Democratic health care experts are fretting that the fight over Sen. Kamala Harris’ plan, and the broader battle over Medicare for All, threatens to eclipse voters’ biggest health policy priorities. | John Locher/AP File Photo 2020 Elections Kamala's rivals seize on health care stumbles She's getting hit from all sides as her poll numbers are dropping.

Kamala Harris offered her health care plan expecting to bridge the party’s divides and decisively answer doubts about her see-sawing positions.

But in the month since, the California Democrat is still struggling to rebut attacks from her chief rivals who are poking holes in its specifics and accusing Harris of putting political calculation before true conviction. Joe Biden’s campaign dismisses it as a “have-it-every-which-way” plan while Bernie Sanders’ camp ripped it as “cobbled together to address various poll numbers.”


Harris’ universal coverage plan has been praised by more than a dozen health policy wonks and former Obama administration officials, including some who prefer it to Sanders’ version of Medicare for All. But politically, it's been a muddle: It's testing whether a senator not known for her health care expertise has the dexterity to thread the needle between Sanders and Biden on a complicated policy. And it’s accelerated questions about why Harris supported Sanders’ plan for nearly two years, standing with him at the 2017 unveiling, before admitting this week to long harboring doubts about the Vermont senator’s proposal.

For Harris, the health care morass is also threatening to become an ominous symbol for why, after her surge following the first debate, she's fallen back since early July to where she started. She now polls closer to Pete Buttigieg and Beto O'Rourke than Sanders and Elizabeth Warren.

“I believe that when Senator Harris is confident in what she’s saying and what she believes, she’s very good,” said Rebecca Katz, a Democratic strategist aligned with progressives. “I am just not sure what she believes when it comes to Medicare for All.”

The questions swirling around Harris’ health plan come amid an intensifying battle within the Democratic Party to define Medicare for All. Sanders’ campaign argues his is the only pure version, with the senator touting an aggressive plan to transition the entire U.S. health system to a government-run health program within four years. Sanders' campaign pushed back Thursday against a report that he was adjusting his plan in the face of union opposition, which the campaign denied. Under Sanders' newly released labor proposal, unions would renegotiate their contracts to capture wages or benefits they sacrificed for more generous health packages, since those plans would disappear under Medicare for All.

Multiple presidential contenders have sought to capitalize on the seeming popularity of the term "Medicare for All" among voters — while distancing themselves from raising taxes on the middle class and eliminating private insurance companies, which critics say it would do.

The issue has been driven by a narrow fight in the Democratic primary, said Larry Levitt of the Kaiser Family Foundation, which has conducted polls and interviews on how voters are responding to Medicare for All proposals.

“There is a group of activist voters who are very focused on whether a candidate is supporting Medicare for All, and beyond that what flavor of Medicare for All he or she is supporting,” Levitt said.

But most voters aren’t focused on the nuances, he added.

The internecine battle over Medicare for All could backfire on the eventual nominee. Biden, Harris and Sanders have all leveled attacks that Republicans could repurpose in the general election. The focus also means Democratic candidates have spent less time in debates and on the campaign trail talking about issues like high drug prices and the Trump administration’s efforts to scuttle the Affordable Care Act altogether

But the Democratic infighting isn't likely to subside anytime soon. And Harris isn’t the only candidate facing questions about her health plan.

Biden, who wants to create a government-run alternative while preserving a role for private insurers, almost flippantly suggested that his administration could “easily” add a public option, a decade after the Obama administration was forced to retreat from the idea despite having full control of Congress. Biden’s plan as written also would leave 10 million people uninsured.

Meanwhile, Sanders and Warren continue to face questions about higher taxes, which Sanders has been more open to acknowledging.

But Harris has given her opponents more ammunition than any other candidate. Early in the campaign, while still running on Sanders’ plan, she wavered on whether she favored eliminating private insurance. Harris raised her hand at June’s debate, suggesting she supported abolishing private insurers, but the next day said she had misinterpreted the question.

In Iowa and Nevada in recent weeks, Harris said she decided to issue her own plan after conversations on the trail — with union members who wanted a longer runway to serve out their bargained health plans and with people who don’t want to abolish private insurers. Compared to Sanders’ proposal, Harris’ plan has a longer, 10-year implementation period, and maintains a role for private insurers by building on the existing Medicare Advantage program.

Addressing her pivot away from Sanders' plan, Harris argued at a union forum earlier this month that other Democratic hopefuls have also embraced different health care plans over time.

“Most of us, I’ll speak for myself, say, ‘Hey, it’s a good idea. I support it.’ The question becomes, ‘Is it the best idea?’” Harris added. “And, for me, that Medicare plan that almost everyone has signed off on, I realized it’s just not the best plan. And so, I decided to come up with my own.”

But at a fundraiser in the Hamptons last weekend, Harris acknowledged to donors that “over the course of many months, I’ve not been comfortable with Bernie's plan, the Medicare for All plan.” The admission — in front of a pool of wealthy supporters — called into question why Harris cosponsored Sanders’ bill in 2017 and remained a supporter for so long in the first place.

Sanders’ campaign pounced. Sanders tweeted about the Hamptons remarks and his speechwriter, David Sirota, accused Harris and other Democrats of letting Donald Trump off the hook while “attacking the Medicare for All framework that now has the support of the majority of Democratic lawmakers in the U.S. House.”

“The Harris flip-flop is a reminder that while Medicare for All received an enthusiastic response at Bernie’s Fox News townhall in Bethlehem, Pennsylvania,” Sirota wrote in his newsletter, “it doesn’t get that kind of response on the big-dollar fundraising circuit in the Hamptons.”

Harris spokesman Ian Sams responded that while other candidates may want to “play politics” or “implement ideological purity tests” on this issue, Harris is focused on getting the policy right.

“Her plan covers everyone, ends co-pays and deductibles, gives Americans a choice between public and private plans, and forces insurance companies to stop ripping people off,” Sams said in a statement. “Experts agree this is the best plan to get us to universal coverage, and in 2019, Democrats should be laying out a bold vision to cover every American while being responsive to people's real concerns about how we get there.”

Democratic health care experts are fretting that the fight over Harris’ plan, and the broader battle over Medicare for All, threatens to eclipse voters’ biggest health policy priorities.

“I definitely do not think they should be fighting about this,” said Arielle Kane, who directs health policy for the Progressive Policy Institute. “The public as a whole does not understand the nuances of health care policy — they just want to know the candidates’ big ideas and values. Can they shop? Is it free? Will they be protected financially?”