprise billing.
Biden: Somewhat. Biden’s public option is more expensive than most employer coverage, but does ban surprise billing.
Bloomberg: Somewhat. Bloomberg’s public option is more expensive than most employer coverage, but does ban surprise billing and cap drugs prices.
Klobuchar: Somewhat. Klobuchar does not give details on affordability for her public option, but does ban surprise billing.
What benefits will be covered?
Warren: All physical and mental health care + dental, vision, and long term care.
Sanders: All physical and mental health care + dental, vision, and long term care.
Buttigieg: All medical and mental health care, no dental, vision. Limited long term care.
Biden: All medical and mental health care, possibly some dental, vision. Limited long term care.
Bloomberg: All medical and mental health care, no dental, vision. Limited long term care.
How long would it take to transition to their plan?
Warren: Elizabeth’s Medicare for All plan will be implemented within the first term—starting with giving anyone the chance to join a Medicare for All program within the first 100 days.
Sanders: Bernie’s Medicare for All plan would be implemented 4 years from date of legislation passage.
Will people still need to launch crowdfunding campaigns to pay for medical bills?
* We welcome changes by candidates to improve their plans so American families know exactly what they’re getting. These are based off of plans as they were on 2/25/2020.
Want more? Click here to download a quick summary of Elizabeth Warren’s Medicare for All plan.Photos: Gage Skidmore
Warren vs. Sanders on Medicare-for-all: How do their plans compare?
Senators Bernie Sanders and Elizabeth Warren, rivals for the Democratic presidential nomination, have unveiled sweeping, multi-trillion-dollar proposals to overhaul the country’s health-care system.
While the two lawmakers, who are jockeying for support among the party’s left-wing, are often viewed as the flipside of the coin — both are proponents of establishing a government-run health care system with no premiums, deductibles or copays — Sanders has tried to distance himself from the Massachusetts Democrats’ single-payer health-care system since she released it last Friday.
ELIZABETH WARREN'S MEDICARE-FOR-ALL PROPOSAL WOULD COST JEFF BEZOS $7 BILLION
On Sunday, during an interview with ABC News, Sanders took a stab at her recently released plan, which would cost the country “just under” $52 trillion, including $20.5 trillion in new federal spending, over the course of a decade.
In her detailed outline, Warren called for new levies on the wealthy and a slew of other taxes to pay for the plan, including an “employer Medicare contribution,” which Sanders warned could harm workers’ wages and suppress job growth.
GET FOX BUSINESS ON THE GO BY CLICKING HERE
“The function of health care is to provide health care to all people, not to make $100 billion in profits for the insurance companies and the drug companies.
So, Elizabeth Warren and I agree on that,” Sanders's, a Vermont independent, said. “We do disagree on how you fund it.
I think the approach that [I] have, in fact, will be much more progressive in terms of protecting the financial well-being of middle-income families.”
The particular tax that Sanders took issue with was the $8.8 trillion contribution from employers, who would pay the government a slightly smaller percentage than they currently pay to provide health care to their workers.
CLICK HERE TO READ MORE ON FOX BUSINESS
“I think that that would probably have a very negative impact on creating those jobs, or providing wages, increased wages and benefits for those workers,” Sanders said. “So I think we have a better way, which is a 7.5 percent payroll tax, which is far more, I think, progressive because it’ll not impact employers of low wage workers but hit significantly employers of upper-income people.”
Here’s a closer look at how Warren and Sanders would pay for their sweeping proposals:
- Taxes on additional take-home pay: Employees would no longer pay into their employer-sponsored health care, but would pay taxes on the extra take-home pay they receive under the new system.
- Taxes on the wealthy: The ultra-wealthy would be hit with a 6 percent tax on income over $1 billion — up from the currently proposed 3 percent — and capital gains income would be taxed annually, rather than at the time of sale. Combined, those proposals would culminate in $2 trillion in funding.
- Taxes on financial firms: A 35 percent tax would be imposed on American companies' overseas profits, while foreign companies would also be taxed their domestic sales, resulting in an additional $1.65 trillion in revenue.
- IRS crackdown: By expanding IRS enforcement and cracking down on tax evasion and fraud, the U.S. could realize about $2.3 trillion in additional federal revenue.
