The vigorous contest of Democrats seeking the 2020 presidential nomination has produced excellent policy proposals to address major issues. In light of the threats to free and fair elections posed by Russian hacking, foreign interference, gerrymandering, Citizens United and voter suppression, and the impeachment proceedings unnerving public trust in government, Senator Amy Klobuchar has released her plan to safeguard elections, strengthen democracy and restore trust in government. This is from the Klobuchar campaign:
Senator Amy Klobuchar released her plan to safeguard our elections, strengthen our democracy and restore trust in government.
Senator Klobuchar believes that everything we talk about getting done – from taking on climate change to gun safety to health care reform — will depend on one thing: a democracy that works for the people and making sure every vote counts.
Today insidious forces are working to suppress the vote and drown out people’s voices with dark money. And our intelligence agencies have confirmed time and time again that there have been foreign attacks on our elections, and that our elections remain a target. Republicans in the Senate have repeatedly blocked Senator Klobuchar’s bipartisan legislation to strengthen our election security while our country faces continued threats from foreign adversaries.
Senator Klobuchar believes it’s time to take back our democracy. She has been a leader in the fight to protect our elections from foreign interference, including by securing $380 million in election security funds in 2018 so states could improve their election infrastructure and protect their election systems from cyberattacks. She leads bipartisan legislation in the Senate that would protect our elections with paper ballots and post-election audits, as well as the bipartisan legislation that would promote accountability and transparency for political ads on the internet.
Senator Klobuchar is also leading the effort in Congress to automatically register every American to vote when they turn 18, and she has fought for the passage of legislation that would restore the Voting Rights Act to take on discrimination at the polls. And she has worked to get dark money out of politics and restore trust in government dating back to her first month as a Senator, when she helped lead the successful push for meaningful ethics reform in Congress.
As President, Senator Klobuchar will champion a major voting rights and democracy reform package and she has already pledged that the For the People Act — legislation that has thirteen of Senator Klobuchar’s legislative provisions — will be the first bill she sends to Congress as President.
Strengthening Election Security and Regulating Online Political Ads
Promote accountability for political ads on the internet. Senator Klobuchar wrote and introduced the bipartisan Honest Ads Act, which would increase transparency and accountability for political ads on the internet by holding large online platforms to the same disclosure and disclaimer standards that apply to radio, broadcast, cable and satellite providers. As President, Senator Klobuchar will push to pass the Honest Ads Act, work to pass the PAID ADs Act — which she leads in the Senate — to make it illegal for foreign nationals to purchase election ads, and work to ban foreign nationals from involvement in decisions regarding political expenditures by corporations, PACs and Super PACs. She will work to prohibit online platforms from allowing political ads that discriminate against people and require online platforms to use human reviewers to approve political ads placed on their platforms. Today, there are no protections preventing misleading and outright false political ads online. That’s why Senator Klobuchar supports preventing social media companies from running political ads full of false claims and lies by holding them responsible.
Take on disinformation campaigns and foreign efforts to influence our elections. As President, Senator Klobuchar will require political campaigns to report any attempt by a foreign entity to influence our elections to the Federal Election Commission and Federal Bureau of Investigation. She will also prohibit U.S. political campaigns from offering non-public material to foreign entities. Senator Klobuchar will work to pass legislation based on the Deceptive Practices and Voter Intimidation Act, which she leads with Senator Cardin, to make it illegal to knowingly deceive others about how to participate in a federal election and to direct the Attorney General to work with states to counter voter intimidation. She will invest in media literacy education to teach students how to identify misinformation online, based on her Digital Citizenship and Media Literacy Act. Finally, she will work to pass the Combatting Foreign Influence Act, which she leads in the Senate, to direct the Director of National Intelligence to establish a Malign Foreign Influence Response Center to coordinate work across the intelligence community and law enforcement to assess foreign influence operations with a whole-of-government approach.
Build U.S. cyber expertise to defend our elections. As President, Senator Klobuchar will make cybersecurity an immediate priority. She will issue an Executive Order launching government-wide cybersecurity initiatives, fast-tracking and streamlining procurement of modern information technology across agencies. She will launch a cabinet-level taskforce on election cybersecurity to coordinate across agencies, including the intelligence community, on how the federal government can work with state and local governments to address cyber threats to our democracy and infrastructure. She will also work to pass legislation based on the Invest in Our Democracy Act, bipartisan legislation she leads in the Senate, to provide grants to states for election officials to receive continuing education in cybersecurity and election administration.
Fortify state election infrastructure against cyberattacks. Senator Klobuchar leads the effort to require all jurisdictions to have paper ballots through her Election Security Act, but Senator McConnell and the White House have prevented the bill from coming to a vote. She also led the successful effort to secure $380 million for State Election Security Grants in 2018. As President, Senator Klobuchar will require states to use paper ballots, set strong cybersecurity standards for voting infrastructure, increase grants to states for upgrades to their voting infrastructure and promote the use of post-election risk-limiting audits. These proposals are based on Senator Klobuchar’s legislation, Senator Wyden’s Protecting American Votes and Elections Act of 2019, which Senator Klobuchar co-sponsors in the Senate, and the SAFE Act, which passed the House in June 2019. She will also require the Director of National Intelligence to assess election threats and work with the Department of Homeland Security and Election Assistance Commission to provide assistance to states to counter those threats.
Eliminating Obstacles to Voting and Making It Easier to Vote
Automatically register every American when they turn 18. Senator Klobuchar believes we must do more to reduce barriers to voting. In the Senate, she has championed the Register America to Vote Act to automatically register all eligible citizens on their eighteenth birthday and she will get it passed as President. Automatically registering voters in every state would result in 22 million newly registered voters in just the first year of implementation, according to the Center for American Progress. Senator Klobuchar will also launch a pilot program to provide resources for initiatives that provide 12th graders with voter registration information. This proposal is based on the Students VOTE Act, legislation Senator Klobuchar leads in the Senate.
Restore the Voting Rights Act. Senator Klobuchar has long advocated for Congress to take action to address the U.S. Supreme Court’s 2013 decision in Shelby County v. Holder, which struck down key parts of the Voting Rights Act. As President, she will restore protections for voters in states with a recent history of discrimination. Senator Klobuchar will also champion the Native American Voting Rights Act, legislation she helps lead in the Senate, to provide the necessary resources and oversight to ensure Native Americans have equal access to the ballot box and the electoral process.
Prohibit voter purges and remove exact-match requirements. Senator Klobuchar has pushed to protect the constitutional rights of Americans from voter purges, which disproportionately impact minority, low-income, disabled, and veteran voters. In Georgia, former Secretary of State Brian Kemp purged over 1.4 million voters from the rolls and held up the voter registrations of 53,000 people because of things like a discrepancy over a hyphen in a last name. As President, Senator Klobuchar will pass her bill with Senator Brown, the SAVE Voters Act, to prohibit states from purging Americans from voter rolls for not voting in recent elections. The bill amends the National Voter Registration Act to prevent a state from using someone’s failure to vote or respond to a state notice as reason to target them for removal from voter rolls. Senator Klobuchar will also work with Congress to pass legislation requiring states to remove “exact-match” requirements and other unnecessary and discriminatory obstacles to registering to vote.
Break down institutional barriers to voting. Senator Klobuchar believes we must do more to make it easier for Americans to vote — not harder. As President, she will champion reforms to break down institutional barriers to voting, including:
Promote early voting and
no-excuse absentee voting. Nine states do not offer early
voting and in 19 states an excuse is required to vote absentee. Senator
Klobuchar will push to make voting more convenient and support voter
participation by working with states to establish early voting and no-excuse
absentee voting nationwide.
Establish minimum notification
requirements for voters affected by polling place changes. Senator Klobuchar will stand up to attempts to suppress voter
turnout by requiring states notify voters affected by polling place changes no
later than seven days before the date of the election or the first day of an
early voting period.
Designate election day as a
federal holiday. Senator Klobuchar will
designate election day as a federal holiday.
Establish Same Day Registration. In addition to championing her legislation to automatically register every American when they turn 18, Senator Klobuchar will also pass legislation she leads in the Senate, the Same Day Voter Registration Act, that requires states to allow people to register to vote on the same day as the election.
Increase accessibility in voting for people with disabilities. Senator Klobuchar believes we need to make it easier for the voices of people with disabilities to be heard on Election Day. As President, she will strengthen requirements for increased accessibility at polling places and expand resources by providing grants for states to make it easier for people with disabilities to vote.
Ensure ballots are counted from Americans living overseas and those serving in the military and their family members. Senator Klobuchar believes we should be doing everything we can to make voting easier for every American – including the 3 million Americans living overseas and more than 1.3 million active duty service members. Recently, she was successful in passing a provision in the Senate’s 2020 National Defense Authorization Act that would require Federal Voting Assistance Program to conduct a comprehensive study on how to scale a ballot tracking program for all military and overseas voters. As President, she will push to require states to ensure that all overseas voters receive their ballots at least 45 days before an election; improve the availability and transmission of absentee ballots abroad; and ensure that those ballots are counted by hand in any recount or audit. In addition, Senator Klobuchar will make sure that spouses of active duty service members do not have to change their legal residency each time they move for a military reassignment, a proposal that is based on the Support our Military Spouses Act, legislation she has championed in the Senate.
Ensure that those affected by natural disasters can still vote. As the effects of climate change become more disruptive, Senator Klobuchar believes that it is especially important to ensure that natural disasters do not prevent Americans from voting. As President, she will ensure that people living in areas where an emergency has been declared, those who have been displaced by a natural disaster, and professional or volunteer service emergency responders have access to an absentee ballot. In addition, anyone who expects to be hospitalized on Election Day or is not able to receive a requested absentee ballot from their state or jurisdiction would also be eligible to receive an emergency ballot. This proposal is based on the Natural Disaster Emergency Ballot Act, legislation Senator Klobuchar has championed in the Senate.
Overhauling Our Campaign Finance System
Overturn Citizens United. Senator Klobuchar believes that the surge in special interest cash in political campaigns since the Citizens United Supreme Court decision is undermining our elections and shaking the public’s trust in our elections. She will lead the effort to pass a constitutional amendment to overturn Citizens United and get the dark money out of politics.
Establish a public financing system and increase the power of small donors. Senator Klobuchar has long pushed for meaningful campaign finance reform to ensure the voices of average Americans are heard. As President, Senator Klobuchar will push to establish a campaign finance system to increase the power of small donors that matches 6-to-1 donations of $200 or less to eligible candidates.
Reform the Federal Election Commission (FEC). Senator Klobuchar believes that gridlock in the FEC — including the recent lack in quorum — has prevented the Commission from fully playing its role in administering and enforcing federal campaign finance laws. She has called on President Donald Trump to work with the Senate to help reestablish a quorum by nominating a commissioner to fill the vacant Democratic seat. And as President she will advance critical reforms to ensure a fully functioning FEC, including reducing the number of members from 6 to 5, ensuring the Commission has an accountable Chair with clear distribution of duties between the Chair and the FEC, and preventing commissioners from remaining in office indefinitely as holdovers. This proposal is based on the Campaign Finance Transparency Act, legislation she leads in the Senate.
Increase transparency in political spending. Senator Klobuchar believes that we must do more to shine a light on the corporate dark money spending. As President, she will champion the passage of the DISCLOSE Act, legislation she co-sponsors in the Senate, requiring corporations, super PACs and certain non-profits to promptly disclose election spending of $10,000 or more and list any donor who gives over $10,000 to the organization.
Ensuring Free and Fair Elections
End partisan gerrymandering. Senator Klobuchar believes that partisan gerrymandering undermines the principles of our democracy. She has signed the Fair Districts Pledge developed by former Attorney General Eric Holder and the National Democratic Redistricting Committee to support fair redistricting that ends map manipulation and creates truly representative districts. Particularly in the wake of the 2019 Supreme Court decision that effectively gave the greenlight to politically manipulate congressional districts, Senator Klobuchar will require states to establish independent, bipartisan redistricting commissions that will develop fair statewide district maps following each decennial census. This proposal is based on the Redistricting Reform Act, legislation Senator Klobuchar leads in the Senate.
Improve the treatment of provisional ballots. Senator Klobuchar will require states to establish uniform and nondiscriminatory standards for issuing, handling, and counting provisional ballots including requiring provisional ballots from eligible voters who voted at the wrong voting place to be counted.
Restore Americans’ right to vote after being released from incarceration. Senator Klobuchar believes that Americans who have been released from incarceration should be able to exercise their right to vote. As President she will restore citizens’ right to vote after being released from incarceration.
Restoring Trust in Government
Ensure that the President is not above the law. Senator Klobuchar believes we must take urgent action to reverse the harm President Trump has done to his office by openly flaunting the rule of law. She will instruct the Justice Department to withdraw the Office of Legal Counsel’s opinions prohibiting the indictment of a sitting president. She will also make it clear that the President and Vice President have to follow conflict of interest laws and require the President and major candidates for President to make their tax returns publicly available.
Overhaul ethics rules for White House employees and other senior officials. Senator Klobuchar believes that accountability starts at the top, and that in addition to strengthening accountability for the President, we must have the highest ethical standards for White House employees and other senior officials. Senator Klobuchar will strengthen investigations of foreign agents who lobby in the United States, give the Office of Government Ethics more enforcement power and provide additional protections for all Special Counsels. She will also publicly post executive branch ethics waivers and report senior officials’ conflicts of interest in rulemaking.
Strengthen protections for whistleblowers. Senator Klobuchar believes that the best way to encourage individuals with knowledge of wrongdoing to come forward is to provide and enforce strong protections for whistleblowers. Within her first 100 days in office, Senator Klobuchar will issue guidance affirming that the Department of Justice cannot intervene in the transmission of a whistleblower complaint to Congress under the Intelligence Community Whistleblower Protection Act. She will also work with Congress to expand whistleblower protections, including for government contractors, and direct all federal agencies to fully implement whistleblower education and anti-retaliation plans.
Increase transparency and protect journalists. As the daughter of a newspaper man, Senator Klobuchar has always believed transparency and journalism are critical to our nation’s democracy. Within her first 100 days in office, she will restore former Attorney General Eric Holder’s guidance on protections for journalists so that they are not jailed for doing their jobs. Senator Klobuchar will also direct the Office of Legal Counsel to make all of its opinions publicly available unless there is a compelling national security reason to prevent their release. She will fully fund Freedom of Information Act offices within executive agencies and direct them to post FOIA requests online.
The vigorous contest of Democrats
seeking the 2020 presidential nomination has produced excellent policy
proposals to address major issues. One of the major issues is how to
restructure the economy for sustainability and protect jobs. Senator Amy
Klobuchar just released a comprehensive plan to address the future of work
in a changing economy This is from the Klobuchar campaign:
DES MOINES – Today, ahead of a panel discussion
at Machinists Lodge 254 in Des Moines, Senator Amy Klobuchar released her plan
for the future of work and a changing economy. Senator Klobuchar’s proposal is
a comprehensive plan to address digital disruption and renew the social
contract in the gig economy, respect the dignity of work, invest in America’s
future and focus on economic justice and shared prosperity.
Senator Klobuchar’s plan includes updating consumer and worker
protections, strengthening collective bargaining and labor rights, establishing
national paid family leave, creating portable personal retirement accounts,
boosting entrepreneurship and investing in cybersecurity.
Senator Klobuchar’s Plan for the Future of Work and a
In America, no matter where you come from, who you know, or where you
live, if you work hard, you should be able to make it in this country. But
that’s not the case for too many people in today’s economy. Senator Klobuchar
is committed to championing economic policies that give all Ameicans an
opportunity to succeed. That means connecting our students and affordable
education to the jobs of today and tomorrow, increasing wages and respecting
the dignity of work, making health care more affordable, ensuring a secure
retirement, investing in our infrastructure and creating jobs, focusing on
economic justice and shared prosperity, and budgeting responsibly for our
future. And it means a Competitive Agenda for America to ensure that America
continues to be a country that thinks, that invents, that makes stuff, and that
exports to the world.
Address Digital Disruption
Senator Klobuchar believes we need to start tackling the challenges
presented by digital disruption and a changing economy. The future of work is
changing, which is putting stress on the social contract we’ve had in this
country when it comes to job training, employment, and retirement. Senator
Klobuchar’s plan is a plan for the future: offering stronger worker
protections, reasserting protections for consumers in a digital world,
investing in cybersecurity across the economy to prevent crippling attacks on
infrastructure and commerce, and taking on consolidation which is threatening
to take us into a new Gilded Age.
Renew the Social Contract for the Gig Economy. Senator
Klobuchar believes we must update our laws to reflect the evolving nature of
Invest in education and job training, including for
workers at risk of losing their jobs to automation. Senator Klobuchar
is committed to creating new opportunities and ensuring a just transition for
workers who have been displaced by the changing economy. She believes the
federal government has an important role to play during economic transitions.
