Kamala Harris speaking in New Orleans at the Essence Fest July 6, 2019
Photo: Paras Griffin (Getty for Essence)

A day before the myriad Democrats vying to unseat Donald Trump face off in a second set of debates, presidential hopeful and California Sen. Kamala Harris put forth a plan to gradually move the nation to a “Medicare for all” health insurance system.

The keyword is “gradually.” Unlike “Medicare for All” plans put forth by Harris’ rivals for the Democratic nod, most notably Vermont Sen. Bernie Sanders, Harris wouldn’t as quickly put an end to the kind of private health insurance that most people in the nation have through their jobs.

Instead, as the New York Times reports, Harris on Monday called for a 10-year adoption of her plan, with gradual buy-in by those who are covered by private insurance.

In addition, Harris’ plan, for the most part, would not be run by the federal government, but instead by private health insurance companies, much like how current plans under Medicare Advantage work. Folks would get to choose which plan they wanted to be on. As the Times explains, cost savings happen under Medicare Advantage because it:

offers extra benefits and limits out-of-pocket costs but is strict about which doctors and hospitals enrollees can use.

“Essentially, we would allow private insurance to offer a plan in the Medicare system, but they will be subject to strict requirements to ensure it lowers costs and expands services,” Ms. Harris wrote in a post on Medium. “If they want to play by our rules, they can be in the system. If not, they have to get out.”

Ms. Harris’s plan would also allow people to choose a somewhat expanded version of traditional, government-run Medicare. But by preserving a major role for private insurers — and calling for a 10-year phase-in period instead of the four-year transition that Mr. Sanders envisions — it could potentially draw less opposition than Mr. Sanders’s plan from insurance companies, many of which have profited handsomely from Medicare Advantage plans.

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Harris’ announcement Monday appeared to seek to clarify her position on health care, an issue about which, as Reuters notes, “Harris had been muddled about in the past.”

And Harris’ proposal will likely still draw criticism from those on the left and the right of the issue.

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As Reuters explains:

Forceful single-payer advocates such as Sen. Bernie Sanders are averse to participation from corporate health insurers, while moderates like former Vice President Joe Biden have warned that Medicare for all would be too disruptive, particularly for the many Americans who get healthcare through their employers.

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Sanders’ camp on Monday immediately pushed back on Harris’ plan, telling the Times:

“Call it anything you want, but you can’t call this plan Medicare for All,” Sanders campaign manager Faiz Shakir said. “Folding to the interests of the health insurance industry is both bad policy and bad politics.”

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A total of 20 Democratic candidates will debate in Detroit over two nights, on Tuesday and Wednesday beginning at 8 p.m.