Why Everyone Was Arguing Over Kamala Harris' Medicare For All Plan At The Debate

Healthcare took center stage during the first half of the Democratic presidential primary debate for the second night in a row on Wednesday. Specifically, the candidates participating in the CNN event duked it out over disagreements with California Sen. Kamala Harris' version of Medicare for All.

Medicare for All, a progressive proposal that existed on the political fringes as recently as the 2016 presidential election but has since gone mainstream, was popularized by Vermont Sen. Bernie Sanders. The measure, which advocates say would lower healthcare costs, would transition everyone in the United States to a single government-run health insurance plan — similar to dozens of countries that have "universal healthcare" systems. Right now, there are about 28.5 million people in the U.S. who are uninsured.

Several other candidates, including Massachusetts Sen. Elizabeth Warren and New York City Mayor Bill de Blasio, have supported the proposal. However, Harris' plan, which she unveiled earlier this week, stops short of completely overhauling the U.S. healthcare system and eliminating private-run insurances like Sanders' does.

"KamalaCare" would not rely on a government-run, single-payer healthcare system modeled after traditional Medicare like Sanders' proposal. Instead, the plans offered in Harris' proposal are based on Medicare Advantage, which is run by private insurers. “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,” Harris wrote in a Medium post announcing the proposal. “If they want to play by our rules, they can be in the system. If not, they have to get out.”

Harris’ plan also seeks to offer coverage to most Americans by allowing them to buy into an expanded version of Medicare. The transition to a new healthcare system would take about 10 years. "I listened to the American families who said four years is just not enough to transition into this new plan, so I devised a plan where it's going to be 10 years of a transition," she said on stage at the debate. "I listened to American families who said I want an option that will be under your Medicare system that allows a private plan."

The private insurance part of the plan has brought criticism. For advocates of Sanders' plan, Harris is trying to play it both ways: Capture the hearts of progressives who believe in a single-payer system and please major players in the healthcare industry.

At the same time, moderates like former vice president Joe Biden and Colorado Sen. Michael Bennet also pushed back against Harris' plan because they believe in expanding the Affordable Care Act, also known as Obamacare, rather than starting over. Most centrist candidates say the private insurance industry is a crucial component of the healthcare system itself, and therefore eliminating it would cause more harm than good.

Bennet specifically pointed out that Harris' plan would ban employer-based health insurance. Harris acknowledged this and replied: "What [the plan] does is it separates the employer from healthcare," adding, "the kind of healthcare you get will not be a function of where you work."

The Sanders camp was not happy with how the candidates on stage Wednesday discussed his healthcare proposal. “Joe Biden and Kamala Harris are on stage right now, trying to maneuver their way around Democatic voters’ support for Medicare for All while continuing to court pharma and insurance industry donors,” Sanders' campaign manager Faiz Shakir said in a statement provided to Refinery29. “If these candidates are serious about addressing the fundamental problem with the healthcare system, they should join Senator Sanders in the No Health Insurance and Pharma Money Pledge and show that they’ll put patients ahead of profits.”