As President she will take action to ensure that workers can pursue additional
education and can do so without a financial burden at any age. She will also
create a new tax credit for employers that invest in training for workers at
risk of being laid off through on-site training programs or provide paid time
off for off-site retraining.
Make it easier to save for retirement. The
retirement system we have today wasn’t designed for today’s economy where
workers stay in a job for an average of four years and more than 57 million
Americans are working in the gig economy. As President, Senator Klobuchar will
work to create innovative, portable personal retirement accounts called
UP-Savings Accounts. Under her plan, employers will set aside at least 50 cents
per hour worked, helping a worker build more than $600,000 in wealth over the
course of a career.
Invest in quality, affordable child care and create a
national paid family and medical leave program. As President, Senator
Klobuchar will create a national paid family leave program to provide workers
with 12 weeks of paid leave per year to care for a new child, a family member
with a serious health condition, or their own serious health condition. She
will also create a new federal-state partnership to make child care more
affordable by capping spending on child care at seven percent of income for
families making up to 150 percent of their state’s median income, invest in
expanding the availability of child care, and work to raise wages for
caregivers and early childhood teachers. Read more about Senator Klobuchar’s
child care and paid family leave policies here.
Give workers access to a non-profit public option for
health insurance. As President, Senator Klobuchar will work to pass
legislation to create a non-profit public option that expands Medicare or
Medicaid. She will also build on the Affordable Care Act to help bring down
costs to consumers, including expanding premium subsidies, providing
cost-sharing reductions, making it easier for states to put reinsurance in
place, and continuing to implement delivery system reform. And she will take on
the other health care challenges we face including the price of prescription
drugs, mental health care, addiction and long-term care. Read more about Senator Klobuchar’s
health care policies here.
Allow gig workers to organize and prevent employees from
being misclassified as independent contractors. As President, Senator
Klobuchar will work to pass Senator Patty Murray’s Protecting the Right to
Organize Act — a bill Senator Klobuchar co-sponsors in the Senate — that
protects gig workers by preventing employers from misclassifying their
employees as independent contractors.
Update the tax code to work for gig workers. Gig
workers face additional challenges in properly tracking earnings and expenses
and calculating and paying taxes. As President, Senator Klobuchar will simplify
withholding for self-employed workers. Giving workers the option of having
their self-employment taxes withheld directly from their 1099s would reduce the
burden of quarterly tax filing and help smooth irregular incomes. She will also
lower the 1099-K threshold for gig economy platforms, so workers have more
information about their earnings, and consider creating a gig worker standard
business deduction to simplify the calculation of business expenses for gig
Update Consumer Protections for the 21st Century
Economy. Advances in technology have opened new opportunities for
consumers, entrepreneurs and businesses, but they have also created new threats
to privacy. Consumer protection laws have not kept pace with these
technological advances. As President, Senator Klobuchar will update consumer
protections so they work in the 21st century economy.
Strengthen consumer privacy protections. As
President, Senator Klobuchar will work to pass legislation similar to the
Consumer Online Privacy Rights Act, which she leads with Senator Maria
Cantwell. The bill would establish strong privacy rights for consumers
including the right to access their data and greater transparency, the right to
prevent data from being distributed to unknown third parties, the right to
delete or correct their data and the right to take their data to a competitor.
It would also establish a “duty of loyalty,” which would prohibit
companies from engaging in deceptive and harmful data practices. In addition,
the legislation would require companies to implement strong data security
policies, receive affirmative consent from consumers for collecting sensitive
information, and give consumers, states, and the Federal Trade Commission new
enforcement authorities. Senator Klobuchar will also work to pass legislation
based on her bipartisan Protecting Personal Health Data Act to create
protections for new health technologies not covered by existing privacy laws.
Increase rights for consumers after data breaches. As
more personal information is collected and stored online, consumers are
increasingly vulnerable to having their data exposed in a data breach. As
President, Senator Klobuchar will push for legislation similar to her
bipartisan Social Media Privacy and Consumer Rights Act to require companies to
notify users within 72 hours when their data has been breached and offer
meaningful remedies for people whose data has been compromised.
Empower consumer protection agencies. Without
effective enforcement, fraud and scams — like robocalls, senior fraud,
identity theft, and predatory student loans — have become problems for too
many Americans. As President, Senator Klobuchar will make sure that the federal
agencies charged with protecting consumers have the tools they need to be
effective cops on the beat, including personnel, technological expertise, and
strong enforcement authorities.
Tackle new forms of discrimination. As
President, Senator Klobuchar will update our laws to counter new forms of
discrimination, like digital redlining and racial bias built into algorithms
that are playing a larger role in everything from hiring decisions to medical
Provide access to a free and open internet. Consumers
and businesses deserve a level playing field on the internet. As President,
Senator Klobuchar will work to codify strong net neutrality principles and make
immediate progress in her first 100 days by using federal contracting
requirements to encourage broadband providers to honor net neutrality
principles and promote a free and open internet.
Invest in Cybersecurity That Protects Our Economy and Our
Democracy. Our economy increasingly relies on internet-connected
devices and infrastructure and this trend will only accelerate in the coming
years. This creates opportunities for terrorists, foreign governments, and
competing firms that could severely damage our economy. And we already know
that our election infrastructure is vulnerable to cyber attack and foreign
governments are working to interfere in our elections. Read more about Senator
Klobuchar’s plans to protect our democracy here.
Build the cybersecurity workforce our economy
needs. The Bureau of Labor Statistics predicts the United States will
add over 550,000 new information technology jobs to our economy over the next
10 years, including in big data and information security. As President, Senator
Klobuchar will expand STEM programs, including for women and traditionally
underrepresented minorities, and invest in apprenticeships so students and
workers can get on-the-job training in the technology jobs of the future, and
she will expand access to credentials through tution-free one- and two-year
degrees, technical certifications, and tuition-free community college.
Protect critical infrastructure against cyberattacks. Cyberattacks
on our electric grid, transportation infrastructure, or water management
systems could be devastating to our economy. As President, Senator Klobuchar
will work to build federal partnerships with the private sector to implement
NIST’s cybersecurity framework. She will make sure the federal government is
assisting companies in addressing global supply chain risks and increasing the
security of emerging technologies. Senator Klobuchar will also improve federal
preparedness for responding to cyber incidents.
Increase cybersecurity expertise in the federal
government. As President, Senator Klobuchar will make cybersecurity an
immediate priority. She will issue an Executive Order launching government-wide
cybersecurity initiatives, fast-tracking and streamlining procurement of modern
information technology across agencies. She will also work to pass legislation
similar to her bipartisan Cyber Security Exchange Act to provide a path for
cyber experts at private firms or academia to work for federal agencies for up
to two years. Federal workers will also be given the opportunity to work in the
private sector to develop their skills in the latest cybersecurity
Strengthen Antitrust Enforcement. U.S. firms
have engaged in $10 trillion worth of acquisitions during the past
decade. Senator Klobuchar believes we need to do more when it comes to
taking on monopoly power and promoting competition not just for our consumers
but for our businesses. Competition does more than just lower prices. It
improves quality, spurs innovation, makes it easier for entrepreneurs to start
new businesses, and creates better jobs. As the top Democrat on the Senate
Judiciary Antitrust Subcommittee, Senator Klobuchar has been a leader in taking
on this new Gilded Age. She leads the Consolidation Prevention and Competition
Promotion Act to make sure our antitrust laws adequately promote competition
and protect consumers, the Merger Enforcement Improvement Act to give antitrust
enforcement agencies the tools they need to be effective, and the Merger Filing
Fee Modernization Act to update merger filing fees.
Investigate monopolization claims and review mergers that
have already taken place. As President, Senator Klobuchar will harness
the power of investigations to look at acquisitions that have already occured
and investigate monopolization claims, including whether the integration of
services insulate tech companies from competition.
Strengthen merger enforcement. As President,
Senator Klobuchar will make sure that our antitrust agencies have the resources
they need to be aggressive and effective, updating the outdated merger filing
fees so that the merging parties of the largest deals start paying their fair
share. She will also give the agencies tools to analyze the effectiveness of
merger conditions so they can make better and stronger enforcement decisions.
Give antitrust agencies and courts the legal tools
necessary to promote competition. As President, Senator Klobuchar will
work to pass legislation creating a more stringent legal standard to protect
competition, shifting the burden of proof for mega-mergers from the government
to the parties to demonstrate that their mergers do not reduce competition, and
clarifying that existing antitrust laws should take into account more than
price and that they should also consider vertical integration, harm to
innovation, as well as monopsony — a market condition where there is only one
Create a new competition advocate. As President,
Senator Klobuchar will create a new position to oversee the effectiveness of
merger enforcement. The Office of the Competition Advocate would help consumers
raise complaints about anti-competitive activity, encourage antitrust
investigations, and analyze and publish reports on merger activity.
Respect the Dignity of Work
Senator Klobuchar believes that everyone who works hard should be able
earn enough to care for and support their family. Respecting the dignity of
work means raising the minimum wage, providing paid family leave and child care
and making sure people have a secure retirement.
Raise the Minimum Wage to $15 an Hour and Enforce
It. As President, Senator Klobuchar will push for legislation to raise
the federal minimum wage to $15 an hour and eliminate the tipped minimum wage.
To make immediate progress toward this goal, she will increase the minimum wage
for federal contractors to that threshold. She will also immediately strengthen
enforcement and expand investigations to make sure that our wage laws are
properly enforced and that workers are able to recover back pay when the
government rules in their favor.
Create a National Paid Family and Medical Leave Program. The
United States is the only industrialized nation without a national paid leave
program, and only 19 percent of American workers have access to paid family
leave through their employer. As President, Senator Klobuchar will create a
national paid family leave program to provide workers with 12 weeks of paid
leave per year to care for a new child, a family member with a serious health
condition, or their own serious health condition. Read more about Senator Klobuchar’s
plan for paid family and medical leave here.
Invest in Quality, Affordable Child Care. Senator
Klobuchar believes that early, quality child care and education is one of the
most important public investments we can make as a country. As President,
Senator Klobuchar will work to create a new federal-state partnership to make
child care more affordable by capping spending on child care at seven percent
of income for families making up to 150 percent of their state’s median income
and invest in expanding the availability of child care and raising wages for caregivers
and early childhood teachers. Read more about Senator Klobuchar’s
plan for child care here.
Make It Easier to Retire. As President, Senator
Klobuchar will work to create innovative, portable personal retirement accounts
called UP-Savings Accounts. Under her plan, employers will set aside at least
50 cents per hour worked, helping a worker build more than $600,000 in wealth
over the course of a career. She will continue to push for legislation to
protect retiree pensions. Senator Klobuchar will also work to strengthen Social
Security, and she believes that this program must remain solvent for
generations to come and she will fight against risky schemes to privatize it.
As President, Senator Klobuchar will work to lift the Social Security payroll
cap. Currently the payroll tax only applies to wages up to $133,000. Senator
Klobuchar supports subjecting income above $250,000 to the payroll tax and
extending the long-term solvency of Social Security. And Senator Klobuchar will
make sure people are treated fairly by the current Social Security system. As
President, she will work to strengthen and improve Social Security benefits for
widows and people who took significant time out of the paid workforce to care
for their children, aging parents, or sick family members. Senator Klobuchar
also opposes cuts and risky schemes to privatize Medicare and will take action
to strengthen Medicare and find solutions so it remains solvent. She will
improve Medicare for current beneficiaries by reforming payment policies
through measures like site neutral payments and providing incentives for
getting the best quality health care at the best price, including bundled
payments and telehealth. Read more about Senator Klobuchar’s
policies for seniors here.
Stand up for Our Unions. As the granddaughter of
an iron ore miner and the daughter of a union teacher and a union newspaperman,
Senator Klobuchar knows firsthand how unions give Americans and their families
the opportunities they need to succeed. As President, she will support real
labor law reform, ensure free and fair union elections, protect collective
bargaining rights, roll back Right to Work laws, and make it easier — and not
harder — for workers to join unions. Read more about Senator Klobuchar’s
labor policies here.
Invest in America’s Future
Right now, our economy is stable thanks to the efforts of our workers
and our businesses. Senator Klobuchar believes that real leaders use times of
stability to take on the challenges before them and invest for the future. As
President, Senator Klobuchar will strengthen our economy by empowering small
businesses and entrepreneurs and expanding exports, get our fiscal house in
order and tackle the big challenges we face as a country.
Empower Small Businesses and Entrepreneurs and Expand
Exports. Senator Klobuchar knows that small businesses and
entrepreneurs help power our economy and create jobs. Supporting small
businesses is one of the best ways to maintain a dynamic economy. And in an
increasingly global economy, she is committed to giving more businesses the
opportunity to export and reach customers across the world.
Expand access to capital for small businesses. Lack
of access to capital is one of the biggest obstacles to starting a small
business. As President, Senator Klobuchar will expand Small Business
Administration (SBA) lending programs and make it easier for small businesses
to get the loans and technical assistance they need to grow. She will also work
to increase small dollar lending by the SBA, which can be particularly
important for women and people of color seeking to start a small
Promote entrepreneurship and reverse the “startup slump.” New
businesses drive economic growth, but fewer startups are launched every year.
Startup rates have fallen to near 30-year lows. Senator Klobuchar recently
launched the bipartisan Senate Entrepreneurship Caucus with Senator Tim Scott
to address the most pressing issues facing entrepreneurs. As President, she
will build on her work through the America COMPETES Act to close the gap
between innovation and commercialization, help colleges and universities
partner with entrepreneurs, accelerate the commercialization of federally
funded research and update regional innovation programs at the Economic
Development Administration. To reverse the startup slump she will also tackle
unprecedented corporate consolidation, make it easier to export, simplify small
business rules, expand access to capital, as well as promote incubators,
mentoring and training.
Make it easier to export, especially for small businesses. Ninety-five
percent of the world’s potential customers live outside of the U.S., but less
than one percent of American businesses export. As President, Senator Klobuchar
will restart the President’s Export Council, which brings together business,
labor, and agricultural leaders with Members of Congress and key Administration
officials to help promote a comprehensive export and trade strategy. She will
also work to pass legislation based on her bipartisan Promoting Rural Exports
Act to establish a Rural Export Center to help rural businesses export their
products to new international markets. And since international tourism is one
of our top exports, she will work to reauthorize Brand USA so the United States
can compete to attract foreign visitors.
Support small manufacturers. As President,
Senator Klobuchar will support and expand the Manufacturing Extension
Partnership program, which the Trump Administration has tried to eliminate. The
program helps small manufacturers innovate, upgrade their technology and
improve production. She will work to create a manufacturing tax incentive to
encourage investment in rural communities or communities that have faced or are
about to face manufacturing job losses. She will also support our small
manufacturers by expanding guaranteed loan programs that make it easier for
rural manufacturers to access capital, pushing for a new tax credit for
manufacturers to hire registered apprentices, providing financing and grants
for equipment and technology upgrades, and working with states, localities,
research universities and community colleges to promote workforce development,
apprenticeships, and innovation in manufacturing.
Govern with Fiscal Responsibility. In less than
three years, President Trump has added $4 trillion to the national debt. The
nonpartisan Congressional Budget Office estimates that by 2029, the national
debt will be higher than it has been at any time since 1946, right after World
War II. And each year over the next decade the federal government will spend an
average of about $1.2 trillion more than it collects in revenue. As President,
Senator Klobuchar will reverse this trend with the goal of lowering the debt to
GDP ratio by the end of her first term and putting our country on a sustainable
Move to a biennial budget process. Senator
Klobuchar will push to overhaul the way Congress budgets federal dollars to
strengthen oversight of government spending and move the country forward when
it comes to tackling the nation’s debt. She is a co-sponsor of Senators Johnny
Isakson and Jeanne Shaheen’s Biennial Budgeting and Appropriations Act, which
would create a two-year budget and appropriations cycle with the first year
dedicated to appropriating federal dollars and the next year dedicated to
conducting oversight of how those federal dollars are being used. Senator
Klobuchar also supports moving from a 10-year forecasting window to a 25-year
forecasting window for Congressional Budget Office and Joint Tax Committee
scores, as the expanded window will better capture the long-term fiscal impact
of federal policies.
Establish a dedicated fund to tackle the U.S. debt and
support our economy. Senator Klobuchar will establish a dedicated fund
to make a down payment to tackle the U.S. debt and protect our economy. She
will initially seed the fund with $300 billion by raising the corporate tax
rate and dedicating savings from the government-wide budget review. When the
economy is doing well, the fund will finance deficit reduction. When specific
economic indicators show our economy is in a recession, the funding will
automatically be diverted to increase spending on programs that are effective
at stimulating the economy like infrastructure spending, increased unemployment
and nutrition assistance, and an increased federal share of Medicaid and CHIP
spending. As tax changes are implemented and as departments complete Senator
Klobuchar’s government-wide review, she will invest additional government-wide
savings towards expanding the fund to decrease the deficit and support our
Eliminate duplicative government spending. Senator
Klobuchar will immediately order all cabinet secretaries to undertake a
comprehensive review of their department’s budget and identify a list of
duplicative and unnecessary programs as well as potential gaps in spending.
