California cares about health care. Where do key 2020 candidates stand?

Jan. 9--California Democrats most want to hear candidates presidential candidates talk about health care as the state's March 3, 2020 primary approaches. It's the top issue among likely voters, according to the most recent survey conducted by the Public Policy Institute of California.

Here's how the top candidates on the Democratic ballot would try to improve the country's health care system, sorted in order of their recent national polling averages and performance in early-voting states:

Joe Biden

Former Vice President Joe Biden wants to preserve the Affordable Care Act passed under the Obama administration, rather than eliminate private health insurance. His plan would cost $750 billion over the next decade and be funded by reversing some provisions of the Tax Cuts and Jobs Act that President Donald Trump signed into law in December 2017.

"As president, Biden is going to defend the ACA from any attacks, whether they're from Republicans or Democrats, and work to build on the Affordable Care Act," said Stef Feldman, Biden's policy director.

If elected, he would establish a public option like Medicare administered by the federal government. He'd also keep in place popular protections under Obamacare that allow young people to stay on their parents' plan until they turn 26 and prevent health insurance companies from refusing coverage or charging people more simply because they have a "pre-existing condition."

He'd work to make health plans more affordable by increasing the generosity of subsidies to Americans making between 100 percent and 400 percent of the federal poverty level, requiring drug companies to negotiate with Medicare and ensuring no family spends more than 8.5 percent of their income on health insurance.

Undocumented immigrants wouldn't be eligible for federal subsidies if they purchased a plan on the individual marketplace. Biden would instead make health care more accessible to them by doubling the funding of community health centers -- a move he says will also improve women's access to contraception.

Bernie Sanders

Vermont Sen. Sanders "wrote the damn bill" calling for a government-run, single-payer health care system that eliminates private health insurance. It would cost a hefty $34 trillion over 10 years, according to a report from the Urban Institute.

"The function of health care is not to make huge profits for the wealthy, it is to guarantee health care to every man, woman and child through a Medicare-for-All, single payer system," Sanders said at an August 2019 rally in Sacramento.

While he has acknowledged taxes would go up for Americans in the middle class, he insists overall costs would go down because he'd eliminate copays, deductibles and surprise bills.

Sanders wants to lower health care costs by allowing patients, pharmacists and wholesalers to buy cheaper prescription drugs from Canada and other countries. He'd also push for Congress to pass a law to cut drug prices in half by linking prices to the average price in Canada, Britain, France, Germany and Japan.

Substance abuse treatment and reproductive care would be covered under his sweeping Medicare-for-All plan.

Elizabeth Warren

Massachusetts Sen. Elizabeth Warren has said she is "with Bernie" on health care. But unlike Sanders, Warren doesn't talk about taxes going up. She instead focuses on overall health care costs going down.

"Because I have identified trillions in revenue to finance a fully functioning Medicare for All system -- without raising taxes on the middle class by one penny -- I can also fund a true Medicare for All option," Warren wrote in a November post on Medium.

Warren wants to prove the viability of her plan before implementing a universal, single-payer plan that abolishes private health insurance.

She said her $20.5 trillion plan would not be implemented until her third year in office, raising concerns among more liberal voters that it wouldn't pass, as presidents have historically seen diminished influence in Congress later in their presidencies.

During her first 100 days, she says she would work with Congress to pass "fast-track budget reconciliation legislation to create a true Medicare for All option that's free for tens of millions." Every American would have the option to get converge through her Medicare for All system. Costs would be "modest" for everyone who voluntarily signs up and free of charge for children under 17 and families making no more than 200 percent of the federal poverty level.

Pete Buttigieg

Former South Bend, Indiana, Mayor Pete Buttigieg is pushing a "Medicare for All Who Want It" plan that would cost about $1.5 trillion over 10 years and be funded almost entirely by rolling back the tax cuts law Trump approved in 2017.

Buttigieg wants people to have access to a government-run public option that would present a more affordable alternative to private health insurance and guarantee contraception coverage. Poorer Americans living in states that have refused to expand Medicaid would be automatically enrolled in his public option plan.

He'd eliminate surprise billing, which commonly occurs when in-network hospital patients receive treatment from a doctor outside of their insurance network.

