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DES MOINES — Roughly how much do you spend each year on health care?
That’s the question Sen. Elizabeth Warren’s new Medicare for All Calculator on her campaign website asks. And whatever answer you type in, that’s how much she promises you’ll save per year on health care costs.
That’s because, according to her long-awaited plan to pay for her universal health care expansion proposal unveiled on Friday, health care consumers won’t be asked to spend one red cent on coverage — no premiums, deductibles, copays, and almost no out-of-pocket spending. Instead, Warren would pay for the plan with a mix of employer contributions, new taxes on the wealthy and corporations, and more stringent tax enforcement.
The plan also relies on some pretty hefty assumptions: repealing the GOP tax law that lowered corporate taxes and passing comprehensive immigration reform with a pathway to citizenship, to name two. But, as Warren promised, the plan offers a roadmap for converting the U.S. to universal coverage, answering critics inside and outside her party who've bashed her for failing to account for how she’d pay for the plan and whether middle-class taxes would go up.
“A key step in winning the public debate over Medicare for All will be explaining what this plan costs – and how to pay for it,” according to a statement on Warren’s website releasing the plan. “My plan will cover every single person in the U.S., and it includes common-sense payment reforms that make Medicare for All possible without spending any more money overall than we spend now.”
The plan comes the same day as the vaunted Liberty & Justice Celebration in Des Moines, a gathering of Democrats that offers candidates a chance to make their case to an arena of thousands.
Warren is leading in the Iowa caucuses, according to recent polls, but South Bend, Indiana, Mayor Pete Buttigieg has surged behind a call for pragmatic solutions to the country’s problems — including an attack on Warren’s “dream big” proposals, like Medicare for All. If Buttigieg was planning to reprise that attack in his speech tonight, he may have some rewriting to do.
According to Warren’s plan, private sector employers would shoulder almost half of the cost, although Warren promises it would be less than they currently pay in employer-sponsored health care contributions. Instead of contributions toward private insurance, employers would make contributions toward Medicare. Most companies with fewer than 50 employees would be exempt.
Next, Warren proposes a tax hike on billionaires. She had already proposed a tax of three cents on every dollar individuals earn over $1 billion, but she announced Friday she wants to double that and ask billionaires to pay a 6 percent surtax on that income.
Warren also proposes to treat capital gains the same as labor income, taxing investment income annually, rather than simply when the investments are sold.
The plan would also hike taxes on large corporations, first by repealing the GOP tax bill passed by the last Congress and by instituting targeted taxes on financial firms, large corporations and multinational companies. These would include things like cracking down on offshore tax shelters, reducing deductions for corporations and a tax on financial transactions.
A substantial share of the payment for Medicare for all would also come from stepped up enforcement of existing tax laws, according to Warren’s plan. She’d use increased funding for the IRS to target high-income tax evaders or people with money in foreign accounts.
Warren also estimated that taxes on the additional take-home pay of individuals who no longer have to pay for private insurance would help contribute to the cost of Medicare for All.
In addition to that, Warren proposes immigration reform with a pathway to citizenship would raise money in the form of new contributions from taxpayers who become citizens.
Finally, the senator included her longstanding proposal to cut some military spending in the mix. She would end the practice of paying for foreign military campaigns with an off-budget fund that has helped Congress pay for the War on Terror without having to include it in the annual defense budget.
“As I have said repeatedly, under my Medicare for All plan, costs will go up for the very wealthy and big corporations, and costs will go down for middle-class families,” according to her website. “I will not sign a bill that violates these commitments. And as my plan to pay for Medicare for All makes clear, we can meet these commitments without a tax increase on the middle class — and, in fact, without any increase in income taxes at all.”
Cover: U.S. Senator and presidential candidate Elizabeth Warren speaks during a town hall at the University of New Hampshire in Durham, NH on Oct. 30, 2019. (Photo by Jessica Rinaldi/The Boston Globe via Getty Images)