When it comes to our nation’s defense, Senator Klobuchar is committed to
maintaining and extending our military superiority over any adversary that
would challenge us. She will ensure that our troops are the best-trained and
best-equipped in the world, while also providing for their families at home.
Yet virtually every analysis of the Pentagon’s budget has found duplicative and
unnecessary programs – so she will ask her Secretary of Defense and other
cabinet secretaries to take a close look at how money is being spent with an
eye towards eliminating duplicative and unnecessary spending.
Tackle Today’s Challenges for a Stronger Future. Senator
Klobuchar believes we need to govern from opportunity, not chaos. And governing
from opportunity means meeting the challenges we face head on.
Build a 21st century workforce. Senator
Klobuchar believes we should align our education system with the needs of our
economy. As President, she will champion tuition-free one- and two-year
community college degrees and technical certifications, expand apprenticeships,
and make it easier for Americans who need help to afford four-year degrees. She
will work to reduce the burden of student loans, support our Historically Black
Colleges and Universities, and expand Pell Grants. Read more about Senator Klobuchar’s
post-secondary education policies here.
Pass comprehensive immigration reform. Senator
Klobuchar believes that comprehensive immigration reform is crucial to moving
our economy and our country forward. As President, she will push for a
comprehensive immigration reform bill that includes the DREAM Act, targeted
border security and an accountable pathway to earned citizenship.
Invest in our infrastructure. Senator Klobuchar
has proposed a bold plan to rebuild America’s infrastructure, invest in our
future, and create millions of good-paying American jobs. Her plan includes
repairing and replacing our roads, highways and bridges as well as building
smart climate infrastructure, ensuring clean water, modernizing our airports,
seaports and inland waterways, expanding reliable public transit options,
rebuilding our schools, overhauling our country’s housing policy, and
connecting every household to the internet by 2022. Read more about Senator Klobuchar’s
policies to build America’s infrastructure here.
Make housing more affordable. Senator Klobuchar believes everyone deserves a safe and affordable home. As President, Senator Klobuchar will expand the Housing Choice Voucher program to make vouchers available to all qualifying households with children, increase access to homeownership while investing in neglected neighborhoods, tackle homelessness, and increase affordable rental housing in rural communities. She will also fight housing discrimination and invest in providing access to counsel in civil cases involving basic human needs. Read more about Senator Klobuchar’s housing policies here.
Focus on Economic Justice and Shared Prosperity
Senator Klobuchar believes that right now the Trump economy works for President Trump and his wealthy friends, not for everyone else. As President, she will take on structural racism and remove barriers to success and support communities at risk from being left behind in the new economy.
Address Structural Racism and Barriers to Success. Senator
Klobuchar is committed to addressing the structural racism in our society and
making sure that everyone has the opportunity to succeed. She believes that no
matter where you live, who you know, where you come from, or what you look
like, you should be able to make it in this country.
Work to end child poverty. As President, within
her first 100 days, Senator Klobuchar will put forward a plan to cut childhood
poverty in half in ten years and end child poverty in a generation. The plan
will be based on a National Academies of Science report and include expanding
the Earned Income Tax Credit, the Child Care Tax Credit, SNAP benefits and
overhauling our country’s housing policy.
Eliminate the wage gap. Today, women working
full-time earn 80 cents for every dollar paid to a man, and the gaps are even
larger for women of color. As President, Senator Klobuchar will work to pass
Senator Patty Murray’s Paycheck Fairness Act to ensure that employers pay
employees equally for equal work — including by prohibiting employers from
asking about the salary history of prospective employees.
Eliminate the wealth gap. Today, Black and
Latino households have only about a tenth of the median net worth of white
households. Senator Klobuchar’s proposal to establish portable, employer-funded
UP-Savings Accounts for retirement savings will help address this disparity.
She is also co-chair of the Diversifying Technology Caucus and the
Entrepreneurship Caucus with Senator Tim Scott. As President she will work to
get more women and people of color in STEM jobs and she will fully empower
agencies to aggressively fight modern-day redlining that prevents businesses
owned by people of color from getting loans and take on predatory lending that
results in higher interest rates in low-income communities of color.
Make education the great equalizer. Senator
Klobuchar believes a good education is one of the very best investments we can
make in our country’s future. As President, Senator Klobuchar will help make
education the great equalizer by increasing teacher salaries, investing in math
and science to prepare our students for the jobs of tomorrow, and rebuilding
our school infrastructure. She has proposed “Progress Partnerships” to help
states take bold action to fund our public schools — including making sure
infrastructure funding goes to high need areas and reviewing state funding
formulas to improve equity. She will also put back in place guidance from
President Obama directing schools to reduce racial disparities in how they
Support Communities at Risk From Being Left Behind in the
Changing Economy. As President, Senator Klobuchar is committed to
providing additional support to at-risk communities so that no one is left
Expand loans for and investments in local communities in
need. For the past 40 years, the Community Reinvestment Act (CRA) has
encouraged financial institutions to make loans and investment in local
communities, especially low-income and minority communities. Senator Klobuchar
will protect the CRA and instruct financial regulators to conduct greater outreach
to assess the true credit needs of their communities.
Support and strengthen the Economic Development
Administration. The Economic Development Administration (EDA) works
directly with communities and regions to promote competitiveness and innovation.
It has a proven track record of success and on average every $1 of EDA
infrastructure funding generates $15 in private investment. Still, the Trump
Administration has repeatedly proposed eliminating the agency. Senator
Klobuchar will ensure the agency has the resources to carry out its mission.
Bridge the rural-urban divide. Senator Klobuchar
has proposed a plan for America’s Heartland that will strengthen our
agricultural and rural communities, bridge the rural-urban divide, and make
sure that kids who grow up in rural America can stay in rural America. This
includes connecting every household to high speed internet by 2022. She knows
that America’s prosperity depends on the success of our farmers and rural
businesses and as a senior member of the Agriculture Committee, she’s been a
champion for farmers and rural communities in the Senate. Read more about Senator Klobuchar’s
agriculture and rural policies here.
Fulfill our responsibility to our communities and workers who have helped power this country. As the granddaughter of a miner who worked 1,500 feet underground, Senator Klobuchar understands the hard work and sacrifice of those who built and powered our country. She is committed to supporting and creating new opportunities for workers and communities that have depended on the fossil fuel industry as our country transitions away from fossil fuels. Senator Klobuchar will work with the public and private sectors to attract new employers and maintain public services, while investing in infrastructure and educational opportunities in areas that experience job loss. As part of any carbon pricing system, she will create a significant manufacturing tax incentive to encourage investment in communities that have faced or are about to face job losses. To make it easier for workers to find new jobs, Senator Klobuchar will also create a new tax credit for companies that hire workers who have previously depended on the fossil fuel industry for employment.
Senator Klobuchar describes how she will pay for these plans and more here, here, here, here, here and here. To pay for her deficit reduction fund, Senator Klobuchar will increase the corporate rate by two additional points to 27 percent and initiate a government-wide budget review. To pay for her child poverty plan, Senator Klobuchar will repeal the regressive portions of the 2017 Republican tax bill.
The vigorous contest of
Democrats seeking the 2020 presidential nomination has produced excellent
policy proposals to address major issues. Clearly
responding to the backlash against her radical plan to finance Medicare for
All, Senator Elizabeth Warren released details of how she would reduce health
care costs in America, eliminate profiteering from the health care system, and
complete a full transition to Medicare for All in her first term. Warren has
already released her plan to fully finance Medicare
for All when it’s up and running without raising taxes on the middle class by
“Medicare for All is
the best way to guarantee health care to all Americans at the lowest cost. I
have a plan to pay for it without
raising taxes on middle class families, and the transition I’ve outlined here
will get us there within my first term as president. Together, along with
additional reforms like my plans to reduce black maternal mortality rates,
ensure rural health care,
protect reproductive rights,
support the Indian Health Service,
take care of our veterans, and
secure LGBTQ+ equality, we will
ensure that no family will ever go broke again from a medical diagnosis – and
that every American gets the excellent health care they deserve. “
This is from the Warren campaign:
On Day One, Elizabeth will use her executive authority
Reverse Donald Trump’s sabotage of Obamacare
Improve the Affordable Care Act, Medicare, and Medicaid.
Protect people with pre-existing conditions
Drastically lower pharmaceutical costs for millions of
families for drugs including Insulin, EpiPens, and drugs that save people from
The first bill Elizabeth will pass is her comprehensive set
of anti-corruption reforms which include ending lobbying as we know it and
knocking back the influence of Big Pharma and insurance companies.
And in her first 100 days, Elizabeth will use a
fast-track legislative process called budget reconciliation to create a true
Medicare for All option that will:
Include all the health care benefits of Medicare for All
described in the Medicare for All Act.
Be immediately free for nearly half of all Americans,
Children under the age of 18
Families making at or below 200% of the federal poverty
level (about $51,000 for a family of four)
Give every American over the age of 50 the choice to enter a
substantially improved Medicare program.
Consumer costs will automatically decline, so eventually
coverage under this plan will be free to everyone
Throughout her first term, she will fight for additional
health system reforms to save money and save lives–including a boost of
$100 billion in guaranteed, mandatory spending for new NIH
And no later than her third year in office, she will pass
legislation to complete the transition to Medicare for All: guaranteed
comprehensive health care for every American, long-term care, vision, dental,
and hearing, with a single payer to reduce costs and produce better health
Elizabeth’s plan can deliver an $11 trillion boost to
families who will never pay another premium, deductible, or co-pay.
And her plan will protect unions and make sure that there’s
support for workers affected by these changes.
My First Term Plan for Reducing Health Care Costs in
America and Transitioning to Medicare for All
I spent my career studying why families went broke. I rang
the alarm bells as the costs for necessities skyrocketed while wages remained
basically flat. And instead of helping, our government has become more tilted
in favor of the wealthy and the well-connected.
The squeeze on America’s families started long before the
election of Donald Trump, and I’m not running for president just to beat him.
I’m running for president to fix what’s broken in our economy and our
democracy. I have serious plans to raise wages for Americans.
And I have serious plans to reduce costs that are crushing our families, costs
like child care, education, housing – and health care.
The Affordable Care Act made massive strides in expanding
access to health insurance coverage, and we must defend Medicaid and the
Affordable Care Act against Republican attempts to rip health coverage away
from people. But it’s time for the next step.
The need is clear. Last year, 37 million American
adults didn’t fill a prescription because of costs. 36 million people
skipped a recommended test, treatment, or follow-up because of costs. 40 million people
didn’t go to a doctor to check out a health problem because of costs. 57 million people
had trouble covering their medical bills. An average family of four with
employer-sponsored insurance spent $12,378 on
employee premium contributions and out-of-pocket costs in 2018. And 87 million Americans
are either uninsured or underinsured.
Meanwhile, America spends about twice as much per
person on health care than the average among our peer countries while
delivering worse health outcomes than many of them. America is home to the best
health care providers in the world, and yet tens of millions of people can’t
get care because of cost, forcing families into impossible decisions. Whether
to sell the house or skip a round of chemo. Whether to cut up pills to save
money or buy groceries for the week. The way we pay for health care in the
United States is broken – and America’s families bear the burden.
We can fix this system. Medicare for All is the best way to
cover every person in America at the lowest possible cost because it eliminates
profiteering from our health care and leverages the power of the federal
government to rein in spending. Medicare for All will finally ensure that
Americans have access to all of the coverage they need – not just what
for-profit insurance companies are willing to cover – including vision, dental,
coverage for mental health and addiction services, physical therapy, and
long-term care for themselves and their loved ones. Medicare for All will mean
that health care is once again between patients and the doctors and nurses they
trust–without an insurance company in the middle to say “no” to access to the
care they need. I have put out a plan to fully
finance Medicare for All when it’s up and running without raising taxes on the
middle class by one penny.
But how do we get there?
Every serious proposal for Medicare for All contemplates
a significant transition period. Today, I’m announcing my plan to expand public
health care coverage, reduce costs, and improve the quality of care for every
family in America. My plan will be completed in my first term. It includes
dramatic actions to lower drug prices, a Medicare for All option available to
everyone that is more generous than any plan proposed by any other presidential
candidate, critical health system reforms to save money and save lives, and a
full transition to Medicare for All.
Here’s what I’ll do in my first 100 days:
I’ll pursue comprehensive anti-corruption reforms to
rein in health insurers and drug companies – reforms that are essential to make
any meaningful health care changes in Washington.
I’ll use the tools of the presidency to start improving
coverage and lowering costs – immediately. I’ll reverse Donald Trump’s
sabotage of health care, protect individuals with pre-existing conditions, take
on the big pharmaceutical companies to lower costs of key drugs for millions of
Americans, and improve the Affordable Care Act, Medicare, and Medicaid.
I will fight to pass fast-track budget reconciliation
legislation to create a true Medicare for All option that’s free for tens of
millions. I won’t hand Mitch McConnell a veto over my health care
agenda. Instead, I’ll give every American over the age of 50 the choice to
enter an improved Medicare program, and I’ll give every person in America the
choice to get coverage through a true Medicare for All option. Coverage under the
new Medicare for All option will be immediately free for children under the age
of 18 and for families making at or below 200% of the federal poverty level
(about $51,000 for a family of four). For all others, the cost will be modest,
and eventually, coverage under this plan will be free for everyone.
By the end of my first 100 days, we will have opened the
door for tens of millions of Americans to get high-quality Medicare for All
coverage at little or no cost. But I won’t stop there. Throughout my
term, I’ll fight for additional health system reforms to save money and save
lives – including a boost of $100 billion in guaranteed, mandatory spending for
new NIH research over the next ten years to radically improve basic
medical science and the development of new medical miracles for patients.
And finally, no later than my third year in office, I
will fight to pass legislation that would complete the transition to full
Medicare for All. By this point, the American people will have
experienced the full benefits of a true Medicare for All option, and they can
see for themselves how that experience stacks up against high-priced care that
requires them to fight tooth-and-nail against their insurance company. Per the
terms of the Medicare for All Act, supplemental private insurance that doesn’t
duplicate the benefits of Medicare for All would still be available. But by
avoiding duplicative insurance and integrating every American into the new
program, the American people would save trillions of dollars on health costs.
I will pursue each of these efforts in consultation with key
stakeholders, including patients, health care professionals, unions,
individuals with private insurance, hospitals, seniors currently on Medicare,
individuals with disabilities and other patients who use Medicaid, Tribal
Nations, and private insurance employees.
And at each step of my plan, millions more Americans will
pay less for health care. Millions more Americans will see the quality of their
current health coverage improve. And millions more Americans will have the
choice to ditch their private insurance and enter a high-quality public plan.
And, at each step, the changes in our health care system will be fully paid for
without raising taxes one penny on middle class families.
Every step in the coming fight to improve American health
care – like every other fight to improve
American health care – will be opposed by those powerful industries who profit
from our broken system.
But I’ll fight my heart out at each step of this process,
for one simple reason: I spent a lifetime learning about families going broke
from the high cost of health care. I’ve seen up close and personal how the
impact of a medical diagnosis can be devastating and how the resulting medical
bills can turn people’s lives upside down. When I’m President of the United
States, I’m going to do everything in my power to make sure that never happens
to another person again.
The First 100 Days of a Warren Administration
Donald Trump has spent nearly every day of his
administration trying to rip health coverage away from tens of millions of
Americans – first by legislation, then by regulation, and now by lawsuit. When
I take office, I will immediately work to reverse the damage he has done.
But I’ll do much more than that.
In my first 100 days, I will pick up every tool Donald
Trump has used to undermine Americans’ health care and do the opposite. While
Republicans tried to use fast-track budget reconciliation legislation to rip
away health insurance from millions of people with just 50 votes in the Senate,
I’ll use that tool in reverse – to improve our existing public insurance
programs, including by giving everyone 50 and older the option to join the
current Medicare program, and to create a true Medicare for All option that’s
free for millions and available to everyone.
But first, we must act to rein in Washington
Anti-Corruption Reforms to Rein in Health Industry
In Washington, money talks – and nowhere is that more
obvious than when it comes to health care. The health care industry spent $4.7
billion lobbying over the last decade. And health insurance and pharmaceutical
executives have been active in fundraising and donating to
candidates in the 2020 Democratic primary campaign as well.
