Q51: Do you have a plan to protect and ensure the coverage for over 20 million people who now have health care through the Affordable Care Act? Also, what is your plan to provide affordable quality health care to the millions of uninsured who are not yet covered?
Biden: Yes. The reason President Obama and I fought so hard for the Affordable Care Act was to make sure that the peace of mind provided by health insurance is a right for all, not a privilege. As president, I will fight to defend and build upon the Affordable Care Act to ensure every American has access to quality, affordable health care. My plan takes a number of steps to build on Obamacare, including allowing Americans who are uninsured or who don’t like their coverage to buy into a Medicare-like public option. My plan also increases premium tax credits so more people will have lower premiums and lower deductibles. My health care plan is the quickest, most effective way to achieve universal health care at 1/30th the cost of Medicare for All.
Access to affordable health insurance shouldn’t depend on your state’s politics. But today, state politics is getting in the way of coverage for millions of low-income Americans. Governors and state legislatures in 14 states have refused to take up the Affordable Care Act’s expansion of Medicaid eligibility, denying access to Medicaid for roughly 4 million adults – including in Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina and Texas. My plan will ensure these individuals get covered by offering premium-free access to the public option for those 4.9 million individuals who will be eligible for Medicaid but for their state’s inaction, and making sure their public option covers the full scope of Medicaid benefits. States that have already expanded Medicaid will have the choice of moving the expansion population to the premium-free public option as long as the states continue to pay their current share of the cost of covering those individuals. Additionally, I will ensure people making below 138% of the federal poverty level get covered. I’ll do this by automatically enrolling these individuals when they interact with certain institutions (such as public schools) or other programs for low-income populations (such as SNAP). View full details of my plan to protect and expand the Affordable Care Act HERE.
Bloomberg: Yes. Health care in the United States costs too much. It leaves too many people uninsured; eats into workers’ wages, public budgets, and employers’ bottom lines; and puts vulnerable families one medical emergency away from financial ruin. Health care costs are also the top financial concern for American families.
The ACA made great strides in helping people who don’t get health insurance through an employer afford coverage in the individual market. Mike would reverse the Trump administration’s attempts at sabotage: He would expand enrollment efforts, restrict the sale of health plans that don’t meet ACA standards, and defend the law against politically motivated lawsuits. He would expand subsidies to cap premiums at 8.5% of a household’s income. He would create a permanent reinsurance program that, by helping insurers with the largest claims, would reduce customer premiums roughly 10%.
Buttigeig: Yes. Through my Medicare for All Who Want It plan, everyone will be able to opt in to an affordable, comprehensive public alternative. This affordable public plan will incentivize private insurers to compete on price and bring down costs. If private insurers are not able to offer something dramatically better, this public plan will create a natural glide-path to Medicare for All. The choice of a public plan empowers people to make their own decisions regarding the type of health care that makes sense for them by leveling the playing field between patients and the health care system. It gives the American people a choice and trusts them to set the pace at which our country moves in a better direction on health care.
De La Fuente: We will expand upon the Affordable Care Act.
Klobuchar: Yes. Senator Klobuchar supports bringing down the cost of health care for everyone by putting a non-profit public option in place that allows people to buy into affordable health insurance coverage through Medicare or Medicaid. She believes that the Affordable Care Act is a beginning, not an end and she has fought the Trump Administration’s efforts to dismantle the Affordable Care Act and opposes the Administration’s efforts to kick people with pre-existing conditions off of their health insurance. As President, Senator Klobuchar will build on the Affordable Care Act and help bring down costs for consumers by expanding premium subsidies, creating additional incentives for states to adopt the Medicaid expansion, and providing cost-sharing reductions to lower out-of-pocket health care costs like copays and deductibles. And she will stand up to risky schemes to privatize Medicaid and protect and strengthen Medicare beginning by ending the ban on Medicare negotiating drug prices on behalf of 43 million seniors in Medicare Part D.
Sanders: Yes. Bernie is running for president because the time is long overdue for the United States to join every other major country on Earth and guarantee health care to all people as a right, not a privilege, through a Medicare for All program. Bernie’s Medicare for All program will guarantee comprehensive health care to everyone in this country, including the nearly 4 million uninsured Black Americans. Health care is not a commodity. It is a human right. The goal of a health care system should be to keep people well, not to make stockholders rich. Bernie’s Medicare for All program would provide comprehensive health coverage to all with no premiums, deductibles, copayments, or surprise bills.
