- The Washington Times - Wednesday, December 18, 2019

When Sen. Elizabeth Warren spars with rivals Thursday in a Democratic presidential debate in Los Angeles, she could be pulling some of her punches when it comes to championing “Medicare for All.”

In recent weeks, Ms. Warren has emphasized the idea of “choice” in her call for Medicare for All amid flagging public support for that type of government-run health care plan.

At a recent campaign stop in Iowa, Ms. Warren predicted that once Americans get a taste of what health care would look like under a government-run system, they’ll be all-in.

“When people have a chance to try it, when you’ve had the choice — nobody has to, but when you’ve had the choice and tried full health care coverage, then we’ll vote,” said Ms. Warren, Massachusetts Democrat. “And I believe America is going to say, ‘We like Medicare for All.’ “

For months during the campaign, Ms. Warren had taken the position that she was all in with Sen. Bernard Sanders of Vermont on Medicare for All. It was the must-have position for far-left candidates such as Ms. Warren and Mr. Sanders.

Ms. Warren’s new rhetoric also coincides with her slipping poll numbers.

After surging past former Vice President Joseph R. Biden in recent months in some polling, Ms. Warren has fallen off in recent weeks as she struggles to navigate the thorny politics of Medicare for All amid attacks from more moderate candidates like Mr. Biden and Mayor Pete Buttigieg of South Bend, Indiana.

The plan from Mr. Sanders, who famously says that he “wrote the damn bill” for Medicare for All, would transition the U.S. health care system to a national government-run plan in four years. His plan would all but abolish private insurance plans, with only limited options remaining for cosmetic and supplemental procedures.

Facing pressure to more clearly articulate her views, Ms. Warren unveiled plans in recent months to pay for her $20 trillion-plus proposal and to transition from the current system.

In her first 100 days, she would use a fast-track legislative procedure to pass a souped-up Medicare-type option for people over the age of 50. A Medicare-type option would offer free coverage for low-income families as well as children. Others could also opt in, though her campaign said the goal is to expand access for everyone eventually.

By her third year in office, she would pass legislation to “complete the transition” to a single-payer system where private insurance would essentially be abolished except in a limited or supplemental capacity. Certain private employer coverage could also be “grandfathered” in.

But the notion of “choice” in health care she’s touted recently is exactly the case that candidates like Mr. Biden and Mr. Buttigieg have made when they argue against Ms. Warren’s vision and tout their plans that call for a Medicare-like public option.

“It’s hard to be nuanced about it if people think ‘that’s Bernie Sanders’ Medicare for All, take away everybody’s health insurance,’” said Scott Ferson, a Massachusetts-based Democratic strategist. “It’s got a brand to it that she attached herself to. [It’s] hard to say, ‘Well, I mean something different than that.’”

Asked about the new language, Ms. Warren told reporters she’s just talking about her plan and wants to make sure people understand it.

“The part I talk about the most is what I want to see happen — and that is the most help to the most people as quickly as possible,” she said. “That’s a choice for everyone to make.”

But the comments come amid recent polling that shows the public isn’t necessarily behind a single-payer system.

In a Fox News poll released this week, 41% of U.S. voters said they would back getting rid of private health insurance and moving to a government-run system, compared to 53% who were opposed.

In a poll taken in October, the public was split on moving to a government-run system, with 47% in favor and 47% opposed.

“She’s in a bit of a box here, and she’s got to get some moderation into this as some difference,” said Floyd Ciruli, a Colorado-based pollster. “On the other hand, it likely will produce some resistance and potential backlash from Bernie’s people.”

Mr. Biden and Mr. Buttigieg are the top-polling contenders who have warned that a transition to Medicare for All would be too big of a shock to the system.

Buttigieg campaign spokesman Sean Savett said that in line with the visions of Ms. Warren and Mr. Sanders, Mr. Buttigieg’s health care plan — dubbed “Medicare for All Who Want It” — would accomplish “universal access to affordable coverage” for all Americans.

“The difference is Pete’s plan also preserves health care choice for all Americans,” Mr. Savett said.

Other than Mr. Sanders, the leading contenders for the nomination have put some distance between themselves and Ms. Warren’s vision.

Tech entrepreneur Andrew Yang has indicated that he supports the “spirit” of Medicare for All, but he laid out a more targeted set of health care policy priorities this week with more of a focus on prescription drug costs and enhanced technology.

“We’re having the wrong conversation on health care,” Mr. Yang said. “We are spending all our time arguing over who wants to cover Americans more. We talk about how we’re going to pay for it, when we already are. What we need to address are the underlying problems driving unaffordability and access.”

Ms. Warren, Mr. Sanders, Mr. Biden, Mr. Buttigieg and Mr. Yang will join Sen. Amy Klobuchar of Minnesota and billionaire former hedge fund manager Tom Steyer on stage Thursday evening in Los Angeles to hash things out.

“She’s got to convince people in New Hampshire that she’s not going to take their health care away,” Mr. Ferson said. “She’s got to figure that out.”

But health care could ultimately become Ms. Warren’s Achilles’ heel, said Chip Felkel, a South Carolina-based GOP strategist.

“I think she’s trying to get some footing on this throwing out the word choice because she thinks that [can] appeal to some folks that may be turned off by Medicare for All,” Mr. Felkel said. “But she can’t have it both ways, and legislatively it’s dead at the door.”

• David Sherfinski can be reached at dsherfinski@washingtontimes.com.

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