Elizabeth Warren has a plan — to annoy union members who work for state and local governments. With her “Medicare for All” plan, the top-tier Democratic contender is revealing a tension in the neo-progressive movement.
Warren’s $20.5 trillion over a decade to pay for Medicare for All requires what she calls a “redirection” in funds: $6 trillion in “existing state- and local-government insurance spending.” Of this figure, $3.3 trillion goes for Medicaid, public insurance for poorer people.
But the other $2.7 trillion comes from the funds state and local governments “currently spend on employer contributions to private insurance premiums for their employees.”
Warren wants these governments to give this money to Washington instead. Teachers, firefighters, police officers and the like would be covered by a federal plan, not by the private plans their employers currently pay for.
This provision bares a weakness in Warren’s wonkiness. She is trying to fulfill her pledge not to raise taxes on middle-class Americans, but she can’t do it without expropriating the state and local taxes they already pay.
Yet Washington can’t just reach out and grab the money that state and local taxpayers provide to their governments. To gain their cooperation, Warren bets that state and local governments will voluntarily go along with this in exchange for future savings — that is, they’ll think that Washington can better manage health-care costs than they can.
The proposal is useful, then, in pointing out a fissure between insurgent politicians such as AOC, who style themselves as wanting universal, but more basic, rights for everyone, and the old-line public-sector unions that make up much of the Democratic voting base, who fight for select — and more expensive — perks for themselves.
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