- Cut defense spending: Scaling back spending on the Pentagon would reallocate roughly $800 billion.
- Immigration overhaul: By creating a pathway to legal citizenship for undocumented immigrants, the U.S. could raise an estimated $400 billion.
- Employer Medicare contribution: Because employees would no longer pay health premiums or co-pays another $1.4 trillion in funding would be generated through taxing that portion of their income, which is deducted for premiums before federal tax is calculated.
- Payroll taxes on employers: Employers would pay a 7.5 percent payroll tax, replacing what they currently pay for health care. Right now, all employees and employers pay a 1.45 percent tax for Medicare, or 2.9 percent total. That would raise an estimated $3.9 trillion over 10 years. The first $2 million would be exempt from that tax in order to protect small businesses.
- Household premiums: Households earning more than $29,000 would pay a 4 percent income-based premium, generating $3.5 trillion over 10 years.
- Taxes on corporations: It would impose a one-time tax on currently held offshore profits, generating $767 billion over 10 years. Large financial institutions would also be hit with a fee, producing $117 billion.
- Taxes on the wealthy: Under the proposal, the marginal income tax rate would increase incrementally for those earning more than $250,000 — a 40 percent tax — to those earning more than $10 million — a 52 percent tax. wise, it would also end the tax break for capital gains and dividends on household income above $250,000. The wealthiest 0.1 percent, or 160,000 households, would also be hit with a wealth tax.
The Sanders-Warren dispute about how to pay for Medicare-for-all, explained
Sen. Bernie Sanders pats the back of Sen. Elizabeth Warren during an event on health care September 13, 2017, on Capitol Hill in Washington, DC. Alex Wong/Getty Images
Elizabeth Warren and Bernie Sanders agree on the broad contours of what the American health care system should look — universal enrollment in a government program that provides care with no premiums, deductibles, or co-payments financed largely by taxes on the rich, and cuts in payment rates to pharmaceutical companies, hospitals, and other health industry players.
But they do disagree in part on how to finance the rest of it.
Warren, in an effort to craft a plan she characterizes as featuring zero tax increases on the middle class, wants to create an “employer contribution” into the Medicare-for-all fund. Sanders, by contrast, has not released a fully detailed plan.
But his office has long touted an employer-side payroll tax as part of the answer.
And in comments on Sunday in response to Warren’s plan, he wedded himself more clearly to that idea, saying his approach is “far more, I think, progressive, because it’ll not impact employers of low wage workers but hit significantly employers of upper income people.”
The practical stakes of this argument are low. The odds of any kind of Medicare-for-all plan actually being enacted by Congress are slim. And obviously anything a potential President Sanders signed into law would have to be something Sen. Warren voted for and vice versa.
But it is worth understanding why these two similar sounding ideas are actually very different in their implications. It underscores that the real challenge of legislating is that you can’t just write down a plan, you need to build a consensus in Congress for your specific approach.
It’s also an interesting counterpoint to some of the prevailing narratives around Sanders and Warren. In this case, Sanders is the one putting more emphasis on technocratic soundness, while Warren seems more attuned to populist politics.
Bernie Sanders’s payroll tax proposal, explained
A payroll tax is just a tax on salaries, assessed either on the employer or the employee. Payroll taxes finance Social Security and the bulk of Medicare under the current American system, and are widely used as part of the revenue base for European welfare states.
Payroll taxes can assessed on employers or employees. In the case of Social Security, half the burden falls on employers and half on employees.
Economists widely believe that it doesn’t actually matter who formally pays the tax, the result in either case is to reduce workers’ take-home pay.
Sanders’s vision for financing Medicare-for-all includes raising employer-side payroll taxes by 7.5 percentage points in order to raise roughly $3.9 trillion over 10 years.
On average, this is less than what employers are currently spending on premium contributions for their employees, so workers and employers should generally come out ahead under this system. But those broad averages mask a wide range of impacts.
According to the Kaiser Family Foundation, the average employer contribution for a single person’s health insurance in 2016 was $5,946.
Sanders’s employer-side payroll tax would be less than that for workers earning below $80,000 a year but higher for more affluent workers.
For family coverage, the average employer contribution was $14,561 which would make the cutoff point about $194,000 in household income.
