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Ever since Joe Biden kicked off his 2020 presidential campaign by attending a big-dollar fundraiser with a major health insurance CEO, it was clear that he would define his health care platform in direct opposition to Medicare for All. The release of his underwhelming BidenCare plan brings no surprises on that front. Rather than highlighting his plan’s policy specifics, Biden is spending the week of its launch attacking Bernie Sanders’s Medicare for All bill. Parroting insurance industry talking points, Biden told a number of lies about the single-payer proposal in a campaign speech and in his BidenCare announcement video: he claimed Medicare for All will throw millions off of their insurance, scrap Obamacare, end Medicare as we know it, cause a hiatus in coverage, and cost more than his own plan. In response, Sanders’s campaign added a short quiz to their website asking visitors to attribute lies about Medicare for All to either Biden, Donald Trump, Mitch McConnell, or United Health CEO David Wichmann. (It’s a tough quiz. I follow these things closely and only scored four out of six.) With their shared lies, Biden, Trump, and McConnell are operating directly out of the insurance industry’s playbook. Remarkably, over the last few years, Medicare for All has grown from a fringe idea to a mainstream demand supported by a heavy majority of voters. Its opponents understand that the more people learn about what Medicare for All truly means the more popular it becomes. Should the public gain a wide understanding of its benefits, other plans won’t be able to stack up. Biden’s plan, for example, looks foolish in comparison. It will keep employees’ insurance at the mercy of their employers, leave ten million uninsured and tens of millions underinsured, and maintain prohibitive out-of-pocket costs while preserving a fundamentally broken system. Medicare for All, on the other hand, will solve all of these problems by implementing a single, public program that guarantees comprehensive care to everyone, free at the point of service, from the cradle to the grave. Simply put: Medicare for All is so good that Biden has no choice but to lie about it. Let’s examine some of his most recent lies with a Glenn Kessler-style Pinocchio rating system.

Biden’s lie: “Medicare goes away as you know it. All the Medicare you have is GONE.” Verdict: 100 Pinocchios This is Biden’s boldest and most duplicitous lie. It’s also one that comes straight from a Donald Trump op-ed. Medicare for All, as its name suggests, will not eliminate Medicare but rather expand it to every US resident. The only parts of the program that will go away are the private supplemental plans seniors are currently forced to buy. Medicare for All will instead make the public plan comprehensive by adding dental care, hearing aids, vision care, and more to its list of covered items — and it will do this while eliminating all co-pays, premiums, and deductibles. BidenCare, on the other hand, will continue denying seniors needed coverage and charging them for care.

Biden’s lie: “How many of you out there have had someone you’ve lost to cancer? Or cancer yourself? No time… We cannot have a hiatus of six months, a year, two, three, to get something done.” Verdict: Really confusing. 80 Pinocchios Biden is of course correct that we cannot have a hiatus of six months to three years during which cancer patients are unable to receive care. Fortunately, there will be no such hiatus with Medicare for All. Biden is pulling this idea out of thin air. (Also, does anybody really think that Bernie is pushing for a health care system that would suspend all cancer treatment? Biden might as well accuse Sanders of proposing Medicare for All death panels.) Sanders’s Medicare for All bill has a four-year transition period during which nobody will lose coverage. The transition will add new age groups to Medicare until every US resident is on the program in the fourth year, and it will create a public option (far more generous than Biden’s) that people can join in the meantime. The program’s list of covered items will expand in the very first year, ensuring that from the get-go people will have far better coverage than they ever would under BidenCare.

Biden’s lie: “How many of you like your employer based healthcare? Do you think it was adequate? Now if I come along and say you’re finished, you can’t have it anymore, well that’s what Medicare for All does. You cannot have it. Period.” Verdict: Technically true, but very deceptive. 20 Pinocchios. Everyone should watch the video in which Biden says this. When he asks if they liked their employer-sponsored care, about ten people in a very crowded audience raised their hand. This is, of course, because nobody has fond feelings toward their private insurer, and most seniors (it was an AARP crowd) are happy to finally be on Medicare. Biden is attempting to convince you that Medicare for All will rip millions of people from their beloved private plans, causing untold disruption. It’s very similar to recent arguments made by Nancy Pelosi and Mitch McConnell. These arguments are absurd. In reality, Medicare for All will introduce real stability by guaranteeing lifelong public insurance to everyone, ensuring that nobody loses coverage ever again. It will rescue people from a system in which employers dictate their employees’ coverage. Having health care tethered to employment is an extremely volatile arrangement — as Matt Bruenig notes, one in four people on employer-sponsored plans are thrown off their insurance each year. Biden is technically correct that people won’t be able to have employer-sponsored insurance once Medicare for All is won — but the truth is that’s a very good thing.

Biden’s lie: “I understand the appeal of Medicare for All. But folks supporting it should be clear that it means getting rid of Obamacare, and I’m not for that.” Verdict: 50 Pinocchios Obamacare did a couple of very good things: it expanded Medicaid eligibility to millions more people and improved coverage by mandating a set of essential benefits. Medicare for All doesn’t do away with either of these things. In fact, it improves upon them by bringing the entire country into a public insurance program that fully covers all medically necessary care. Biden might as well be warning that winning a beautiful new car will mean getting rid of your busted ‘95 Taurus. Medicare for All is superior to Obamacare in every way. It will cover everyone, eliminate out-of-pocket costs, put an end to the phenomenon of “Medicaid envy” (where people on the wrong side of an arbitrary income cutoff lose eligibility for Medicaid), and give patients total freedom of choice in doctor and hospital. If anyone loves Obamacare, it’s because it gave them some small monetary reprieve or coverage that they lacked before. Medicare for All will help them even further by erasing all out-of-pocket costs and giving everyone comprehensive coverage. Medicare for All doesn’t “get rid of” Obamacare; it replaces it with a far better system.

Biden’s lie: BidenCare is “the best way to lower costs and cover everyone.” Verdict: 200 Pinocchios This gets 200 Pinocchios because it’s actually two lies: that BidenCare is the best way to lower costs, and that it’s the best way to cover everyone. The latter is Biden’s funniest lie because it directly contradicts the details of his own plan. While every other Democrat is running on support for universal health care, Biden makes clear right on his website that his plan will only cover 97 percent of Americans. Assuming that number is correct, nearly ten million people will remain uninsured and 125,000 will die due to lack of insurance in the first ten years. It’s therefore a little audacious to say the plan will cover everyone. BidenCare will lower costs somewhat for patients. It caps an employee’s premiums at 8.5 percent rather than 9.86 percent, while also making more people eligible for gold plans, meaning lower deductibles. But it’s important to understand that under BidenCare, people will continue to be saddled with thousands of dollars in out-of-pocket costs and regularly drained by expensive premiums. Only Medicare for All will get rid of these costs. In terms of overall health care spending, BidenCare will cost $750 billion over a decade. This is on top of current spending, which is projected at $42.9 trillion over the next ten years. Medicare for All will cost trillions less.