Black women are three and a half times more likely to die from pregnancy than white women and almost twice as likely to be uninsured. One of the big reasons for that is uninsurance and underinsurance. Medicare for All will provide free, comprehensive maternity care and end uninsurance in this country. A big issue impacting this disparity is the lack of health care providers who are African American.
We will make massive investments train and hire more health care providers of color. We need more doctors who are people of color, more dentists, more nurses, more psychologists to provide culturally competent care in their communities.
And we will invest in our health care infrastructure including community health centers to ensure underserved communities of color can receive that culturally competent care in their community.
Steyer: Yes. I do — and I believe we can improve it. The Affordable Care Act provided needed protections for people with preexisting conditions, enabled young people to remain on their parents’ plan through age 26, and established an open marketplace for individuals and small businesses to purchase insurance. All of these things expanded access to healthcare, and ensured that significantly more Americans will have basic health coverage when they are healthy, and be cared for when they are not. But 4.9 million Americans still lack coverage due to the cruelty of the Republican-controlled state governments that failed to expand Medicaid under the ACA. I will immediately offer fully subsidized enrollment in the public option for any qualifying individual who should be covered under an expanded Medicaid.
The Affordable Care Act allows individuals and families earning between 138% – 400% of the Federal Poverty Line to receive a premium tax credit to help defray the cost of coverage. The subsidy is calculated on a sliding scale. Make one single dollar above the threshold, however, and the financial assistance disappears. This “subsidy cliff” leaves middle class seniors paying upwards of 20% of their income on premiums with no assistance.
My plan will cap the percentage of income any enrollee spends on their care to make this system more equitable. Those making between 138-400% of the Federal Poverty Line would continue to receive subsidies on a sliding scale, and those making above 400% of the Federal Poverty Line would spend a maximum of 8.5% of their total income on their health care premiums.
Warren: Yes. The Affordable Care Act made massive strides in expanding access to health insurance coverage, and we must defend Medicaid and the ACA against Republican attempts to rip health coverage away from people. But it’s time for the next step. The cost of health care is crushing American families, even those with good insurance. Last year 37 million American adults didn’t fill a prescription, 36 million people skipped a recommended test, treatment, or follow-up, and 40 million people didn’t go to a doctor to check out a health problem — all because of costs. 57 million people had trouble covering their medical bills. An average family of four with employer-sponsored insurance spent $12,378 on employee premium contributions and out-of-pocket costs in 2018. And 87 million Americans are either uninsured or underinsured. And we know that people of color face significant barriers to getting the health care coverage they need and have higher uninsured rates than their white counterparts. Tens of millions of people are one bad diagnosis away from going broke—but they don’t have to be. The Affordable Care Act made massive strides in expanding access to health insurance coverage, and we must defend Medicaid and the Affordable Care Act against Republican attempts to rip health coverage away from people. But it’s time for the next step. Part One: Starting on day one of my presidency, I will protect people with pre-existing conditions, reverse the Trump administration’s sabotage of our health care system, and take immediate action to bring down the high costs of many common prescription drugs, including Insulin and EpiPens. Part Two: Within my first 100 days, I will push Congress to give everyone the choice to join an improved Medicare program that covers vision, hearing, mental health, dental, and long term care. I will accomplish this by lowering the Medicare age to 50, and giving everyone the opportunity to join a Medicare for All option that will be free for children under 18 and for millions of families making under double the poverty level (about $50,000 for a family of four). That’s a total of nearly 135 million Americans who could get free, high-quality coverage. Everyone else who wants to opt-in would pay a modest fee. Part Three: Once everyone has the chance to try out the improved Medicare option, I will push Congress, no later than her third year in office, to complete the transition to Medicare for All — to put $11 trillion back in the pockets of American families that will never pay another premium or deductible, without raising middle class taxes by one penny. In my administration, everyone in America will be able to see the doctor they need and be covered for vision, dental, hearing, and more—at little or no cost to them whatsoever. My plan will cover every single person in the U.S.—without raising taxes one penny on middle-class families. No more out-of-network costs, no surprises, and no one going broke because they get sick. You can read my plan to pay for Medicare for All here: https://elizabethwarren.com/plans/paying-for-m4a You can read my plan to transition to Medicare for All here: https://elizabethwarren.com/plans/m4a-transition
Q52: Do you have a plan to protect and expand Medicare and Medicaid?