Today, the principal lobbying groups for the drug companies,
health insurers, and hospitals have teamed up with dozens of other
health industry groups to create the Partnership for America’s Health Care
Future – a front group whose members spent a combined $143 million on
lobbying in 2018 and aims to torpedo
Medicare for All in this election. The Partnership has made clear that “whether
it’s called Medicare for All, Medicare buy-in, or the public option,
one-size-fits-all health care will never allow us to achieve [our]
Let’s not kid ourselves: every Democratic plan for
expanding public health care coverage is a challenge to these industries’
bottom lines – and every one of these plans is already being drowned in money
to make sure it never happens. Any candidate who believes more modest reforms
will avoid the wrath of industry is not paying attention.
If the next president has any intention of winning any
health care fight, they must start by reforming Washington. That’s why I’ve
released the biggest set of anti-corruption reforms since Watergate – and why
enacting these reforms is my top priority as president. Here are some of the
ways my plan would rein in the health care industry:
Close the revolving door. My plan will close the revolving door between
health care lobbyists and government, and end the practice of large
pharmaceutical companies like Novartis, United Health, Roche, Pfizer, and
Merck vacuuming up senior
government officials to try and monopolize government expertise, relationships,
and influence during a fight for health care reform.
Tax excessive lobbying. My plan will also
implement an excessive lobbying tax on
companies that spend more than $500,000 per year peddling influence – like
Pfizer, Amgen, Eli Lilly, Novartis, and Johnson & Johnson. Money from the
tax would be used to strengthen congressional support agencies, establish an
office to help the public participate in the rule-making process, and give our
government additional resources to fight back against an avalanche of corporate
End lobbyist bribery. My campaign finance plan
will ban all lobbyists – including health insurance and pharma lobbyists – from
trying to buy off politicians by donating or fundraising for their campaigns.
This will shut down the flow of millions of dollars in
Limit corporate spending to influence elections. My
plan bans all election-related spending from big corporations with a
significant portion of ownership from foreign entities. That would block major
industry players like UnitedHealth, Anthem, Humana, CVS Health, Pfizer,Amgen, AbbVie, Eli Lilly, Gilead, and Novartis – along
with any trade associations that receive money from them – from spending to
Crowd out corporate contributions with small dollar
donations. I support a constitutional amendment to get big money out
of politics. But until we enact it, my plan would institute a public financing
program that matches every dollar from small donations with six more dollars so
that congressional candidates are answering to the people who need health care
and affordable prescription drugs, rather than health insurance and
Passing these reforms will not be easy. But we should enact
as much of this agenda as possible, as quickly as possible. I will also use my
executive authority to begin implementing them wherever possible – including
through prioritizing DOJ and FEC enforcement against the corrupt
influence-peddling game. And I will voluntarily hold my administration to the
standards that I set in my anti-corruption plan so that all our federal
agencies, including those involved in health care, serve only the interests of
Money slithers through Washington like a snake. Any
candidate that cannot or will not identify this problem, call it out, and
pledge to make fixing it a top priority will not succeed in delivering any
public expansion of health care coverage – or any other major priority.
Immediate Executive Actions to Reduce Costs and Expand
Public Health Coverage.
There are a number of immediate steps a president can take
entirely by herself to lower drug prices, reduce costs, and improve Medicare,
Medicaid, and ACA access and affordability. I intend to take these steps within
my first 100 days.
Dramatically Lower Key Drug Prices
As drug companies benefit from taxpayer-funded R&D and
rake in billions of dollars in
profits, Americans are stuck footing the bill. The average American spends
roughly $1,220 per year on
pharmaceuticals – more than any comparable country. As president, I
will act immediately to lower the cost of prescription drugs, using every
available tool to bring pressure on the big drug companies. I’ll start by
taking immediate advantage of existing legal authorities to lower the cost of
several specific drugs that tens of millions of Americans rely on.
Some drug prices are high because pharmaceutical companies
jack up prices on single-source brand-name drugs, taking advantage of
government-granted patents and exclusivity periods to generate eye-popping
profits. Pharma giant Gilead, for example, launched its
Hepatitis C treatment Harvoni at $94,500-per-twelve week treatment – leaving as many as 85 percent of more than 3 million Americans with
Hepatitis C struggling to afford life-saving treatments.
The government has two
existing tools to combat price-gouging by brand-name drug companies, in
addition to tough antitrust enforcement against companies that abuse our patent
system and use every trick in the book to avoid competition. First, the
government can bypass patents (while providing “reasonable and entire
compensation” to patent holders) using “compulsory licensing authority.” The
Defense Department has used this authority as recently as 2014.
Second, under the march-in provisions of the Bayh-Dole Act, the
government can require re-licensing of certain patents developed with
government involvement when the contractor was not alleviating health or safety
needs. Just in this decade, federal research investments have contributed to
the development of hundreds of drugs –
all of which could be subject to this authority.
But new drugs aren’t the only unaffordable drugs on the
market. Even older, off-patent drugs can be expensive and inaccessible. Lack of
generic competition allows bad actors like Martin Shkreli to
boost the prices of decades-old drugs. Some of the biggest generic drug
companies in the country are now being sued by forty-four states for
price-fixing to keep profits high. Limited competition and other market
failures can also lead to drug shortages. Fortunately, the government can also
act to fix our broken generic drug market by stepping in to publicly
manufacture generic drugs, stopping price gouging in its tracks and bringing
On the first day of my presidency, I will use these tools
to drastically lower drug costs for essential medications – drugs with high
costs or limited supply that address critical public health needs. And
during my administration, we will use these tools to make other drugs
affordable as well.
Insulin was discovered nearly 100 years ago as
a treatment for diabetes – but today the drug is still unaffordable for too
many Americans. Eli Lilly’s brand-name insulin prices increased over 1,200% since the 1990s.
Insulin costs are too high because three drug companies –
Novo Nordisk, Sanofi, and Eli Lilly – dominate the market, jacking up prices.
Americans with diabetes are rationing insulin, and
taxpayers are spending billions on it
through Medicare and Medicaid. It’s obscene.
No American should die because they can’t afford a century-old drug that can
be profitably developed for
$72 a year. I will use existing authorities to contract for manufacture of
affordable insulin for all Americans.
EpiPens deliver life-saving doses of
epinephrine, a drug that reverses severe allergic reactions to things like
peanuts and bee stings. Though epinephrine has been around for over a century, the pens
that deliver it are protected by a patent that
limits competition. In 2016, this lack of competition allowed Mylan, EpiPen’s
manufacturer, to jack up EpiPen prices by 400%, leaving
families unable to afford this life-saving medication. Though cheaper versions
have recently entered
the market, prices remain out of reach for
many American families. As president, I will use existing authorities to
produce affordable epinephrine injectors for Americans (and especially
children) who need it.
Humira is a drug with anti-inflammatory effects used
to treat diseases like arthritis, psoriasis, and Crohn’s disease. It
is the best-selling prescription
drug in the world, treating millions. AbbVie, Humira’s manufacturer, has doubled the price
of Humira to more than $38,000 a year. In 2017, Medicaid and Medicare spent over
$4.2 billion on it – while AbbVie, its manufacturer, developed a “patent thicket” to
shield itself from biosimilar competition. In May 2019, the company
entered into a legal settlement preventing a competitor from entering the U.S.
market until 2023 – probably because prices went down by up to 80% once
biosimilars entered in Europe. My administration will pursue antitrust action
against AbbVie and other drug companies that pursue blatantly anti-competitive
behavior, and, if necessary, use compulsory licensing authority to facilitate
production, saving taxpayers billions.
Hepatitis C drugs like Harvoni are part of
a class described as
“miracle” drugs. Harvoni’s price tag – $94,500-per-treatment – left 85% of the more than 3 million Americans living
with Hepatitis C without a lifesaving medication, while taxpayers foot a $3.8billion bill. Although
the price has come down in recent years, it is still expensive for
too many. One estimate suggests that by
using compulsory licensing, the federal government could treat all Americans
with Hepatitis C for $4.5 billion – just 2% of the $234 billion it would
otherwise cost. That is exactly what I will do.
Truvada is a drug that – until recently –
was the only FDA-approved form
of pre-exposure prophylaxis, which can reduce the risk of HIV from sexual
activity by up to 99%. Truvada’s
manufacturer, Gilead, relied on $50 million in federal grants to
develop it, but today they rake in multi-billion dollar profits while Americans
struggle to afford it. The CDC estimates a million Americans could benefit from
Truvada, though only a fraction do today – largely due to to its $2,000-a-month price tag, which is nearly thirty times what
it costs in other countries. My administration will facilitate the production
of an affordable version – reducing HIV infections and saving taxpayers billions of dollars each
Antibiotics provide critical protection from
bacterial and fungal infections, and we are in desperate need of new
antibiotics to combat resistant infections. Every year, nearly
three million Americans contract antibiotic-resistant infections – and more
than 35,000 people die. But antibiotics don’t generate much money,
discouraging pharmaceutical investment, causing shortages, and contributing to price hikes.
Earlier this year, one biotech firm filed for bankruptcy after
marketing a new antibiotic, Zemdri, for less than a year. My administration
will identify antibiotics with high prices or limited supply and help produce
them to combat resistance and provide patients with the treatments they need.
Drug shortages leave doctors and patients
scrambling to access the treatments they need, forcing many to ration
medications and use inferior substitutes. Our nation’s hospitals, for example,
are currently experiencing a shortage of
vincristine – an off-patent drug that is the “backbone” of childhood cancer
treatment. The vincristine shortage began when Teva, one of its two suppliers,
made the “business decision” to stop manufacturing the drug. When I am
president, the government will track drugs in consistent shortage, like
vincristine, and I will use our administrative authority to ensure we have
Finally, I will also direct the government to study whether
other essential medicines, including breakthrough drugs for cancer or high-cost
drugs for rare diseases, might also be subject to these interventions because
they are being sold at prices that inappropriately limit patient
Make Mental Health and Substance Use Treatment A
The law currently requires health insurers to provide mental
health and substance use disorder benefits in parity with physical health benefits.
But in 2018, less than half of
people with mental illness received treatment and less than a fifth of people
who needed substance use treatment actually received it. As
president, I will launch a full-scale effort to enforce these requirements –
with coordinated actions by the IRS, Centers for Medicare and Medicaid
Services, and Department of Labor to make sure health plans actually provide
mental health treatment in the same way they provide other treatment.
Reverse Trump’s Sabotage
I will reverse the Trump administration’s actions that have
undermined health care in America. Key steps include:
Protecting coverage for people with pre-existing
conditions. The Trump administration has abandoned its duty
to defend current laws in court, cheering on efforts to destroy protections for
pre-existing conditions, insurance coverage for dependents until they’re 26,
and the other critical Affordable Care Act benefits. In a Warren
administration, the Department of Justice will defend this law. And we will
close the loopholes created by the Trump administration, using 1332 waivers,
that could allow states to steer healthy people toward parallel, unregulated
markets for junk health plans. This will shut down a stealth attack on people
with pre-existing conditions who would see their premiums substantially
increase as healthier people leave the marketplace.
Banning junk health plans. The Trump
administration has expanded the use of
junk health insurance plans as an alternative to comprehensive health plans
that meet the standards of the ACA. These plans cover few benefits,
discriminate against people with pre-existing conditions, and increase costs
for everyone else. And in some cases they direct as much as 50 percent of
patient premiums to administrative expenses or profit. I will ban junk plans.
Expanding ACA enrollment. I’ll re-fund the
Affordable Care Act programs that help people enroll in ACA coverage, programs
that have been gutted by the Trump administration.
Expanding premium tax credits. I will reverse
the Trump administration rule that artificially reduced premium tax credits for
many people, making coverage less affordable –
and instead will expand these credits.
Rolling back Trump’s sabotage of Medicaid. I’ll
reverse the Trump administration’s harmful Medicaid policies that take coverage
away from low-income individuals and families. I’ll prohibit restrictive and
ineffective policies like work requirements – which have already booted 18,000 people in
Arkansas out of the program – as well as enrollment caps, premiums, drug
testing, and limits on retroactive eligibility that can prevent bankruptcy.
Restoring non-discrimination protections in health
care. I will immediately reverse the Trump administration’s
terrible proposed rule permitting
health plans and health providers to discriminate against women, LGBTQ+ people,
individuals with limited English proficiency, and others.
Ending the Trump administration’s assault on reproductive
care. I’ll roll back the Trump administration’s domestic and global
gag rules, which deny Title X and USAID funding to health care providers who
provide abortion care or even explain where and how patients can access safe,
legal abortions. And I will overturn the Trump administration’s embattled proposed rule to
roll back mandatory contraceptive coverage.
Strengthen the Affordable Care Act
As president I will use administrative tools to strengthen
the ACA to reduce costs for families and expand eligibility. Key steps include:
Stop families from being kicked out of affordable
coverage. Because of something called the “family glitch,” an
entire family can lose access to tax credits that would help them buy health
coverage if one parent is offered individual coverage with a premium less than
9.86% of their family income. I’ll work to make sure that a family’s access to
tax credits is based on the affordability of coverage for the whole family –
not just one individual – so families who don’t actually have access to
affordable alternatives don’t lose their ACA tax credits.
Expand eligibility to all legally present
individuals. I’ll also work to extend eligibility for ACA tax credits
to all people who are legally present, including those eligible for the
Deferred Action for Childhood Arrivals program.
Put money back in workers’ pockets. The
Affordable Care Act requires insurance
companies to spend at least 80 percent of total premium contributions on health
care claims (and, in many cases, at least 85 percent), leaving the rest to be
spent on plan administration, marketing, and profit. Insurers who waste money
must issue rebates – but too often, these are returned to employers who don’t pass
on the savings to their employees. Insurance companies are expected to pay
out $1.3 billion in
rebates in 2019, with employers in the small-group market receiving an average
rebate of $1,190 and employers in the large-group market receiving an average
rebate of $10,660. My plan will require employers to pass along the full value
of the rebate directly to employees.
As president I will use administrative tools to strengthen
Expand Dental Benefits. The Medicare statute
prohibits coverage of dental care that is unrelated to other medical care,
unless it is medically necessary. This has been interpreted to largely exclude
any oral health care. As a result, almost two-thirds of
Medicare beneficiaries, or nearly 37 million people, lack access to dental
benefits. I will use my administrative authority to clearly expand the
medically necessary dental services Medicare can provide, improving the health
of millions of Medicare beneficiaries.
Stop private Medicare Advantage plans from bilking
taxpayers. Roughly one-third of Medicare beneficiaries get coverage
through a private Medicare Advantage plan. Medicare payments to these plans for
each enrollee are supposed to reflect the cost of covering that person through
traditional Medicare, but overwhelmingevidence shows that
these private plans make their enrollees appear sicker on paper than they
actually are to earn inflated payments at the expense of taxpayers. Some suggest that this
adds $100 billion or more to Medicare spending over ten years. My
administration will put an end to this fraud.
As president I will use administrative tools to strengthen
Medicaid and potentially allow millions more to access the program.
Use waiver authority to increase Medicaid eligibility. With
the approval of the federal government, states can use Section 1115
demonstration waivers to expand coverage to people who aren’t otherwise
eligible for Medicaid. Currently, however, states can only obtain these waivers
if projected federal spending under the new program will not be higher than without the
waiver. While I pursue legislative reforms to expand coverage, I’ll
also change this administrative restriction to allow these demonstrations to
fulfill their promise of providing affordable health coverage, including
working with states that want to expand Medicaid to uninsured individuals and
families above the statutory upper limit of Medicaid (138% of the poverty
level). Any state that chooses to expand in this way will not be penalized for
doing so when full Medicare for All comes online.
Streamlining eligibility and enrollment. Far too
many people miss out on Medicaid coverage because of red tape. Some states take
coverage away if someone misses just one piece of mail or forgets to notify the
state within 10 days of a change in income. These kinds of harsh policies help
explain why more than a million children “disappeared” from the
Medicaid and CHIP programs in the past year. I will eliminate these kinds of
unfair practices, and instead work with states to make it easier for everyone –
families, children, and people with disabilities – to maintain this essential
Ensuring access to care for beneficiaries in managed care
plans. I’ll roll back the Trump administration’s proposed changes to
rules regulating Medicaid managed care plans, which would dilute important
standards, such as requiring health plans to maintain adequate provider
networks guaranteeing access to care for Medicaid enrollees.
Antitrust Enforcement for Hospitals and Health
For years, both horizontal
mergers (where hospitals purchase other hospitals) and vertical mergers (where
hospitals acquire physician practices) have produced greater hospital and
health system consolidation, contributing to the skyrocketing costs of health
care. Today, “not a single
highly competitive hospital market remains in any region of the United
States.” Study after studyshowsthat mergers mean higher prices, lower quality,
and increased inequality due to the growing wage gap between
hospital CEOs and everyone else. Bringing down the cost of health care means
enforcing competition in these markets.
