Kamala Harris’s statements on private insurance are incoherent

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Sen. Kamala Harris, D-Calif., made an attempt to “clarify” her remarks calling for eliminating private insurance, but in the process, she just created more confusion.

During a CNN town hall in January, Harris drew headlines for endorsing the elimination of private health insurance. It was the pretty clear takeaway from her comments, and she seemed comfortable at the time with the image it conveyed of her being an unapologetic progressive leader. But perhaps fearing in retrospect that she got a little ahead of her skis, she attempted to explain away the comments in an interview with Jake Tapper on Sunday’s “State of the Union.”

She now claims that when she called for eliminating private insurance, “It was in the context of saying, let’s get rid of all the bureaucracy. Let’s get all of the waste … If you watch the tape, I think you’ll see that there are obviously many interpretations of what I said. What I meant is, let’s get rid of the bureaucracy.”

Okay, so let’s go back to the videotape.

In the town hall, Tapper said, “Correct me if I’m wrong, to reiterate, you support the ‘Medicare for all’ bill, I think initially sponsored by Sen. Bernie Sanders, you’re also a co-sponsor.” After Harris indicated that is true, Tapper said, “I believe it will totally eliminate private insurance. So people out there who like their insurance, they don’t get to keep it?”

At that point, Harris, who prides herself on being a tough prosecutor who is exacting with her choice of words, could have argued that she did not support getting rid of private insurance, or argued that the bill she supported did not do that.

Instead, she followed up with, “Listen, the idea is that everyone gets access to medical care and you don’t have to go through the process of going through an insurance company, having them give you approval, going through all the paperwork, all of the delay that may require,” Harris said. “Who of all us have not had that situation where you have to wait for approval and the doctor says, ‘I don’t know if your insurance company is going to cover this?'” She continued, “Let’s eliminate all of that. Let’s move on.”

So again, she was asked a direct question about eliminating private insurance, and rather than say she didn’t want to do so, her follow up was to make a common argument for why the healthcare system would be more efficient without private coverage and then to call for eliminating “all of that.”

The problem is, even if we charitably interpret her initial statements as referring to streamlining bureaucracy, it doesn’t address her support of Sanders’ “Medicare for all” bill, which would essentially eliminate private insurance.
Specifically, the plan would bar the sale of private insurance, either directly to individuals or through employers, that duplicates any of the benefits of the government-run plan. While the proposal thus theoretically leaves open the door for private coverage, in reality, the benefits promised by the government-run plan are so broad, that the private plans would only be a niche market for a small number of services.

What’s odd is that when pressed by Tapper on this point on Sunday, Harris made two points that cut against each other.

To rebut Tapper’s interjection, “But the bill gets rid of insurance,” Harris says, “But — no, no, no, no, it does not get rid of insurance. It does not get rid of insurance.”

This exchange follows:

TAPPER: Well, because the bill gets rid of private insurance for everything that…

HARRIS: It doesn’t get rid of supplemental insurance for…

TAPPER: Right, for cosmetic surgery, but for all…

HARRIS: So, it doesn’t get rid of all insurance.

TAPPER: OK. It doesn’t get rid of all insurance.

HARRIS: OK. Right.

So basically, her big argument that it’s wrong to say her plan would eliminate private insurance is that people will then be able to have supplemental coverage. But then — because private insurance could not offer any benefits covered by the government — as she goes on to explain all the benefits of the new government-run plan, she’s actually simultaneously shrinking the role of private coverage under the new system.

After Tapper noted that private insurers wouldn’t be able to cover essential benefits, Harris said, “the answer to that question is because ‘Medicare for all’ and the vision of what it will be includes an expansion of coverage. So, ‘Medicare for all’ will include vision. It will include dental. It will include hearing aids.”

The problem for Harris is that the whole reason why people care about the issue of eliminating private insurance is that there are currently nearly 180 million people who have private coverage for their essential benefits that they are mostly happy with. That’s why the question of “what’s going to happen to private insurance” is pertinent. It’s not like people worried about losing their coverage in a socialized health insurance model are going to be reassured by the fact that several years down the road, there may be an opening for them to purchase a plan to cover some cosmetic surgery. They’re worried about losing their current plan, and what that might mean for their choice of doctors and hospitals.

What makes Harris’s position particularly incoherent is her response to Tapper’s follow up — what happens to the generous healthcare plans that unions negotiated, often at the expense of higher salaries?

Harris responded, “Well, listen, let me just tell you something. I completely agree with those members of organized labor who have negotiated for plans and have, in those negotiation processes — processes, often give what could have been higher wages in exchange for a higher coverage for healthcare … And we have got to — we have to address that. It’s a legitimate concern which must be addressed.”

And what, exactly, would be done to address it?

During the Obamacare fight, Democrats negotiated a special carve out that delayed the Cadillac tax on generous employer healthcare plans for unions. This ended up being held up as an example of the backroom special interest deals that triggered a backlash against the law, and eventually, the delay of the tax’s implementation was extended to everybody. It was subsequently delayed again, and isn’t scheduled to go into effect until 2022.

It’s very unclear how Harris would “address” the issue with unions without running into a similar problem, only on a much larger scale. Anybody with job-based insurance could argue that their employers could have paid them higher salaries were it not for the increases in healthcare costs, so why shouldn’t they be entitled to the same deal as unions?

Harris’s earlier strategy of clearly opposing private insurance, while carrying risks, carried the benefit of exuding a certain confidence and clarity. Now, she’s a muddle, protesting that she isn’t for eliminating private insurance, even though the plan she supports would clearly do so as far as most normal people would be concerned. So she now risks looking incoherent, without really taking away the ability of Republicans to attack her for backing the elimination of private insurance.

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