The lag in unveiling a payment plan speaks to the difficult position Warren is in: She can either offer some kind of large tax above her wealth tax on the very rich or be pegged as evasive about a major element of her platform. Both carry political risks.
“The cheapest possible way to make sure that everyone gets health care is Medicare-for-all,” the senator from Massachusetts said at the end of a town hall in Indianola, attended by about 475 people. “What I see, though, is, we need to talk about costs.” Over “the next few weeks,” Warren added, she will offer a proposal for “specifically how we pay for it.”
The Medicare-for-all legislation introduced by Sen. Bernie Sanders (I-Vt.) in 2017 does not lay out how the proposal would be funded. A separate “white paper” proposed some ideas, like a 4 percent “premium” paid by families making more than $29,000 per year.
Sanders has not shied away from telling voters they will have to pay higher taxes under a Medicare-for-all plan. But, he’s said, that cost would be more than offset by other savings.
“At the end of the day, the overwhelming majority of people will save money on their health-care bills,” Sanders said at last week’s debate in Ohio. “But I do think it is appropriate to acknowledge that taxes will go up. They’re going to go up significantly for the wealthy. And for virtually everybody, the tax increase they pay will be substantially less than what they were paying for premiums and out-of-pocket expansions.”
Warren supports the Medicare-for-all bill unveiled by Sanders. But so far, she’s refused to say taxes will go up for middle-class families, even when asked directly.
As a result, she has been taking fire on the cost question from her Democratic rivals. In a Sunday interview with CNN’s Jake Tapper, South Bend, Ind., Mayor Pete Buttigieg scoffed at the idea that Warren might use “pay-fors” previously sketched out by Sanders.
“We need to see how this is going to be paid for,” Buttigieg said. “Right now, whether you copy-paste the Bernie Sanders math or do it some other way, there is a hole amounting to trillions of dollars in how this is supposed to work.”
Single-payer advocates have been frustrated by the tax and cost debate, pointing out that the cost of the entire program — usually pegged at $30 trillion over 10 years — does not factor in how much taxpayers shell out for insurance under the current system.
“The single-payer taxation debate constantly, frustratingly, refuses to differentiate between literal compulsory taxes and virtually compulsory private taxes — premiums, hospital bills, etc.,” said Timothy Faust, author of the Medicare-for-all tract “Health Justice Now,” and a supporter of single-payer insurance. “The only reason to advocate for the public option is if you fundamentally believe that it is important to keep insurance companies profitable.”
Warren said Sunday that current estimates show Medicare-for-all will cost “trillions and trillions” of dollars, and added that “there are a lot” of potential revenue streams.
She also said that she’s been working on her plan to pay for the proposal for “months and months.” She added: “It’s just a little more work until it’s finished.”
Warren, using a double negative, repeated a pledge that she won’t sign a bill into law that “does not reduce the cost of health care for middle class families.”
When asked by a reporter after her town hall if her plan would include taxes on the middle class, Warren declined to answer saying: “The whole plan will be out — you’ll be able to look at it.”