As president, I will appoint aggressive antitrust enforcers
who recognize the problems with hospital and health system consolidation to the
Department of Justice and Federal Trade Commission. My administration will also
conduct retrospective reviews of significant new mergers, and break up mergers
that should never have taken place.
Bringing Health Records into the 21st Century
Congress spent $36 billion to get
every doctor in America using electronic health records, but we still do not have adequate digital
information flow in health care – in part because two big
companies make up about 85% of the market for
medical records at big hospitals. As they attempt to capture more of the
market, these companies are making it harder for systems to communicate with each other. My
administration will ramp up the enforcement against information blocking by big
hospital systems and health IT companies, and I will appoint leaders to the FTC
and DOJ who will conduct a rigorous antitrust investigation of the health
records market, especially in the hospital space.
Elevating the Voices of Workers in the Transition to
Medicare for All
The fundamental goal of my presidency will be returning
power to working people. Medicare for All accomplishes that by giving every
American high-quality coverage and freeing them from relying on the whims of
their employers or private insurance companies for the health care they need.
My plan to transition to Medicare for All will also put working people first,
and elevate their voices at each stage of the process.
My plan seeks to build on the achievements of generations of
working people and their unions who have fought for and won health care. I view
good health plans negotiated through collective bargaining as a positive
achievement for working people, and I will seek as part of the first phase of
my plan the elimination of the excise tax on those plans.
In my first weeks in office, I will issue an Executive Order
creating a commission of workers (including health care workers), union
representatives, and union benefit managers that I will consult at every stage
of the transition process. The commission will be responsible for providing
advice on each element of the transition to Medicare for All, including, at a
Ensuring workforce readiness and adequate access to care
across all provider types.
Determining national standards of coverage and benefits,
including long-term care.
Learning from successful existing non-profit health care
administrators and integrating them into the new Medicare for All system.
Ensuring a living wage for all health care workers and that
savings generated within the new system by hospitals and other health care
employers are shared fairly with all of the workers in the health care system.
Ensuring that workers are able to use the collective
bargaining process during the transition period and under the new Medicare for
All system to ensure both effective health outcomes and to ensure that savings
generated by the new system are fairly shared with workers.
In administering the Medicare for All system, my
administration will also rely on unions’ expertise on designing good benefits
for workers and helping workers navigate our health care system. During the
transition to Medicare for All – and even when we ultimately reach a full
Medicare for All system – my administration will seek to partner with
collectively bargained non-profit health care administrators. For example, we
will draw upon their expertise in helping workers choose providers, and look
for opportunities to enter into contracts with the administrators of unions’ collectively
bargained health plans to provide these services. And my plan will guarantee
that union-sponsored clinics are included within the Medicare for All system
and will continue serving their members.
Finally, Medicare for All will be an enormous boost to
the economy, lifting a weight off of both workers and businesses and creating
good new jobs, including in administering health care benefits. Still, the
Medicare for All legislation includes billions of dollars to provide assistance
to workers who may be affected by the transition to Medicare for All, and I
plan on consulting with the new worker commission and other affected parties to
ensure that money is spent as effectively as possible. In the past, transition
assistance programs have been underfunded and have not been as responsive as
they should have been to the actual needs of workers. That will not be the case
in my administration. No worker will be left behind.
Legislation to Expand Medicare and Create a True Medicare
for All Option
In 2017, Senate Republicans came within one vote of
shredding the Affordable Care Act and taking health care coverage away from
more than 20 million people. How did they get so close? By using a fast-track
legislative process called budget reconciliation, which only requires 50 votes
in the Senate to pass laws with major budgetary impacts. President Obama also
used this process to secure final passage of the Affordable Care Act.
I am a strong supporter of eliminating the filibuster, which
I believe is essential to preventing right-wing Senators who function as wholly
owned subsidiaries of major American industries from blocking real legislative
change in America. Any candidate for president who does not support this change
should acknowledge the extreme difficulty of enacting their preferred
legislative agenda. But I’m not going to wait for this to happen to start
improving health care – and I’m not going to give Mitch McConnell or the
Republicans a veto over my entire health care agenda.
That’s why, within my first 100 days, I will pass my own
fast-track budget reconciliation legislation to enact a substantial portion of
my Medicare for All agenda – including establishing a true Medicare for All
option that’s free for millions and affordable for everyone.
A True Medicare for All Option. There are many
proposals that call themselves a Medicare for All “public option” – but most of
them lack the financing to actually allow everyone in America to choose true
Medicare for All coverage. As a result, these proposals create the illusion of
choice, when in reality they offer tens of millions of Americans the decision
between unaffordable private insurance and unaffordable public insurance. A
choice between two bad options isn’t a choice at all.
My approach is different.
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. The plan
will be administered by Medicare and offered on ACA exchanges. Here are its key
Benefits. Unlike public option plans, the
benefits of the true Medicare for All option will match those in the Medicare
for All Act. This includes truly comprehensive coverage for primary and
preventive services, pediatric care, emergency services and transportation,
vision, dental, audio, long-term care, mental health and substance use, and
Immediate Free Coverage for Millions. This plan
will immediately offer coverage at no cost to every kid under the age of 18 and
anybody making at or below 200% of the federal poverty level (about $51,000 for
a family of four) – including individuals who would currently be on Medicaid,
but live in states that refused to expand their programs.
Free, Identical Coverage for Medicaid
Beneficiaries. States will be encouraged to begin paying a
maintenance-of-effort to the Medicare for All option in exchange for moving
their Medicaid populations into this plan and getting out of the business of
administering health insurance. For states that elect to maintain their
Medicaid programs, Medicaid premiums and cost sharing will be eliminated, and
we will provide wraparound benefits for any Medicare for All option benefits
not covered by a state’s program to ensure that these individuals have the same
free coverage as Medicaid-eligible people in the Medicare for All option.
Eventual Free Coverage for Everyone. This plan
will begin as high-quality public insurance that covers 90% of costs and allows
people to utilize improved ACA subsidies to purchase coverage and reduce cost
sharing. There will be no premiums for kids under 18 and people at or below
200% of the federal poverty level. For individuals above 200% FPL, premiums
will gradually scale as a percentage of income and are capped at 5.0% of their
income. Starting in year one, the plan will not have a deductible — meaning
everyone gets first dollar coverage, and cost sharing will be zero for people
at or below 200% FPL. Cost sharing will scale modestly for individuals at or
above that level, with caps on out-of-pocket costs. In subsequent years,
premiums and cost sharing for all participants in this plan will gradually
decrease to zero.
Reducing Drug Prices. The Medicare for All
option will have the ability to negotiate for prescription drugs using the
mechanisms I’ve previously outlined,
helping to drive down costs for patients.
Automatic Enrollment. Anyone who is uninsured or
eligible for free insurance on day one, excluding individuals who are over 50
and eligible for expanded coverage under existing Medicare, will be
automatically enrolled in the Medicare for All option. Individuals who prefer
other coverage can decline enrollment.
Employee Choice. Workers with employer coverage
can opt into the Medicare for All option, at which point their employer will
pay an appropriate fee to the government to maintain their responsibility for
providing employee coverage. In addition, unions can negotiate to include a
move to the Medicare for All option via collective bargaining during the
transition period, with unionized employers paying a discounted contribution to
the extent that they pass the savings on to workers in the form of increased
wages, pensions, or other collectively-bargained benefits. This will support
unions and ensure that the savings from Medicare for All are passed on to
workers in full, not pocketed by the employer.
Provider Reimbursement and Cost Control. I
have identified cost
reforms that would save our health system trillions of dollars when implemented
in a full Medicare for All system. The more limited leverage of a Medicare for
All option plan will accordingly limit its ability to achieve these savings –
but as more individuals join, this leverage will increase and costs will go
down. Provider reimbursement for this plan will start above current Medicare
rates for all providers, and be reduced every year as providers’ administrative
and delivery costs decrease until they begin to approach the targets in my
Medicare for All plan. The size of these adjustments will be governed by
overall plan size and the progress of provider adjustment to new, lower
Expand and Improve Existing Medicare for Everyone Over
50. In addition to the Medicare for All option, any person over the
age of 50 will be eligible for expanded coverage under the existing Medicare
program, whose infrastructure will allow it to absorb new beneficiaries more
quickly. The expanded Medicare program will be improved in the following
Benefits. To the greatest extent possible,
critical benefits like audio, vision, full dental coverage, and long-term care
benefits will be added to Medicare, and we will legislate full parity for
mental health and substance use services.
Eventual Free Coverage for Everyone. Identical
to the Medicare program, enrollees will pay premiums in Part B and D, with a
$300 cap on drug costs in Part D. Plugging a huge hole in the current Medicare
program, out-of-pocket costs will be capped at $1,500 per year across Parts A,
B, and D, eliminating deductibles and reducing cost sharing. In subsequent
years, premiums and cost sharing will gradually decrease to zero.
Employee Choice. Identical to the Medicare for
All option, workers 50-64 can opt into expanded Medicare, at which point their
employer will pay an appropriate fee to the government to maintain their
responsibility for providing employee coverage.
Reducing Drug Prices. The expanded Medicare
program will receive the ability to negotiate for prescription drugs using the
mechanisms I’ve previously outlined,
helping to drive down costs for patients. And we will create a publicly run
prescription drug plan that is benchmarked off the best current Part D
Automatic Enrollment. Every person without
health insurance over the age of 50 will be automatically enrolled in the
expanded existing Medicare program.
Provider Reimbursement and Cost Control. Provider
reimbursement for new beneficiaries will start above current Medicare rates for
all providers, and be reduced every year as providers’ administrative and
delivery costs decrease until they begin to approach the targets in my Medicare
for All plan. It will be a new condition of participation that providers who
take Medicare or other federally subsidized insurance also take the Medicare
for All option. We will also adopt common sense reforms to bring down bloated
reimbursement rates, including reforms around post-acute care, bundled
payments, and site neutral payments.
Improving the Affordable Care Act. My reforms
will also strengthen Affordable Care Act plans – including the new Medicare for
All option – by making the following changes:
Expand Tax Credit Eligibility. We will lift the
upper limit on eligibility for Premium Tax Credits, allowing people over 400%
of the federal poverty level to purchase subsidized coverage and greatly
increasing the number of people who receive subsidies.
Employee Choice. We will allow any person or
family to receive ACA tax credits and opt into ACA coverage, regardless of
whether they have an offer of employer coverage. If an individual currently
enrolled in qualifying employer coverage moves into an ACA plan, their employer
will pay an appropriate fee to the government to maintain their responsibility
for providing employee coverage.
Lower Costs. Right now, people may pay up to 9.86% of their
income before they get subsidies. Under my plan, this cap would be lowered –
and to make sure those tax credits cover more, we will benchmark them to more
generous “gold” plans in the Marketplace. And we will increase eligibility for
cost sharing reductions, ensuring that more individuals can get into an
affordable exchange plan immediately.
Eliminate the Penalty for Getting a Raise. Right
now, if someone’s income goes up, they can be forced to repay thousands of
dollars in back premiums. We will change this and base tax credits on the
previous year’s income. And if someone’s income goes down, they will get the
higher subsidy for that year.
State Single-Payer Innovation Waivers. To help
states try out different payer arrangements and pilot programs, we will allow
states to receive passthrough funding to expand or improve coverage via the
ACA’s Section 1332 waivers. Combined with Medicaid waivers, these changes will
allow interested states to start experimenting immediately with consolidating
public payers and move towards a single-payer system.
Additional Financing. My plan to pay for
Medicare for All identifies $20.5 trillion in new revenue, including an
Employer Medicare Contribution, which will cover the long-term, steady-state
cost of a fully functioning Medicare for All system. The cost of this
intermediate proposal will be lower. Any revenue needed to meet the
requirements of fast-track budget reconciliation will be enacted as part of
this legislation from the financing options that I have already proposed.
Additional Health System Reforms to Save Money and Lives
After pursuing administrative changes, expanding existing
Medicare, and creating a true Medicare for All option, every person in the
United States will be able to choose free or low-cost public insurance. Tens of
millions will likely do so. But we can’t stop there. We must pursue additional
reforms to our health system to save money and save lives. Some of my
Investing in Medical Miracles. Many medical
breakthroughs stem from federal investments in
science – but in 2018, 43,763 out of 54,834 research
project grant applications to the National Institutes of Health (NIH) were
rejected. We will boost medical research by investing an additional $100
billion in guaranteed, mandatory spending in the NIH over ten years, split
between basic science and the creation of a new National Institute for Drug
Development that will help take the basic research from the other parts of NIH
and turn it into real drugs that patients can use. We will prioritize
treatments that are uninteresting to big pharmaceutical companies but could
save millions of American dollars and lives. Any drugs that come out of this
research and to American consumers can be sold abroad, with the proceeds
reinvested to fund future breakthrough drug development. And by enacting my
Affordable Drug Manufacturing Act, the government can manufacture generic drugs
that are not available due to cost or shortage.
Ending the Opioid Epidemic. The opioid epidemic
is a public health emergency. In 2017, life expectancy in the United States
dropped for the third year in a row, driven in large part by deaths from drug
overdoses. We will enact my legislation, the CARE Act, to invest $100 billion
in federal funding over the next ten years in states and communities to fight
this crisis – providing resources directly to first responders, public health
departments, and communities on the front lines of this crisis.
Improved Administration. To cut down on time
wasted on paperwork, we will create single standardized forms for things like
prior authorizations and appeals processes to be used by all insurers (private
and public), and we will establish uniform medical billing for insurers and
All-Payer Claims Database. Right now, there are so
many middlemen in health care that no one knows for certain how much we pay for
different services across the whole system. A centralized repository of
de-identified claims data will help the government, researchers, and the market
better understand exactly what we pay for health care and what kind of quality
it gets us. Demystifying what we pay for what we get will be a critical part of
ensuring fair reimbursement under Medicare for All.
Antitrust Enforcement. In addition to
administrative actions to rein in anti-competitive hospital and electronic
medical record practices, we’ll also ban non-compete and no-poach agreements
and class action waivers across the board, while making it easier for private
parties to sue to prevent anti-competitive actions. I’ll work with states to
repeal Certificate of Public Advantage, or COPA, statutes
that shield health care
organizations from federal antitrust review and can lead to the
creation of large monopolies with little to no oversight. And I’ll also push to
ensure our antitrust laws apply to all health care mergers.
Ending Surprise Billing. Imagine being a woman
who schedules her baby’s delivery with her obstetrician at an in-network
hospital, but it turns out that the anesthesiologist administering the epidural
isn’t in-network. Even though she had no choice – and probably had no idea that
doctor was out-of-network – under the current system she gets hit with a huge
bill. We will end the practice of surprise billing by requiring that
services from out-of-network doctors within in-network hospitals, in addition
to ambulances or out-of-network hospitals during emergency care, be treated as
in-network and paid either prevailing in-network rates or 125% of the Medicare
reimbursement rate, whichever is lower.
Preventing Provider Shortages. With more people
seeking the care they need, it will be essential to increase the number of
providers. I will make these
critical investments in our clinicians, including by dramatically scaling up
apprenticeship programs to build a health care workforce rooted in the
community. I will lift the cap on residency placements, allowing 15,000 new
clinicians to enter the workforce. I will expand the National Health Service
Corps and Indian Health Service loan repayment program to allow more health
professionals – including physicians, physician assistants, registered nurses,
nurse practitioners, and other licensed practitioners – to practice in
underserved communities. I will also provide grants to states that expand
scope-of-practice to allow more non-physicians to practice primary care. And I
will push to close the
mental health provider gap in schools.
Completing the Transition to Medicare For All
By pursuing these changes, we will provide every person in
America with the option of choosing public coverage that matches the full
benefits of Medicare for All. Given the quality of the public alternatives,
millions are likely to move out of private insurance as quickly as
No later than my third year in office, at which point the
number of individuals voluntarily remaining in private insurance would likely
be quite low, I will fight to pass legislation to complete the transition to
the Medicare for All system defined by the Medicare for All Act by the end of
my first term in office.
Moving to this system would mean integrating everyone into a
unified system with zero premiums, copays, and deductibles. Senator Sanders’s
Medicare for All Act allows for supplemental private insurance to cover
services that are not duplicative of the coverage in Medicare for All; for
unions that seek specialized wraparound coverage and individuals with
specialized needs, a private market could still exist. In addition, we can
allow private employer coverage that reflects the outcome of a collective
bargaining agreement to be grandfathered into the new system to ensure that
these workers receive the full benefit of their bargain before moving to the
new system. But the point of Medicare for All is to cut out the middleman.
Every successful effort to move the United States to create
and expand new social programs – like Social Security and Medicare and Medicaid –
has required multiple steps. In fact, every credible Medicare for All proposal
has a significant, multi-step transition built in. That’s why it’s important to
have both short-term goals and long-term goals to guide the process and to
deliver concrete improvements to people’s lives at every stage.