Biden: Yes. I believe that Medicaid plays an absolutely critical role in our health care system and it must be protected and strongly funded going forward. As president, I will fight all efforts to undermine it – such as work requirements and other tactics to reduce enrollment. My Administration won’t let states skirt their duties under Medicaid and will take enforcement action against any state that allows profiteering to get in the way of Medicaid beneficiaries’ health. I will also take steps to ensure Medicaid’s beneficiaries can access home and community-based long-term care when they want it.
Governors and state legislatures in 14 states have refused to take up the Affordable Care Act’s expansion of Medicaid eligibility, denying access to Medicaid for an estimated 4.9 million adults. My plan will ensure these individuals get covered by offering premium-free access to the public option for those 4.9 million individuals who will be eligible for Medicaid but for their state’s inaction, and making sure their public option covers the full scope of Medicaid benefits. States that have already expanded Medicaid will have the choice of moving the expansion population to the premium-free public option as long as the states continue to pay their current share of the cost of covering those individuals. Additionally, I will ensure people making below 138% of the federal poverty level get covered. I’ll do this by automatically enrolling these individuals when they interact with certain institutions (such as public schools) or other programs for low-income populations (such as SNAP)
I will also protect and strengthen Medicare as we know it. The Affordable Care Act strengthened Medicare by extending the life of the Medicare Trust Fund; giving Medicare beneficiaries access to free recommended preventive services, such as an annual wellness visit; and closing the prescription drug coverage gap, often referred to as the “donut hole.” As president, I will continue to defend our nation’s commitment to older Americans and people with disabilities through Medicare. I will keep Medicare as a separate and distinct program and ensure there is no disruption to the current Medicare system. View details of my plan to protect and expand Medicare and Medicaid HERE.
Bloomberg: Yes. Mike will protect and build upon Medicare and Medicaid. He will cap out-of-pocket drug expenditures in Medicare and expand the program to include an optional policy covering dental, hearing, and vision care. He would also require states to cover oral health services for adults in Medicaid. Mike will create a Medicare-like public option — health insurance that would be administered by the federal government but paid for by customer premiums. In rolling out this option, priority would go to the uninsured, including low-income people who are in states that haven’t expanded Medicaid under the ACA. A public insurance option would improve consumer choice and increase competition in the private insurance market, pushing down everyone’s premiums. People of modest means who buy the public option would be eligible for the same subsidies that would apply on the health insurance exchanges.. And he will allow people in states that haven’t expanded Medicaid under the ACA, who would otherwise be eligible, to enroll in the public-option free of charge.
Buttigeig: Yes. My plan improves Medicare and Medicaid in several ways. I will improve affordability in Medicare by capping out-of- pocket costs, with lower caps for low-income seniors. To support providers in underserved areas, such as rural communities, I will increase Medicare reimbursement rates and encourage states to increase Medicaid reimbursement rates. I will end Medicaid work requirements and automatically enroll in the public option all individuals with lower incomes in states that have refused to expand Medicaid. Other reforms to strengthen Medicaid include establishing mental health parity so Medicaid covers mental illness in the same way they cover chronic conditions like diabetes, and removing the Medicaid exception for people who are incarcerated. I will ensure that people with disabilities on Medicaid have access to care in their homes and communities, including by ending waitlists for waiver programs. My administration will also allow Medicaid to reimburse for wraparound services related to the social determinants of health.
De La Fuente: Yes. We will expand and modify the existing program.
Klobuchar: Yes. Senator Klobuchar opposes cuts and risky schemes to privatize Medicare and will take action to strengthen Medicare and find solutions so it remains solvent. She will improve Medicare for current beneficiaries by reforming payment policies through measures like site neutral payments and providing incentives for getting the best quality health care at the best price, including bundled payments and telehealth. And she will support new, expanded Medicare coverage for dental, hearing and vision care that makes these services affordable for all seniors. Senator Klobuchar will also stand up to efforts to cap Medicaid spending and conduct a reassessment of the guidelines the Centers for Medicare and Medicaid Services use in granting of Medicaid waivers for states that have or wish to privatize the program, cap the program, impose discriminatory work requirements or convert it into a block grant to stop waivers that harm Medicaid beneficiaries. As President, she will also provide significant additional incentives to push states to adopt the Medicaid expansion.
