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Capitol Ideas: Democrats' health care debate crucial and likely here to stay

U.S. Rep. Tulsi Gabbard, D-Hawaii, talks during an AARP/Des Moines Register presidential candidates forum Wednesday at The Hotel at Kirkwood Center in Cedar Rapids. At five presidential forums last week, candidates answered questions on topics ranging from funding for cancer research to prescription drug costs and Social Security regulations. Many took the opportunity to discuss their ideas for health care. (Rebecca F. Miller/The Gazette)
U.S. Rep. Tulsi Gabbard, D-Hawaii, talks during an AARP/Des Moines Register presidential candidates forum Wednesday at The Hotel at Kirkwood Center in Cedar Rapids. At five presidential forums last week, candidates answered questions on topics ranging from funding for cancer research to prescription drug costs and Social Security regulations. Many took the opportunity to discuss their ideas for health care. (Rebecca F. Miller/The Gazette)

The only thing hotter than the health care debate in the Democratic presidential primary last week were the temperatures in Iowa.

Gosh, it was hot here. Wasn’t it? I can’t wait until we’re closer to the caucuses and complaining about how cold it is.

But while the temperatures in Iowa have cooled off, don’t expect the same to happen with the Democrats’ health care debate anytime soon. This discussion seems destined to have staying power.

It’s not surprising that the presidential hopefuls want to connect with potential caucusgoers on what is, from talking to them at campaign events, their top issue. Last week gave them that opportunity with the series of five forums hosted in Des Moines, the Quad Cities, Cedar Rapids, Sioux City and Council Bluffs, by AARP and the Des Moines Register, and U.S. Sen. Bernie Sanders’ speech on his Medicare-for-all proposal.

The candidates are starting to distinguish themselves — and their health care plans — as this caucus campaign wears on. The buzz words “affordable, quality access” no longer are sufficient as candidates are unveiling specific policy proposals with varied levels of details.

Some lanes seem to be forming, with candidates such as Sanders and U.S. Sen. Elizabeth Warren proposing Medicare-for-all; others, such as U.S. Sens. Cory Booker and Kamala Harris, are proposing more modest steps in the interim en route to Medicare-for-all; and still others, such as former Vice President Joe Biden and U.S. Sen. Amy Klobuchar, are calling for expansion of the Affordable Care Act through the addition of a public option.

The devil is in Iowa — it was hot last week, I tell you — and in the details. The candidates should and will face further questions about their health care plans. Will they lower premiums and copays? How will they affect current government programs such as Medicare and Medicaid? How would they be financed? And is there any hope of getting any of these plans passed without unified Democratic control?

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We still have about 200 days until the Iowa caucuses. So there is plenty of time for the candidates to face those questions.

One debate that will be interesting to watch unfold is what kind of health care policy will best serve the Democratic candidate in next year’s general election.

Some candidates, including former U.S. Rep. John Delaney and U.S. Sen. Michael Bennet, have argued the Democrats should not embrace Medicare-for-all. Delaney has gone so far as to say if the Democrats campaign on Medicare-for-all in 2020, they will lose again to President Donald Trump.

Republicans already are hammering on the term socialism to argue against the Democrats’ policies. A candidate who embraces a government-run health care program could feed into that narrative.

Sanders argues a majority of Americans will embrace Medicare-for-all because it detaches from insurance companies that are built to profit, and because he says it would eliminate premiums, deductibles and copays.

Electability, whatever that means to each caucusgoer and voter, is one of the top qualities Democrats are looking for in their nominee. It’s easy to imagine a candidate’s health care policymaking up a large share of voters’ electability formula.

Whether that favors any type of health care plan over the other remains to be seen, and is something reporters like yours truly will be asking about at campaign events in the weeks and months ahead.

Erin Murphy covers Iowa politics and government for Lee Enterprises. His email address is erin.murphy@lee.net. Follow him on Twitter at @ErinDMurphy.

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