I believe the next president must do everything she can
within one presidential term to complete the transition to Medicare for All. My
plan will reduce the financial and political power of the insurance companies –
as well as their ability to frighten the American people – by implementing
reforms immediately and demonstrating at each phase that true Medicare for All
coverage is better than their private options. I believe this approach gives us
our best chance to succeed.
Why do we need to transition to Medicare for All if a robust
Medicare for All option is available to everyone? The answer is simple and
blunt: cost and outcomes. Today, up to 30% of
current health spending is driven by the costs of filling out different
insurance forms and following different claims processes and fighting with
insurance companies over what is and is not covered. I have demonstrated how a
full Medicare for All system can use its leverage to wring trillions of dollars
in waste out of our system while delivering smarter care – and I’ve made clear exactly
how I would do it. The experience of other countries shows that this system is
the cheapest and most efficient way to deliver high-quality health care. As
long as duplicative private coverage exists, we will limit our ability to make
health care delivery more effective and affordable – and the ability of private
middlemen to abuse patients will remain.
Medicare for All will deliver an $11 trillion boost to
American families who will never pay another premium, co-pay, or deductible.
That’s like giving the average working family in America a $12,000 raise. This
final legislation will put a choice before Congress – maintain a two-tiered
system where private insurers can continue to profit from being the middlemen
between patients and doctors, getting rich by denying care – or give everybody
Medicare for All to capture the full value of trillions of dollars in savings
in health care spending. I believe that the American people will demand
Congress make the right choice.
As Second Lady in the Obama Administration, Dr. Jill Biden worked closely with First Lady Michelle Obama on behalf of bettering lives for military families. VP Joe Biden, candidate for President, is proposing a plan to reinvigorate and expand that program for military families, caregivers and survivors. This is from the Biden campaign:
FACT SHEET: The Biden Plan to Fulfill Our Commitment to Military Families, Caregivers and Survivors
As parents of a service member who deployed to Iraq, Vice
President Joe Biden and Dr. Jill Biden understand that it’s not just military
members who sign up to serve our nation, their families do too. The Bidens
understand the sleepless nights, wondering if your deployed loved one is safe;
the difficulties children experience while their parent is serving far away;
and all the added sacrifices and challenges, big and small, military families
face because they choose selfless service. Our military families never fail to
give their best to the United States, and we owe them our best in return.
Less than one percent of Americans sign up to serve. They volunteer to
shoulder the sacrifices necessary to keep our country safe. That’s why Vice
President Biden has long been adamant that, as a nation, our one truly sacred
obligation is to properly prepare and equip our troops when we send them to
war, and to take care of them and their families — during deployments and when
they return home.
Building on the Biden Commitment to Military Families
The Obama-Biden Administration made support for our military families a
signature issue–and a personal priority. Together with First Lady Michelle
Obama, Dr. Biden created Joining Forces, a national initiative driving
top-level focus on the issues that matter to military families, service
members, and veterans including employment, education, and wellness. Joining
Forces supported opportunities that led to the hiring or training of more
than 1.5 million veterans and
military spouses and drove reforms in all 50 states to reduce credentialing
barriers for qualified military spouses seeking employment. Dr. Biden also
supported the Department of Defense’s (DoD’s) Military Spouse Employment
Partnership, which brought together hundreds of companies to help 100,000 military spouses find
As a life-long educator, Dr. Biden spearheaded “Educate the Educators”–a
commitment from more than 100 colleges and universities to
take steps to meet the unique needs of military-connected children–and championed the GI Comparison tool to
help veterans and military family members choose high-quality post-secondary
educational institutions. She also worked to make sure that all 50 states signed the Interstate
Compact on Educational Opportunity for Military Children to better
address relocation challenges facing military school-aged children.
Vice President Biden and Dr. Biden continued this commitment after leaving
office, making support for military families a key focus of their continued
public service. The Biden Foundation sought to drive
economic opportunity for military spouses, create supportive educational
environments for military-connected children, and change the conversation
around mental health for service members, veterans, and their families.
As President and First Lady, the Bidens will ensure we keep our national
commitment to military families by relaunching and strengthening Joining
Forces, making it a priority for a Biden Administration.
We know that many future service members come from military families. So family
readiness is integral to mission readiness, both now and in the future. This
cannot be an afterthought. It is a national security imperative, and it should
be resourced and supported as such.
Providing Resources for Military Spouses, Caregivers, and
Prioritizing Support for Military Children
President Biden will inspire a future generation of
Americans to volunteer for military service by ensuring we fulfill our
obligations to the generations who have already answered the call to serve our
country and by supporting the well-being of ALL military families.
Modernize Compensation to
Keep Pace with the Current Economy: Today,
more military families are struggling to make ends meet, and
some report food insecurity, lack of quality childcare, and poor financial health.
That is totally unacceptable. Military service members and their families risk
everything for our country–they must be guaranteed a living wage. But the
existing compensation framework simply does not allow military
families–especially those who are young and more vulnerable–to thrive in
today’s modern economy. President Biden will work aggressively to update the
federal workforce compensation framework for service members so that the
government leads the way in ensuring hard-working families can attain a middle
class life, and he will support legislation which will, in the meantime,
provide an additional allowance for military families living below the poverty
Create Stability by
Increasing Time between Permanent Change of Station (PCS) Moves: Every year, more than 400,000 Permanent Change of Station
(PCS) moves occur for service members and their families. This
system is expensive, and it is broken. Military families consider frequent
relocation as a driver for negative outcomes in career opportunities for military
spouses, military child education, and the
development of supportive social networks. While every service member and
family understands that mission is paramount, we must invest in solutions that
build stability for families and set conditions for service member retention
and military family well-being.
As president, Biden will commission research and develop solutions to support
the increase of time between PCS moves while ensuring we meet targets for
Operational and Personnel Tempo in order to meet our national security demands.
This will require that we comprehensively examine the potential positive and
negative impacts of any changes to deployment cycles, unit assignment policies,
and force size calculations. One such solution could be investing in the
creation of virtual or hybrid learning scenarios for mandatory Professional
Military Education (PME) so that service members and their families can remain
in place, rather than PCS to a new base for a short educational tour.
Ensure Military Spouse
Professional and Economic Opportunity: Military
spouses are often more highly educated than their civilian peers, yet they face
an unemployment rate of around 30%. Frequent relocation
and high operational tempos often stifle their career trajectory. The military
personnel system was designed with the single-earner family in mind, but many
military families, like their civilian counterparts, depend on earning a second
income or simply want the opportunity for the military spouse to pursue a
career. Military families are increasingly experiencing challenges such
as food insecurity or insufficient savings for
emergencies, and with far too many military spouses unemployed or
underemployed, meeting these needs is a challenge. LGBTQ military spouses may
also be disproportionately affected when they reside in states that are allowed
to discriminate based on an individual’s sexual orientation or gender identity.
The Trump Administration has not only allowed but encouraged these
discriminatory practices, all while claiming to support the military. It’s
hypocritical and just plain wrong.
To increase economic opportunity for military spouses, President Biden will:
Invest $500 million in a 3-year Department of Defense (DOD)
military spouse entrepreneurship pilot program, which will provide
micro-grants, mentorship, and technical assistance to military spouses who are
interested in starting or growing small businesses.
Ensure that the DoD’s Military Spouse Education and Career
Opportunity office is fully funded and staffed so that effective programming
such as the Military Spouse Employment Partnership (MSEP), My Career
Advancement Account (MyCAA) scholarships, and the Military Spouse Transition
Program (MySTeP) have the opportunity to deliver results and raise awareness
and utilization among military families.
Build bridges between the private sector and the U.S.
government to help educate employers about the value of military spouse talent,
drive commitments to hire, retain, and promote them, and create concrete career
opportunities, as Joining Forces did.
Expand the Work Opportunity Tax Credit (WOTC) to include
Undo the Trump administration’s discriminatory policies and
redouble efforts with state officials to ensure that LGBTQ military spouses
have the support they need to pursue successful careers.
Continue efforts begun during the Obama-Biden Administration
to put an end to unnecessary occupational licensing requirements. While
licensing is important in some occupations to protect consumers, in many
occupations licensing does nothing but thwart economic opportunity. If a
military spouse who works in an occupation that requires a license or
credential and has to move because of their military member’s career, they may
have to get certified all over again. As president, Biden will build on the
Obama-Biden Administration’s efforts to incentivize states to reduce unnecessary
licensing requirements and to ensure licenses are transferable from one state
to the next.
Fully fund installation-based child care facilities and
expand awareness of the DoD fee assistance program, as supported by leading advocates
for military families,, so that military spouses can more easily
pursue their educations and careers and tap into respite care to relieve
stressors of deployments.
for Caregivers:Caregivers of
wounded, ill, or injured service members and veterans face a variety of
challenges, including negative health outcomes, lost wages, and difficulties
planning their future. They are essential to military families and our
veterans, and we owe them the same commitment and support that they show to our
wounded, ill, or injured service members and veterans.
As president, Biden will:
Ensure that caregivers of active duty service members
receive adequate professional and peer support, including competent mental
health care, financial readiness training, and transition support throughout
the rehabilitation timeline (whether that is leading to the service member’s
medical retirement or a return to duty).
Provide transparency and high-touch case management via
in-person or telehealth sessions with caregiver coordinators for those
caregivers enrolled in the Department of Veterans Affairs (VA) Caregiver
Support Program, especially to provide personalized assistance as they navigate
dual eligibility for benefits and services from both the DoD and VA.
A critical part of meeting our commitment to military
families is to do so on time, something the Trump Administration has failed to
do. President Biden will ensure that the eligibility expansion for the VA
Caregiver Support Program meets its timelines and collects longitudinal
satisfaction data through regular surveying of those enrolled or enrolling in
Help caregivers of wounded, ill, injured, or elderly
veterans pay for long-term care by providing relief through the creation of a
$5,000 tax credit for informal caregivers, modeled off of legislation supported
by AARP. This tax credit will be in addition to the financial support provided
by the VA Caregiver program.
Support proposals to expand opportunities for much needed
respite care for caregivers, to include those offered within DoD, VA, and
through the Department of Health and Human Services (HHS).
Institute a waiver for the Survivors’ and Dependents’
Educational Assistance Program (Chapter 35), so that spouses and survivors who
have not accessed their benefits in the allotted time frame will have the
opportunity to request additional time.
Improve Military Child
Education: There are more
than 1 million children of active
duty service members worldwide. Whether they are educated in Department of
Defense Education Activity (DoDEA) schools, local school districts, parochial
schools, home schools, or online schools, military children require support to
ensure they have every opportunity to succeed in their education.
As president, Biden will:
Propose legislation to expand the Military Student
Identifier (MSI) to all military-connected
children (to include children of National Guard and Reserve personnel
regardless of activation/order status), children of veterans, and children of
deceased service members or veterans, who are often impacted by the service of
their parents. Under the Obama-Biden Administration, we passed into law the
Every Student Succeeds Act, which included the MSI, a designation that allows
educators and schools to better understand where military-connected children
are receiving their education, and how we can better support
them. Currently, the MSI extends only to children of active duty service
members, excluding children of National Guard, Reserve, veterans, caregivers,
and children of the fallen. But these children face unique challenges too,
and we need to know who they are so we can determine what support they need .
Promote efforts across states to streamline enrollment
requirements, standardize educational resources, and train teachers and
school-based leadership to ensure we are meeting the unique needs of military
children effectively, no matter where they study or how often they have to
Promote greater awareness of the Interstate Compact on
Educational Opportunity for Military Children among military families,
teachers, and administrators.
Create and disseminate training tools that empower
military-connected parents to better advocate for their children.
Provide financial incentives for school districts to train
educators on the unique needs and barriers faced by military-connected youth so
that they are able to help military children thrive, no matter where they
receive their education.
Support and protect post-9/11 GI benefits for veterans and
qualified family members by strengthening the GI Bill Comparison Tool and
School Feedback Tool to help put an end to post-secondary institutions’
Enact legislation eliminating the so-called 90/10 loophole
that gives for-profit schools an incentive to enroll veterans, service members,
and military family members who are using the GI Bill or Tuition Assistance in
programs that aren’t delivering results.
Improve Behavioral Health Services for Military Dependents: Children and spouses in military families are
resilient, but they do experience high levels of stress, whether due to
frequent moves, deployment and training schedules of the service member, or
weak social/emotional support networks. School-age children and adolescents who
experience separation from a parent (either through deployment or other
assignments) show higher levels
of emotional and behavioral distress. About 25 percent of high
school freshmen and juniors in a military family have reported suicidal
thoughts during the previous year, and the stresses of military life can exacerbate health issues,
among them depression, anxiety, or substance use disorders.
Biden has committed to achieving mental health parity, expanding access to
behavioral health care, and removing the stigma surrounding behavioral health
issues. He will redouble our efforts to ensure enforcement of mental health
parity laws and expand funding for mental health services.
It is also essential that we invest in an infrastructure that promotes health
and well-being, reduces risky behaviors, and provides timely, convenient access
to high-quality mental health and substance use/abuse services for military
dependents. We must ensure that DoD facilities are fully staffed, equipped,
resourced, and able to support the behavioral health of military dependents. If
this capacity is not in place, we must invest in solutions to create additional
affordable, accessible, and high-quality capacity in the civilian sector. Care
must be effective and grounded in evidence-based treatments. Providers must be
culturally competent, educated in the unique needs of military families. And
families who seek support should never go into debt for treatment or be
concerned about confidentiality.
The Biden Administration will:
Increase funding for and expand access to telehealth for
military families, particularly in areas not able to access timely care.
Expand the number of free, non-medical Military OneSource
counseling sessions for military families from 12 sessions to 18
and expand access to Coast Guard families regardless of activation status.
Invest in recruiting and retaining behavioral health care
professionals in military treatment facilities to ensure there are enough
clinicians to support the needs of not only our active duty force, but military
Redefine the federal “Health Professional Shortage Areas”
(HPSAs) to specifically include military-impacted geographies.
Expand the National Health Services Corps to incentivize
early professional behavioral health providers to serve this population.
Re-prioritize and expand the work of the Substance Abuse and
Mental Health Services Administration (SAMHSA) interagency task force on the
behavioral health needs of veterans and military families, to include issues
related to traumatic brain injury, substance use disorder and addiction, and
other related conditions. Additionally, President Biden will fully restore SAMHSA’s focus on
evidence-based solutions and appoint a specific position on the
Domestic Policy Council to drive a whole-of-government focus on these
Direct the Department of Defense to produce a robust, annual
report on the state of military family behavioral health, in coordination with
VA and SAMHSA.
Housing: The government has
broken its trust with military families by providing sub-par housing. Now, we
have to work twice as hard to rebuild this trust. That will require the utmost
transparency and accountability from both the government and the private sector
partners charged with housing the families of our service members.
The Biden Administration will:
Enforce a comprehensive and standardized tenant bill of
rights for all military families, and as advocates have rightly demanded,
ensure DoD senior leadership enforces compliance. We won’t be making more
empty promises to military families. We will hold these landlords, and
Require regular, standardized, objective, and published
reporting of military family satisfaction and concerns from all housing.
Establish a public-facing document outlining expectations of
quality and consequences for all housing providers and, when necessary,
terminate long-term leases held by private companies.
Families: Long periods of
sustained war-fighting have made us reactive in our responses to military
family needs. To best support these families and optimize their health and
well-being, we must improve our understanding of their current and emerging
needs. We can’t be caught on our heels. We must anticipate and prepare
solutions that respond to the evolving needs of military families across the
military life cycle. We must be able to track and identify emerging trends so
that we can be nimble and responsive to the changing needs of our military
As president, Biden will:
Convene a multi-disciplinary working group of policy makers,
program leaders, and research and subject-matter experts to construct a
strategic research plan to inform solutions to support military families.
Designate specific resources for research and development
related to military families outcomes within the budget of the Office of the
Under Secretary of Defense for Personnel and Readiness, to include resources
for research within both the Military Family and Community Policy and the
Defense Health Program.
Require that DoD work across the federal government to
leverage national and state-level assessments of health and well-being to
ensure they appropriately assess military affiliation in ongoing data
collections across the United States. It is imperative that all national
surveys include variables that allow us to examine how well military families
fare relative to others.
Vice President Joe Biden, candidate for president, with Dr. Jill Biden, issued a statement on Veterans Day, and his campaign issued a detailed plan about what a Biden Administration would do for veterans. Here are is the statement and fact sheet from the campaign:
memorably wrote that, “A soldier is the most holy of all humans, because [they
are] the most tested.” From Fort McHenry to San Juan Hill, from the Argonne
Forest to Midway, from the Mekong Delta to Fallujah, and on every battlefield
between, America’s veterans have always been the most tested among us — and
they have never failed in their duty.