Amy Klobuchar

Minnesota Sen. Klobcuhar has called Sanders' Medicare for All proposal a "bad idea" because "149 million Americans will no longer be able to have their current insurance" within four years.

She instead wants a non-profit public option that gives Americans the ability get lower insurance costs and drug prices. Like Sanders, though, she would allow people to personally buy drugs from countries like Canada. She also wants to allow Medicare to negotiate for cheaper prescription drug costs.

In her first 100 days, Klobuchar would direct the Centers for Disease Control and Prevention to "study gun violence as a public health issue and help identify approaches to reduce gun violence and save lives." She'd also allow health providers like Planned Parenthood to receive funding under Title X.

Michael Bloomberg

The former New York City mayor is looking to build on Obamacare by creating a Medicare-like public option administered by the federal government but paid for by customer premiums.

To reduce insurance costs, he'd extend tax credits for individuals and families who spend more than 8.5 percent of their income on health insurance premiums. If elected president, he'd work with Congress to have the Department of Health and Human Services negotiate drug prices with pharmaceutical companies and make prices more comparable with other industrialized countries.

Andrew Yang

Entrepreneur Andrew Yang believes Democrats are "having the wrong discussion on healthcare," arguing that the 2020 field is spending all its time "arguing over who is the most zealous in wanting to cover Americans."

While he supports "the spirit of Medicare for All," he wants to focus on the underlying causes of rising drug and insurance costs. He's open to allowing the importation of drugs from other countries, but only if his three other preferences fail. He'd rather have Congress pass a law to negotiate drug prices, adopt pricing models more in line with costs people from other countries are paying and create public manufacturing sites in the United States to produce generic drugs.

Tom Steyer

Tom Steyer, a billionaire activist in California who has pushed for solutions to global warming, wants a public option that would administered by the Centers for Medicare and Medicaid Services, a federal agency within the Department of Health and Human Services. That public option would be financially separated from Medicare and Medicaid.

Private health insurance providers wanting to participate in Medicare or Medicaid would also need to participate in the public option. He estimates his plan will cost about $1.5 trillion over 10 years.

Cory Booker

New Jersey Sen. Cory Booker, as well Warren, is a sponsor on Sanders' Medicare for All bill. As president, Booker would push a health care plan that includes universal paid family and medical leave.

He would lower prescription drug costs by importing drugs from countries like Canada and allowing Medicare to negotiate for lower prices. He also wants to create a tax penalty for drug companies that "unfairly raise the cost of their drugs and take patents away from drug companies that sell the same medication for less in other countries."

BEHIND OUR REPORTING

How we did this story

This story emerged in response to a survey The Bee shared gauging voter attitudes leading up to California's March 3, 2020 presidential primary election. After gathering feedback from more than 100 people who completed the form, health care proved to be a top issue likely voters were considering when evaluating the 2020 Democratic field. If you want to help inform our reporting leading up to the election, make sure to complete our form. It takes less than three minutes to fill out.

What other policy comparisons can you expect?

This health care policy comparison is the first installment in a series of stories examining candidates' ideas to problems affecting Californians. Other comparisons you can expect include the environment, housing affordability, immigration and higher education.

We've also posted a story evaluating the electability arguments the top candidates are making about why they believe they are the most likely person to defeat President Donald Trump in a hypothetical general election matchup.

Why did we order the candidates this way and exclude others?

There are 14 candidates presently in the race, nine of whom have a viable pathway to get onto the Democratic presidential debate stage. We purposefully omitted the five candidates who don't have a clear shot at appearing on the stage.

The time readers spend on a story decreases as they get lower and lower into a story. As a result, we chose not to list the candidates alphabetically and instead give greater visibility to the candidates doing best in the polls. Elizabeth Warren, who is among the top tier of candidates, would've been buried at the bottom, while Cory Booker, who is polling substantially lower, would've been listed higher if The Bee listed the candidates alphabetically.

___

(c)2020 The Sacramento Bee (Sacramento, Calif.)

Visit The Sacramento Bee (Sacramento, Calif.) at www.sacbee.com

Distributed by Tribune Content Agency, LLC.