In short, most of them want to expand government payment for and control of health care in the United States. Looking at the top 10 candidates (Biden, Sanders, Warren, Harris, Buttigieg, O’Rourke, Booker, Klobuchar, Yang, Castro, Gabbard) according to recent polls captured on 538, I staked out the candidates current positions on reforming the health care system based on a variety of sources (here, here, here, and here).
VIEW THIS TABLE FOR THE HEALTHCARE ECONOMIST’S DEMOCRATIC CANDIDATE CHEATSHEET
All top 10 candidates support a “public option” where individuals could buy into government health insurance. All top 10 candidates support the federal government negotiating drug prices. All top 10 candidates supported importing drugs from other countries. Most of the top 10 candidate would support coverage of undocumented immigrants (O’Rourke and Klobucher did not commit one way or another on this). However, key differences do emerge between the Democratic candidates plans. .
While 7 of the top 10 candidates supported Medicare for All, Biden, O’Rourke, and Klobaucher did not. Biden prefers to keep Obamacare and add a public option (Politico called it ACA 2.0). O’Rourke prefers keeping the private health insurance system for working age adults, but offering Medicare to individuals who do not otherwise have employer-provided insurance. Klobaucher prefers expending Medicare to age 50+ and offering a public option. For those who support Medicare for All the phase in period varies, with generally expanding Medicare’s age eligibility down over time. Sanders’ plan (website, Vox) has among the fastest implementation time (4 years) whereas Harris prefers a more gradual phase-in period (10 years).
Most candidates prefer to keep the option of private insurance or have not clearly expressed an opinion. Only Sanders and Warren would explicitly eliminate private health insurance. To date, Warren has largely mirrored Sanders health care proposals. Kamala Harris’s Medicare for All plan can be read as more of a Medicare Advantage for All where private plans can be included as options in the Medicare for All benefit. Warren and Sanders (as well as Yang) also proposed having the government produce (or maybe contract out?) to produce generic drugs once patents have expired.
It is unclear whether the selected candidate will track to a less liberal, more moderate stance if they are chosen as the Democratic Presidential Nominee. Nevertheless, if a Democrat is elected president, expect some big health care policy changes in the coming years.