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Why Bernie Sanders wants to know your health insurance deductible

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(Bloomberg) — A week after Hillary Clinton accused Bernie Sanders of jeopardizing the Democrats’ hard-fought Patient Protection and Affordable Care Act (PPACA) victory by reopening the debate over health insurance, her chief competitor for the party’s 2016 presidential nomination is rolling out a new strategy for selling his “Medicare for All” plan.  

See also: Sanders releases ‘Medicare for all’ health plan

Asking audience members at his rallies to shout out their own deductibles—the amount they have to pay out-of-pocket each year before their medical insurance kicks in.

During a town hall meeting Friday night in Hudson, New Hampshire, Sanders said that while he’s proud of PPACA, better known as Obamacare, and served on the committee tasked with writing it, 29 million Americans remain uninsured.

“And today in America, even more people are under-insured, with high deductibles and high co-payments,” he said. “Anybody in this room have high deductibles? What ya got? Anyone wanna tell us?” 

Sanders asked the same question at events in North Conway and Bedford on Friday. Each time, people shouted numbers ranging from $4,000 or $5,000, all way up to $11,000 or $12,000. In Bedford, one woman added, “and nothing’s covered!” 

“I always feel like a Vermont auctioneer here,” Sanders, who represents the neighboring state in the U.S. Senate, said in Hudson. “Except, you know, the winner is not necessarily winning the prize that they want.”

As the polls have tightened in Iowa and New Hampshire, the states that kick off voting in the 2016 presidential race with contests in early February, Democrats Clinton and Sanders have increased the intensity and frequency of attacks on each other.

During his New Hampshire swing, Sanders once again alluded to the $675,000 Clinton was paid by the investment bank Goldman Sachs for speeches, and said he’d been “attacked” for maintaining that health care is a universal right. 

Sanders unveiled his sweeping health care proposal on Jan. 17, hours before the Democratic presidential candidates met for their final debate before the Iowa caucuses on Feb. 1. The Clinton campaign had been pressing for details, and arguing that it would effectively put insurance coverage in the hands of Republican governors and raise taxes on the middle class.  

During the debate, Clinton said starting from scratch on health care and “pushing our country back into that kind of a contentious debate, I think, is the wrong direction.” The former first lady, who unsuccessfully championed a plan to expand health care insurance when her husband, Bill Clinton, was president, has since attempted to embrace President Barack Obama’s legislative achievement as her own.  

Sanders, on the other hand, is focusing on gaps in the program.

The contrasting tones speak to a major difference between the Clinton and Sanders campaigns. Clinton has emphasized her experience and pragmatism, critiquing Sanders for not revealing how he would pay for his estimated $15 trillion single-payer health care plan, then for not providing enough details. A former U.S. Sen. representing New York, she has also questioned the ability of Sanders to muster political support for his proposal from a Congress where Republicans hostile to Obama’s less ambitious health coverage plan hold the majority in both chambers.

Sanders prefers to focus on the ideal of universal coverage. When he speaks about his health care plan, he doesn’t mention the 2.2 percent tax on all income that would help pay for it, or the 6.2 percent payroll tax businesses would pay. Some left-leaning policy journalists have also questioned whether Sanders’s plan sufficiently acknowledges the difficulties and drawbacks of a single-payer system. 

Jonathan Cohn wrote at The Huffington Post that the Democratic primary is a contest “between a candidate talking about what he hopes the health care system will look like someday, and one focused on what she can actually achieve now.”

For Sanders supporters, many of whom are personally experiencing the health insurance challenges Sanders discusses, aiming high is more appealing than settling for less. Even if a President Sanders couldn’t accomplish his whole agenda, working towards his platform might leave the country better off. 

“I’m not naive,” said Barbara Rudy, a 58-year-old IBM employee from Millbrook, N.Y., who attended the Hudson town hall. “I don’t believe Bernie’s going to be able to do 100 percent of what Bernie thinks he can do. He has to depend on Congress to do some of this.” Still, she said, “if he gets half done of what he wants to do, we’re going to be in better shape.”

Jacki Johansen, a 54-year-old office manager and single mother from Bedford, N.H., said her current job doesn’t offer health insurance and she hasn’t made enough to pay for a PPACA policy in the past. “I think he really makes a good point in saying that it’s a right, and when you do compare it to other countries, it really does seem insane that we don’t have coverage when everybody else does,” she said. “Even if we just make a move in the right direction, then that’s a good thing.”

Marcia Griffith, a self-employed 53-year-old from Milford, New Hampshire, said that she’s currently shopping around for a PPACA exchange plan, and is looking at annual deductibles in the range of $3,500 to $5,000. When she lived in Switzerland, she said she saw how a “socialist type” system operates in the real world. “I’ve seen it work. It can work. And there are various levels within it, but everyone gets health care,” she said.

Lower drug prices? Clinton said she’d work on it. Three free doctor visits a year for people? She backs that one. Lower out-of-pocket costs? She said it was essential.

“I believe that we can wage an election on what is achievable, what is smart and what is workable,” she said. “If we’ve got the right presidential candidate, we’ve got a good shot of taking back the Senate.”

Introducing Clinton, Sen. Jeanne Shaheen, a Democrat from New Hampshire, highlighted her tenure as a secretary of state and before that in the Senate.

Recalling Clinton’s widely-praised performance during a punishing 11 hours of testimony in October by a Republican-led House committee investigating her handling of terrorist attacks in Benghazi, Libya, Shaheen said none of the other presidential contenders could have performed so ably. “Not Donald Trump, not Ted Cruz and not Bernie Sanders,” she said.

See also:

Why health plan enrollees want to scream

Underinsurance persisting in exchanges


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