In each generation, a small fraction of Americans serve and sacrifice on behalf
of us all. Less than one percent of our population risks everything to protect
our country, incurring in the rest of us a debt far greater than our nation
could ever repay. We have always believed that the most sacred obligation of
our government is to do right by the men and women who defend our nation at war
— to care for them and their families, both while they are deployed and after
they come home. It’s an obligation we are honor-bound to keep.
Veterans Day offers us a moment to reflect on that obligation, and to recommit
ourselves to all that it truly means. Every one of our veterans deserves
timely, world-class health care — the very best of what our country has to
offer. They deserve comprehensive mental health support, and a thoughtful,
well-funded plan to address the ongoing tragedy of veteran suicides. They deserve
a serious approach to ending veteran homelessness, and greater resources to
help them readjust to life at home once their service concludes. Not only
do they deserve
these things — their families and caregivers do, too.
Our veterans also deserve a leg up when it comes to educational and economic
opportunities — everything from tuition assistance to skills training to
entrepreneurship programs. That isn’t just for their benefit; America benefits
enormously from the leadership, talent, and experience of veterans who gird
every sector of our economy with sinew and smarts. The GI Bill was one of the
greatest engines of widespread prosperity our country has ever conceived,
helping to cement the most resilient middle class in the history of the world
in the wake of World War II. Our veterans and our country deserve that
commitment to be upheld and advanced.
Most of all, our veterans deserve leaders who will fight for them as ardently
and as forcefully as they have fought for us.
That’s why, on this Veterans Day, we are proud to release a detailed and
comprehensive plan to honor the full breadth of our obligation to veterans and their families — and to restore the sacred commitments
that this White House has seen fit to ignore.
This plan and this cause are personal to us. Over the course of many years, it
has been our honor to visit our troops in Bosnia, Kosovo, Iraq, and
Afghanistan, and to witness their incredible strength of character firsthand.
We have been blessed to visit with wounded veterans in Landstuhl, Germany, and
at the Brooke Army Medical Center in San Antonio, and to welcome troops to our
home for Thanksgiving dinners and spend many Christmas Days with the heroes at
Walter Reed. When our son Beau was deployed to Iraq for a year, we whispered
prayers, and learned a small portion of what sacrifice means to the families of
those who serve.
Every one of the more than 18 million veterans in our country has earned our
admiration and our gratitude — but it is our duty to repay them with something
more than that. We must honor their service with bold policies that meet our
sacred obligation, with opportunities commensurate to the sacrifices they and
their families have made, and with trustworthy national leadership.
The Biden Plan to Keep Our Sacred Obligation to Our Veterans
believes that as a nation, we have many obligations, but we have only one truly
sacred obligation: to properly prepare and equip our troops when we send them
into harm’s way, and to care for them and their families–both while they are
deployed and after they return home. As the parents of a son who deployed to
Iraq, Joe and Jill Biden understand the gravity of this promise. Our service
members ensure our freedoms, our security, and the very future of our country.
They are willing to sacrifice everything. Many do. And each of them deserves
our respect and enduring gratitude, both while on active duty and after
separating from service.
President Trump has repeatedly failed our veterans and ignored this sacred
obligation. From the outrage of deporting undocumented veterans without
checking their record of military service, to allowing his wealthy Mar-a-Lago
friends to drive veterans policy, to pursuing policies designed to privatize
and dismantle the Department of Veterans Affairs (VA), Trump neither
understands nor respects the idea of “duty, honor, country” that inspires our
brave military members to serve and imbues our veterans with pride.
Biden Record of Delivering for Our Veterans
Joe Biden has fought aggressively for our service members and veterans
throughout his career in public service. His record speaks for itself. On the
broad range of issues that matter to our brave military members and our
veterans, Joe Biden has always had their back.
As a senator, Joe Biden was an early advocate for Vietnam veterans who were
exposed to Agent Orange and other toxins to be able to access the care and
benefits they deserve.
He championed funding for prosthetics for veterans and mammogram coverage for
female veterans, fought for proper burial allowances, and supported the
concurrent receipt of retirement and disability pay for veterans. He
co-sponsored the legislation to establish the Vietnam, Korean, and WWII
memorials in Washington, D.C., as well as the post-9/11 GI Bill to provide
educational benefits to a new generation of heroes.
Biden also led the way in the Senate on critical issues to protect the health
of our military, most notably driving the fight to increase funding for
up-armored Mine-Resistant Ambush Protected vehicles (MRAPs)
by $23.6 billion, which saved thousands of lives and limbs of U.S. service
members in Iraq and Afghanistan. And he introduced legislation to prohibit
cuts to military medical care during times of war.
During the Obama-Biden Administration, the VA also led in creating the Blue Button app to help veterans access their
health data and medical records more easily. Today, Blue Button is used by
more than 2 million veterans.
Additionally, Dr. Jill Biden and First Lady Michelle Obama created and led
the Joining Forces initiative to build support for
our veterans and military families, including a focus on increasing
employment opportunities. Between April 2011 and the end of the
Administration, Joining Forces supported programs and secured commitments
from employers that led to the hiring or training of more than 1.5 million
veterans and military spouses.
Our longest wars have taken their toll, both on our newest generation of
veterans and on the system built to support them and previous generations of
veterans. According to the most recent census data, there are more than 18 million veterans in the United States, and today’s
veterans population has needs that the VA has never before addressed. This is
reflected both in the growing interest for “anywhere, anytime” health care
service models and in our growing understanding of behavioral health challenges,
the harmful impacts of burn pits, environmental toxins, traumatic brain injury,
and the devastating epidemic of opioid addiction and suicide. The VA must adapt
to meet the ever-evolving needs of the veteran community.
At the same time, the VA continues to struggle with poor organizational
performance, staff shortfalls, leadership gaps, and IT systems failures. The
integration of a new generation of veterans into the VA system has added a
substantial number of veterans eligible for health care and other benefits as
overall demand for services has surged, with the combination creating capacity
challenges across the system. Too often, the VA’s performance in terms of
access, outcomes, cost, and accountability is mixed. There have been both important
successes and intolerable failures or gaps in service. Solving these challenges
will require a substantial investment in talent, leadership time, budget, and
public attention. It’s what we owe our veterans. It is past time to rethink and
reinvent a better VA.
There is nothing partisan about improving support for service members,
veterans, their families, caregivers, and survivors. As president,
Joe Biden will unite the country and restore the VA as the premier agency for
ensuring our veterans’ overall well-being by:
Veterans World Class Health Care to Meet Their Specific Needs
Progress to Eliminate Veterans Homelessness and Bring Down Suicide Rates
Meaningful Employment and Educational Opportunities
Management and Accountability.
support the VA mission, a Biden Administration will ensure coordination with
the Department of Defense (DoD), Department of Housing and Urban Development
(HUD), state agencies, and the thousands of non-governmental organizations that
support this vital community. It will work faithfully to restore public trust
in the VA so that no one in the military community or beyond will ever again
question whether the United States of America keeps its promises to those who
serve our country.
Providing Veterans World Class Health Care to Meet Their
The Veterans Health Administration serves upwards of 9 million veterans and is responsible for their
whole health, physical and mental. Studies have found that health outcomes at VA hospitals are often better than their non-VA counterpart, and more
than 90 percent of those who receive their health
services through the VA report that they would recommend it to a fellow
veteran. As president, Joe Biden will work to ensure that the VA provides the
world class health care that our veterans have earned and deserve and sets the
example for private sector care.
In the area of mental health, the VA and DoD have done pioneering work to
address the specific needs of veterans, deploying innovative treatment
solutions such as telehealth and other platforms to address a variety of
conditions. The private sector trails the VA in its ability to provide
behavioral health services to the nation as a whole, much less to understand
the unique needs of veterans.
At the same time, the VA is also struggling with a rapidly deteriorating
infrastructure, and many VA facilities are more than 60 years old. Further,
across the system, the variance in quality of — and access to — care is
unacceptable. As the demand for treatment has increased, the VA must
continually strive to improve services and outcomes for veterans, especially in
the areas of pain, polytrauma recovery, substance-use disorder (SUD),
post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), and
general behavioral health, in the most effective and cost-efficient way
In addition to protecting and building on the Affordable Care Act with a public option to expand access to quality,
affordable health care and lower costs, and commitments to keep rural hospitals open and expand health care
delivery models for rural areas, a Biden Administration will:
in the Department of Veterans Affairs. During the Obama-Biden Administration,
we improved access to health care offerings for veterans in their communities,
but there is still more work to do. Private sector points of care were designed
to provide care to veterans when it was faster, closer, or offered superior
services for a particular veteran’s needs. We must ensure that health care
purchased in the community actually improves access and convenience and does
not compromise the health of our veterans. President Biden will establish the
right balance of VA care and purchased care, region by region, based on veteran
needs, existing VA capacity, and availability of market alternatives.
thorough assessment of the staffing needs and requirements across the VA to
inform specific hiring initiatives and programs for attracting and retaining
medical professionals. This includes ensuring that professionals are working to
the full scope of their license and creating incentives to support health care
professionals joining the VA workforce.
update Community Care Guidelines, ensuring that if a veteran
is referred to a community care provider that does not meet the same level of
access and quality as the VA, the veteran will be referred back to the VA.
This full-circle referral process will better ensure that veterans are seen in
a timely manner and receive the best possible quality of care.
cultural competency training protocols to ensure that providers in VA
facilities and in community care settings understand and are equipped to
support the needs of LGBTQ veterans in the health care setting.
Congress to improve health services for women veterans. Biden will ensure that
each VA Medical Center has at least one full-time women’s primary care
physician; and, within 200 days of taking office, make available a women
veterans training module for community health care providers. And, Biden will
work with Congress to enact the Deborah Sampson Act and ensure that the safety
and privacy concerns of women veterans are addressed throughout his
to ensure there is safe, reliable child care at all VA Medical Centers.
Work with Congress to eliminate co-pays for preventive
health care for veterans, which can create unnecessary barriers to seeking
basic preventive care.
Expand the list
of presumptive conditions to ensure no veteran who experienced a TBI or had
exposure to burn pits or other environmental toxins goes without access to VA
health care and benefits. We cannot ask our veterans who are suffering to wait
decades, as we did with Agent Orange. President Biden will also increase access
to VA care beyond the 5-year eligibility window for combat veterans, as
conditions related to toxic exposure may take many years to manifest.
research dollars by $300 million to invest in better understanding the impact
of TBI and toxic exposures (including burn pits) on long-term health outcomes,
and continue to drive research focused on the needs of disabled veterans.
disabled veterans that require a prosthesis are able to access the most modern
prosthetics technology available, and that they are able to upgrade their
equipment at no cost as new developments occur.
for direct and purchase-care treatment for disorders related to the misuse of
alcohol and opioids in order to reduce unacceptably long wait-times for
Administration will support the legalization of cannabis for medical purposes
and reschedule cannabis as a schedule II drug so researchers can study its
positive and negative impacts. This will include allowing the VA to research
the use of medical cannabis to treat veteran-specific health needs.
Ensure the full
integration of veteran caregivers as members of the health care team for
veterans. The VA offers a diverse array of programs and supports for
caregivers, however, we must ensure that the VA remains a caregiver-friendly
environment and respects their role in ensuring the recovery and rehabilitation
of their loved one.
funding for and expand access to telehealth through the VA, particularly in
rural areas not able to access timely care.
hospitals and clinics to serve our veterans better through a nationwide
infrastructure plan that provides a comprehensive refresh of VA health
facilities. Biden will retrofit VA’s existing brick and mortar physical
locations, where patient volume warrants, and repurpose older facilities to
meet new needs such as assisted-living facilities and long-term care
alternatives. Biden will improve both the buildings and equipment, so the VA
continues to lead in providing 21st century care.
modern, clean, and recovery-oriented housing for veterans being treated for
SUDs and those who are homeless by refurbishing buildings condemned or not in
use, such as the massive VA Los Angeles campus.
Driving Progress to Promote Veterans’ Mental Health and
Suicide is a public health crisis–the 10th leading cause of death in the
United States. As a society, we need to work together to eliminate the stigma
felt by those who are suffering and struggling with their mental health. There
is no shame in asking for help. As president, Joe Biden will increase access to
mental health treatment by enforcing full mental health parity and ensuring all
Americans have access to high-quality mental health care, regardless of their
insurance coverage status. Service members and veterans are at an elevated risk
of dying by suicide. Recent data show that, on average, 20 veterans and service members die by suicide every day,
and among some groups, the rate of suicide is rising alarmingly. Even one death
by suicide is devastating, and we must do more to stem the tide. The Trump
administration has grossly mismanaged this crisis, at one point leaving millions of VA dollars dedicated to suicide prevention efforts
unused, and that’s just not right. This is a serious challenge, and
our goal must be to remove the stigma in military communities to seek help,
ensure that every veteran that reaches out is immediately connected to support
and services, and to ultimately end the suicide crisis among veterans. As
president, Biden will ensure a multi-faceted, substantive, and sustained
commitment that addresses this as the public health emergency that it is.
The same is true when it comes to veterans experiencing homelessness. The
Obama-Biden Administration proved that we can make huge inroads to address this
persistent challenge with sustained attention and cross-coordination among
government departments. But with just over 23,000 veterans without shelter on any given night,
we have much more work to do.
A Biden Administration will:
the first 200 days in office a comprehensive public health and cross-sector
approach to addressing suicide in veterans, service members, and their
aggressively to facilitate immediate access to mental health services for
veterans in crisis, to include standardizing performance expectations around
same day, walk-in and urgent mental health services; hiring more ER psychiatric
staff and peer specialists; expanding crisis line capacity to ensure all calls
are answered and appropriate referrals occur within hours; and implementing
specific programs to encourage veterans to prioritize their mental health by
reaching out to the VA when they need support. Within the first year in office,
President Biden will have a goal of completely eliminating wait times for
veterans who reach out with suicidal ideation so that they are immediately
taken into treatment.
states, community-based organizations, and employers, implement public
education and outreach initiatives to help veterans understand that care is
available and effective. We must work to end the culture of silence around
mental health issues and remove the stigma associated with getting mental
health treatment, particularly among service members who are more used to
helping others than asking for it themselves.
DoD’s Suicide Prevention Office and the VA have the resources and staff they
need to make smart investments with allocated funds–and that money dedicated
to suicide prevention efforts never goes unused.
national center of excellence for reducing veteran suicide, similar to the
National Center on Homelessness among Veterans. Biden will recruit top-level
leadership to build strategic partnerships and solutions that extend beyond the
VA’s health care system.
providers of veterans services funded by the VA to receive training on suicide
risk identification and safety planning, to include lethal means restriction
and appropriate response and reporting about suicide.
that promote the value and dignity of life by supporting programs that increase
economic stability; promote connectedness through structured social support; and
reduce risky behaviors, such as substance use, poor sleep, and improper firearm storage.
at Vet Centers to ensure veterans in communities can access readjustment
counseling services and resources, including financial and long-term planning.
President Biden will specifically expand outreach and resources for veterans as
they experience periods of transition, not just out of the military, but
throughout their life, including into post-career retirement.
that contribute to higher suicide risk. This includes implementing programs to
disseminate high-quality treatments for PTSD, ensuring that veterans have
access to the best treatments available no matter where they receive care, and
instituting policies that seek to eliminate discrimination, end harassment and
hold perpetuators of sexual assault in the military accountable. A Biden
Administration will not tolerate the sexual assault culture that has become all
too common in the military and veteran sector.
Congress to continue to drive down veteran homelessness by permanently
authorizing the Supportive Services for Veterans Families (SSVF) program, which
provides critical funding for wrap-around services for those facing
homelessness. President Biden will also work to ensure that we better
understand the unique needs of women and LGBTQ veterans experiencing homelessness.
policy and review processes for veterans so that less-than-honorable discharges
will not be unjustly awarded for conduct directly linked to the behavioral
health effects of PTSD, TBI, or other trauma experienced while serving.
Creating Civilian Lives of Meaning and Opportunity
The Obama-Biden Administration worked tirelessly to bring down high
unemployment levels among our veterans. Over the course of 8 years, the
Obama-Biden administration cut the veteran unemployment rate by more than half.
That is vitally important progress, but now, we have to think about empowering
our veterans and their future employers with the tools they need to build
pathways to successful, long-term careers. Recent data indicate that veterans
are more likely than their civilian counterparts to take a job at lower skill-level. As president, Biden will
keep his foot on the gas to ensure that service members transitioning back to
civilian lives have the best opportunities to succeed and build fulfilling
A Biden Administration will:
with DoD to ensure that the Transition Assistance Program (TAP) is implemented effectively
and that outcomes are regularly reported.
more transitioning service members are able to access job training and
placement services prior to their end of active duty service. By expanding
private sector relationships through programs like the SkillBridge program, Biden will give qualified
transitioning service members the opportunity to start building a meaningful
civilian career as early as possible.
