Kamala Harris releases Medicare-for-all plan ahead of second 2020 US Democratic debate

U.S. Senator Kamala Harris on Monday released a Medicare-for-all proposal ahead of the second Democratic presidential debate, when candidates’ differing approaches to giving Americans greater access to affordable health insurance is expected to feature prominently.

Harris’ plan would allow Americans to buy into the Medicare government health insurance program, establishing a 10-year phase-in period during which newly born children would be automatically enrolled and healthcare providers can transition. The plan would allow private health insurers to offer Medicare plans if they meet requirements on costs and benefits, according to a preview of the plan provided to Reuters by her campaign.

“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. If they want to play by our rules, they can be in the system. If not, they have to get out,” Harris is expected to write in a post on the online publishing platform Medium.

Harris, 54, has struggled to clarify how she would craft a Medicare-for-all plan since launching her White House bid in January. At times she has wavered as to whether such a plan would preserve a role for private health insurers. Access to affordable healthcare is one of the early defining issues in the Democratic nominating contest.

At the first Democratic presidential debate in June, Harris raised her hand when the candidates were asked whether they would abolish private health insurance in favor of a government-run plan. She later said she had misunderstood the question.

Harris, in explaining her Medicare-for-all proposal, was deliberate in differentiating it from a Medicare-for-all bill in the U.S. Senate offered by White House rival Bernie Sanders. Harris has co-sponsored the legislation.

While the Sanders legislation would phase in a Medicare-for-all plan over four years, Harris would extend that phase to 10 years. Unlike the Sanders proposal, it preserves a role for private insurers.

The Sanders bill proposes several options for financing the Medicare expansion, including a 7.5% income-based tax paid by employers, a 4% income-based premium, exempting the first $29,000 in income for a family of four, and eliminating some tax deductions.

Harris’ proposal would raise to $100,000 the threshold after which families would pay a related tax, and establish a tax on Wall Street trading.

“To pay for this specific change, I would tax Wall Street stock trades at 0.2%, bond trades at 0.1%, and derivative transactions at 0.002%. Think of it like this: that’s a $2 fee on a $1,000 trade by investors and big banks,” Harris is expected to write on Medium.

Harris and Sanders will not share a debate stage this week. Sanders will appear on July 30, the first night, and Harris on July 31, the second night.

Kathleen Sebelius, the former chief of the U.S. Department of Health and Human Services during the Obama administration, said Harris’ plan would be a “sensible expansion” of the Medicare system.

“To get all Americans covered by health insurance, where cost is not a barrier, we need innovative ideas like this,” Sebelius said in a statement.