On the other hand, lower income households, who currently don’t get employer-sponsored health insurance, could find themselves getting very robust coverage in exchange for a very modest tax increase.
Some low-income families are already getting free insurance from the government through Medicaid — those families might end up seeing a small reduction in take-home pay in order to swap one government insurance plan for another.
Of course, even families whose take-home pay diminished somewhat due to Sanders’s payroll tax would reap benefits in the form of eliminating co-payments and deductibles. The point is that while the structure of Sanders’s plan is broadly progressive and broadly beneficial to most households, the exact calculus of who ends up ahead and who does not hinges on a complicated set of factors.
Elizabeth Warren’s employer contribution idea is designed to be simple
Warren’s plan, by contrast, asks companies with over 50 employees to simply calculate their current average expenditure on health insurance and pay 98 percent of that total to the government.
The virtues of this plan are twofold.
- It guarantees that in the short term everyone is paying less in a clear and mechanical way.
- Warren can say — technically — there is no new tax here. It’s a case of transforming the existing legal mandate for large employers to provide health insurance into a mandate to pay into a government-run fund.
Compared to Sanders’s plan, Warren’s plan is more favorable to the interests of high-income earners (the part that Sanders s to emphasize) but also more favorable to Medicaid recipients (probably a framing she would prefer) since there’d be no extra tax on them.
Her plan also generates some odd inequities. Right now, a company that spends more on its employees’ health insurance gets something in exchange — happier, more generously compensated employees.
Under Warren’s plan, that company would end up paying higher fees to the government but every worker would get the same insurance plan — in effect putting the previously more generous companies at a disadvantage.
In the short term this would generate more whining than actual problems. But over time it would be increasingly unsustainable.
So Warren says that “over time, an employer’s health care cost-per-employee would be gradually shifted to converge at the average health care cost-per-employee nationally.
” If you ignore the transition period and just think about the long-term result, Sanders is proposing a flat tax on wage income while Warren is proposing a kind of regressive employer poll tax.
Bernie the technocrat vs. Warren the populist
The odds of these bills passing Congress are extremely low. And even if it did, Congress would write the bill and there’s no reason to think either Sanders or Warren have fundamental, principles-driven objections to either way of doing this.
But the plans candidates release are illustrative of how they think about things, and this particular case is interesting because it runs somewhat contrary to the stereotype.
Warren has much more of a reputation as the uber-wonk with plans for everything, while Sanders is seen more as a moralist and a populist who cares less about the technical merits of proposals than whether they illustrate underlying points.
In this particular case, however, that dynamic is reversed.
It’s Warren whose plan optimizes for easily illustrating the point that almost everyone’s costs will go down, even at the cost of embracing a vision that’s not going to be technically sustainable for very long.
She’s then vague about the timing of the transition off her plan, and is going to transition to something that’s probably a worse deal for many people than a more technocratic alternative would be.
Sanders, by contrast, is proposing a big new broad tax, even though big new broad taxes tend to be unpopular. This is how foreign single-payer systems are typically designed, and it’s almost certainly what a team of policy wonks would recommend if they were setting all political considerations aside.
Life (and politics) is more complicated than stereotypes. The exigencies of a presidential primary require leading politicians to differentiate themselves against each other, at times in somewhat arbitrary ways.
Governing requires the reverse, the building of consensus and coalitions.
For now, though, the opposite dynamic is taking root: Even the most ideologically similar candidates are diverging in their plans and moving away from consensus about how exactly to redesign the health care system.
“,”author”:”Matthew Yglesias”,”date_published”:”2019-11-04T17:30:00.000Z”,”lead_image_url”:”https://cdn.vox-cdn.com/thumbor/LDK0n7D1jVcSDyXqjM88Tg5jp9E=/0x0:3000×1571/fit-in/1200×630/cdn.vox-cdn.com/uploads/chorus_asset/file/9250289/846583036.jpg”,”dek”:null,”next_page_url”:null,”url”:”https://www.vox.com/policy-and-politics/2019/11/4/20946215/sanders-warren-medicare-payroll-tax”,”domain”:”www.vox.com”,”excerpt”:”Bernieâs plan is more technically sound, Warrenâs may be an easier sell.”,”word_count”:1278,”direction”:”ltr”,”total_pages”:1,”rendered_pages”:1}