Sanders: Yes. Bernie Medicare for All program ensures comprehensive health care to everyone, regardless of race, class, disability, age, gender and sexual identity, and immigration status. When Bernie is in the White House, we will create a Medicare for All, single-payer, national health insurance program to provide everyone in America with comprehensive health care coverage, free at the point of service. Under Medicare for All there will be no networks, no premiums, no deductibles, no copays, no surprise bills.
Medicare coverage will be expanded and improved to include: include dental, hearing, vision, and home- and community-based long-term care, in-patient and out-patient services, mental health and substance abuse treatment, reproductive and maternity care, prescription drugs, and more.
And we will stop the pharmaceutical industry from ripping off the American people by making sure that no one in America pays over $200 a year for the medicine they need by capping what Americans pay for prescription drugs under Medicare for All.
Steyer: Yes. As president, I will provide a healthcare system that covers more Americans at a lower cost. I will repeal Trump’s rollbacks to the Affordable Care Act, enact a strong public option, and institute insurance industry rate review. My public option will enable the government to negotiate health care costs directly with medical groups and providers, just like Medicare does today.
By preserving the Affordable Care Act and introducing a public option we can use the negotiating power of the government to dramatically lower costs, including for prescription drugs and premiums. We can provide quality medical care to millions more families and individuals while allowing Americans to keep their employer-based health care if they choose to do so. I don’t believe in forcing people to give up their health care if it works well for them and their families — and I don’t think we should give corporations another chance to push more of their own costs onto American taxpayers. A public option will expand coverage while making healthcare much more affordable and improving system quality, deliverability and accountability.
In my healthcare framework, individuals who receive their care through a large employer’s plan could opt into the public option if it is better for their needs. For businesses with greater than 50 employees, there would be a penalty payment to help defray the cost of that enrollee’s plan. My plan would also grow the Small Business Health Options Plan (SHOP) and allow businesses with fewer than 50 employees to opt into the public option or choose to offer the private plan.
Warren: Yes. The Affordable Care Act made massive strides in expanding access to health insurance coverage, and we must defend Medicaid and the ACA against Republican attempts to rip health coverage away from people. But it’s time for the next step. The cost of health care is crushing American families, even those with good insurance. Last year 37 million American adults didn’t fill a prescription, 36 million people skipped a recommended test, treatment, or follow-up, and 40 million people didn’t go to a doctor to check out a health problem — all because of costs. 57 million people had trouble covering their medical bills. An average family of four with employer-sponsored insurance spent $12,378 on employee premium contributions and out-of-pocket costs in 2018. And 87 million Americans are either uninsured or underinsured. And we know that people of color face significant barriers to getting the health care coverage they need and have higher uninsured rates than their white counterparts. Tens of millions of people are one bad diagnosis away from going broke—but they don’t have to be. The Affordable Care Act made massive strides in expanding access to health insurance coverage, and we must defend Medicaid and the Affordable Care Act against Republican attempts to rip health coverage away from people. But it’s time for the next step. Part One: Starting on day one of my presidency, I will protect people with pre-existing conditions, reverse the Trump administration’s sabotage of our health care system, and take immediate action to bring down the high costs of many common prescription drugs, including Insulin and EpiPens. Part Two: Within my first 100 days, I will push Congress to give everyone the choice to join an improved Medicare program that covers vision, hearing, mental health, dental, and long term care. I will accomplish this by lowering the Medicare age to 50, and giving everyone the opportunity to join a Medicare for All option that will be free for children under 18 and for millions of families making under double the poverty level (about $50,000 for a family of four). That’s a total of nearly 135 million Americans who could get free, high-quality coverage. Everyone else who wants to opt-in would pay a modest fee. Part Three: Once everyone has the chance to try out the improved Medicare option, I will push Congress, no later than her third year in office, to complete the transition to Medicare for All — to put $11 trillion back in the pockets of American families that will never pay another premium or deductible, without raising middle class taxes by one penny. In my administration, everyone in America will be able to see the doctor they need and be covered for vision, dental, hearing, and more—at little or no cost to them whatsoever. My plan will cover every single person in the U.S.—without raising taxes one penny on middle-class families. No more out-of-network costs, no surprises, and no one going broke because they get sick. You can read my plan to pay for Medicare for All here: https://elizabethwarren.com/plans/paying-for-m4a You can read my plan to transition to Medicare for All here: https://elizabethwarren.com/plans/m4a-transition
Black Women's Roundtable 2020 Election Voter Guide 