Work with the
Department of Labor to enforce the Vietnam Era Veterans Readjustment Assistance
Act (VEVRAA) hiring benchmark among federal contractors
and subcontractors, and provide preferences and incentives to corporations that
meet the benchmark.
corporate mentorship programs between veteran-owned businesses and existing
contractors to support veteran entrepreneurship.
implementation of the Forever GI Bill so that veterans receive the educational
benefits they have earned on time.
annual reporting to be led by the VA in partnership with the Department of
Education and promote interagency cooperation and data sharing to better
understand academic outcomes for all GI Bill users.
best-practice guidelines for supporting veterans in higher education to assist
higher education institutions to improve graduation rates among GI Bill
recipients and provide financial incentivizes for campuses that follow
guidelines and transparently report their outcomes.
aggressively to close the 90/10 loophole on GI Bill and Tuition Assistance
dollars to keep for-profit bad actors from raiding the benefits service members
and veterans have earned.
undocumented members of our armed services, veterans, and their spouses from
deportation, because if you are willing to risk your life for this country, you
and your family have earned the chance to live safe, healthy, and productive
lives in America.
Work with DoD
and the Department of Homeland Security to provide timely naturalization for
those who have served honorably in our military, with an earned path to
citizenship prior to discharge or retirement.
Improving VA Management and Accountability
The agency charged with meeting the needs of our veterans–not only their
health care needs, but administering their full range of benefits and
overseeing the cemeteries that guard their honor in death–should not be
limited by outdated management tools and practices. Our veterans deserve the
best services available. As president, Biden will enhance the capacity of the
VA to serve our veterans as efficiently as possible by overseeing a
generational upgrade to clinical and management systems, by leveraging
commercial best-practices and modern technologies to meet the unique demands of
public sector mission.
A Biden Administration will:
care access, quality, and customer experience by seamlessly augmenting direct care
with purchase care enabled under the Mission Act. Enhance the administrative,
financial, and operational systems that underpin the provision of care in the
network model by improving vital case management systems, quality oversight,
integrative health treatments and supporting administrative, financial and IT
systems. These reforms will help ensure access to high-quality care and a
first-rate customer experience that satisfies all veterans, regardless of where
they receive care.
standards of health record interoperability that ensure a comprehensive health
record is provided by community care organizations back to the VA.
improving human resource and management practices across the VA to strengthen
the customer experience for our veterans and deliver services more efficiently.
This will include a focus on workforce training and cultivating a culture
across the VA that places a premium on quality and service.
options under the Mission Act to pilot alternative payment models and
prioritize care models that improve the quality of care, not just the volume of
services. Veterans should be able to access care in a way that works best
for them, not the way that is most convenient for the system, in particular
when it comes to meeting specific needs such as rehabilitation services, SUD,
and behavioral health.
and errors in claims processing and in scheduling the medical exams necessary
for veterans to complete their disability claims. This has been a constant
source of frustration for veterans. The long delays in the system, and
rates of error — in both Regional Offices and the Board of Veterans’ Appeals —
are too long and too high, and unfairly delay adjudication of veterans
claims. A Biden VA will identify the sources of the problem and undertake
the investments in personnel and training needed to ensure that veterans
receive accurate decisions in a more timely manner.
veterans gain access to their own health data and medical records through
the Blue Button app. Blue Button has been downloaded by more than 2
million veterans and is increasingly being used by Medicare beneficiaries
and the private sector. By making Blue Button easier to use, the VA will
continue to lead the movement of patient-centered models of care.
VA-hosted health record that can serve any and every American who wants one. We
can leverage Blue Button to access health information no matter where it is, to
allow veterans and citizens to manage and use it as they see fit. By putting
our veterans first, we can make the VA the nexus of the best care everywhere.
national health database for non-profit research scientists and the commercial
sector that would accelerate discovery of the best therapies against the
devastating diseases of our time: cancer, heart disease, and Alzheimer’s, and
dementia. Biden will direct the VA to support the database using its
infrastructure, making access available to all. Veterans will be able to
choose, on an individual basis, whether or not to contribute their data. This
national repository for longitudinal health data will enable us to use
technological innovations to see patterns that people don’t easily recognize
and make connections we don’t normally make for the U.S. population as a whole.
WASHINGTON – Senator Bernie Sanders on Veterans Day released his veterans agenda, called “Honoring Our Commitment to Veterans,” which will guarantee veterans the benefits and services they were promised, protect and expand disability benefits for veterans, guarantee justice for veterans and expand opportunities for veterans. The proposal comes as Americans around the country honor Veterans Day.
This is from the Sanders campaign:
“As a nation, we have a moral obligation to provide the best quality care to those who put their lives on the line to defend us,” Sanders, who served as Chairman of the Senate Veterans’ Affairs Committee from 2013 to 2015, said. “Just as planes and tanks and guns are a cost of war, so is taking care of the men and women who we sent off to fight the wars. It includes caring for the spouses and children who have to rebuild their lives after the loss of a loved one. It includes caring for the hundreds of thousands of veterans with multiple amputations or loss of eyesight, post-traumatic stress disorder and traumatic brain injury. It includes veterans who are having difficulty keeping jobs in order to pay their bills, and it includes the terrible tragedy of veterans committing suicide. As president, I will do everything that I can to make sure that every veteran gets the benefits that they are entitled to receive on time and without delay. Further, we will not dismantle or privatize the VA. We will expand and improve the VA.”
During Sanders’ time as Chairman of the Senate Veterans’ Affairs Committee, a series of reports revealed that the Veterans Health Administration was failing veterans, leaving many to wait too long for care and putting lives in danger. Sanders worked with Sen. John McCain to successfully negotiate and pass a bill that invested billions into the VA system. The landmark legislation authorized twenty-seven new medical facilities and provided $5 billion to hire more doctors and nurses to care for the surging number of veterans returning from the wars in Iraq and Afghanistan and those veterans from earlier eras in need of more complex care.
The Sanders campaign on Monday also released a new video, “Keeping Our Promise,” which highlights Sanders’ work on that landmark legislation.
Sanders’ plan will:
the nearly 50,000 vacancies at the VA during your first year in office. Under a
Bernie Sanders administration, the VA will hire the doctors, nurses and medical
professionals necessary to provide the care that veterans need when they need
Provide at least $62 billion in new funding
to repair, modernize and rebuild the infrastructure at the VA in order to
provide the cutting-edge health care services our veterans have earned and
Ensure that all those with prior military
service in every state and territory have access to the full complement of
health care services they need to stay healthy and well.
Improve and simplify the claims process so
veterans receive the compensation they have earned quickly, accurately, and
without bureaucratic red tape.
Reform harmful VA regulations that restrict
access to care and benefits based on character of discharge.
Ensure veterans can use the full complement
of benefits through the G.I. Bill without hassle or red tape.
Senator Elizabeth Warren released her plan to support and protect America’s veterans, service members and military families ahead of Veterans Day.
“All three of my
brothers served, so I know the responsibility we have to our service members,
military families, and veterans. As Commander-in-Chief, I will lead our Armed
Forces with awareness of the unique challenges service members and military
families face, and the difficulties veterans encounter as they navigate VA
during their transition to civilian life. I will honor our troops not only by
executing sound military strategy, but also by caring for our veterans after
they take off the uniform. And I will prioritize our most important strategic
asset – our people – as I reform Pentagon spending and address our most
pressing national security crises. The way I see it, this is not complicated.
It’s about a government that keeps its promises to those who served — it’s
about our values. “
This is from the
Charlestown, MA – As President, Senator Elizabeth Warren pledged to:
Raise service members’ pay at or above the Employment Cost
Index and protect earned benefits, ensuring that total compensation remains
competitive with the civilian sector and that it reflects the unique demands of
Prioritize family readiness by addressing spouse employment,
housing, child care and education, and take care of military caregivers
Expand mental health services and work to end military
suicide by setting a goal of cutting veterans’ suicides in half within her
Tackle sexual assault and prosecute sexual harassment as a
stand-alone crime under military law
Enforce equal treatment for all who serve, including women,
immigrants, and LGBTQ+ service members
Ease the transition for veterans by eliminating the benefits
backlog and establishing a “warm hand-off” between DOD and VA
Reject attempts to privatize the VA by investing in a VA
worthy of the veterans it serves — to provide the high-quality,
evidence-based, culturally competent programs that our veterans rely on for
years to come.
As a member of the Senate Armed Services Committee,
Elizabeth has worked to achieve pay raises for senior enlisted
personnel, fix repeated promotion delays for
our National Guard, and fought to protect military families from fraud and
abuse. Major provisions of her bill with Congresswoman Deb Haaland (D-N.M.) to
address unsafe and unsanitary housing conditions on military bases were
included as part of the Senate-passed FY2020 NDAA.
Keeping Our Promises to Our Service Members, Veterans,
and Military Families
This Veterans Day, Americans will gather in towns and cities
across our country to thank our military personnel past and present. With three
brothers who served, this day is especially meaningful to me.
Less than 1% of the U.S. population currently serves in
uniform. And while Americans rightly honor their service on November 11, too
often the day-to-day sacrifices of military families go unseen and unremarked.
Parades and salutes to the troops are important ways that Americans express
their gratitude, but they’re only platitudes if they’re not backed up with
meaningful action and policies that support our military both during and after
service — not just on Veterans Day, but every day.
For me, that starts with care in how we deploy our forces
abroad. Defense policy is veterans policy. For decades, we have been mired in a
series of wars that have sapped our strength and skewed our priorities. As a
member of the Senate Armed Services Committee, I have seen up close how 18
years of conflict have degraded equipment, eroded our forces’ readiness, and
postponed investment in critical military capabilities.
The burden of these wars has fallen primarily on our
military personnel, who have endured repeated deployments in dangerous places
around the globe year after year, and their families. 7,027 American
service members have lost their lives, almost 60,000 have been
injured, and countless more live every day with the invisible wounds of war.
I know our service members and their families are smart,
tough, and resourceful — they will accomplish any mission we ask of them,
whatever the cost. But it’s not fair to our men and women in uniform to ask
them to solve problems that don’t have a military solution. Nor is it fair to
them when we refuse to make the tough calls to change course when our
strategies aren’t working.
A strong military should act as a deterrent so that most of
the time, we won’t have to use it. We can honor our veterans by ending these
endless wars, reining in our bloated defense budget and reducing the influence of defense
contractors at the Pentagon, and bringing our troops home
responsibly — and then providing our veterans with the benefits they’ve
earned. That’s why today I’m introducing my plan to care for our nation’s
veterans, service members, military families, and survivors.
Protecting Earned Benefits for Those Who Serve
In prior generations, America experienced a tight
relationship between people in uniform and the rest of our nation. For a host
of reasons, however, our all-volunteer military is becoming more and more distant
from the population it serves. In recent years the military has sometimes
struggled to attract and retain sufficient personnel to meet recruitment
targets, in both raw numbers and increasingly technical skill sets. A majority of young
people are ineligible to serve, and low unemployment rates and declining propensity for
military service mean that even fewer apply to serve in today’s military. Many
who enlist do so because they have a family member who
It is clear that the services must do more to compete with
21st century careers and employers to continue to attract and retain the best
for the All Volunteer Force. That means more flexible talent management systems
and improved quality of life for service members and their families — and it
also means preserving best-in-class benefits for our military personnel. But
it’s about more than recruitment and readiness. It’s about honoring the
commitment of those who choose to serve with commitments of our own.
Guaranteeing Pay and Benefits
In past years, Congress and the Pentagon have too often
sought to balance the budget on the backs of our service members through
proposals for lower pay raises, increased out-of-pocket costs, and cuts to
benefits like housing and commissaries. Proposals that undermine total
compensation are a betrayal of our obligation to our service members, and they
undermine our ability to recruit and retain the best possible All Volunteer
To ensure that compensation remains competitive with the
civilian sector and that it reflects the unique demands of military life, as
President I will propose pay raises at or above the Employment Cost Index. I’ll
ensure that benefits such as housing allowances keep pace with market rates in
base communities, and work to ensure that service members are educated and
empowered to make decisions about their retirement and savings choices in light
of new options for blended retirement.
Empowering Military Students
Over the past 70 years, the GI Bill has helped send millions
of veterans to college, easing their transition to civilian life, and
contributing to our economic growth. I am committed to ensuring these benefits
are guaranteed and protected in the future — for our veterans and their family
members. I’ve fought to expand eligibility for educational benefits, including
by working to provide Post-9/11 GI Bill benefits for Purple Heart recipients who
were not previously eligible, and expanding the Yellow Ribbon education program
to cover families of
fallen service members.
As benefits have increased — and increased in complexity —
as a result of GI Bill expansions, VA has scrambled at times to keep up,
leaving military students in the lurch. I’ve worked to ensure that delays at VA
don’t negatively impact student veterans, including by helping to pass a
bipartisan measure to protect student veterans’ access to education in
the event of delayed GI Bill disbursements.
Too often, the benefits provided to military and veteran
students have made them targets for predatory lenders and shady for-profit
schools. I’ve fought to protect students from these scams, including by
obtaining refunds for military borrowers cheated by loan servicers like
Navient. I also fought to restore GI benefits to
those cheated by fraudulent for-profit colleges like ITT Tech and Corinthian
But there is more to be done. My plan for affordable higher
education will make two- and four-year public college free, and
cancel student loan debt up to $50,000 for 42 million Americans — helping
thousands of military families burdened with higher education expenses beyond
what is covered by the GI Bill, and ensuring all of our veterans and their
families have the chance to get essential job training and degrees without
taking on a dime of student loan debt. My plan also completely cuts shady
for-profit colleges off from federal aid dollars, which will end their abuse of
veteran students for their GI Bill benefits once and for all.
Preventing Fraud and Abuse
When I set up the Consumer Financial Protection Bureau, I
made protecting service members and veterans a priority. We established an
Office of Servicemember Affairs, and I recruited Holly Petraeus to run it.
Together, we met with active-duty service members and families to discuss
financial issues, including the base where two of my brothers completed their
I saw firsthand that today’s military families face
difficult financial challenges as they try to make ends meet, balancing
multiple deployments with raising a family. Some even told me that they felt like
they were fighting two wars at once – one in a distant war zone and another
here at home against creditors. But I’m proud to say that since 2011, the
office we established has heard from over 90,000 service
members from all 50 states and saved them nearly $230 million, providing
some measure of relief for our military families.
I’ve made fighting for military families a similar priority
in the Senate. I fought to prevent predatory lenders from “loan churning,” or
repeatedly refinancing VA-backed mortgages to pocket hefty fees. I
successfully expanded financial protections for
Gold Star spouses, passing a bipartisan bill to allow a survivor to terminate a
residential lease within one year of a service member’s death. And I worked
with my Republican colleagues in Congress to pass my Veterans Care Financial
Protection Act to protect low-income and older veterans in assisted care from
scams targeting their pension benefits.
As President, I’ll work with Congress to give the CFPB new
tools and additional authority to enforce the Servicemembers Civil Relief Act.
And I’ll appoint individuals at the CFPB and DOJ who will use the full extent
of those authorities to aggressively go after scammers and protect our men and
women in uniform. Criminals and predators will keep coming up with new and
creative ways to target the military community. We must be vigilant — but
military families can feel confident that a Warren Administration will always
have their backs.
Prioritizing Family Readiness
Military families form the backbone of our armed forces.
Just like other middle-class families, they worry about making ends meet:
finding child care, giving their children a good education, retiring with
dignity. But military families — particularly dual military couples — also
face special challenges, like regular moves from assignment to assignment and
the anxiety of a loved one’s deployment. And too often, the unique needs of
military communities are overlooked by Washington.
A Warren Administration will continue and expand current policy of
weighing basing and force structure decisions to account for quality of life
factors in the surrounding communities, including safe living environments,
available child care, quality of public schools, and employment opportunities
and licensing reciprocity for military spouses. There’s also a lot more we can
do to support and uplift our military families.
Increasing Military Spouse Employment
A majority of
military families report two incomes as vital to their family’s well-being. But
employment opportunities for military spouses are hindered by a variety of
factors, including frequent moves and lack of available child care at some
posts. Last year 30% of military
spouses were unemployed, and 56% of working
spouses reported being underemployed. Spouses in fields that require professional
licenses face an additional challenge, as occupational licensing and
credentialing standards vary from state to state.
Reduced spousal employment isn’t just bad for military
families — it results in up to $1 billion annually
in lost income and associated costs. We need to make spousal employment a
The Obama Administration made real progress in encouraging
states to offer licensing and credentialing reciprocity for the military
community — now we need to finish those efforts to remove barriers to military
We can start by making permanent the program to reimburse military spouses for
professional relicensing. I’ll also work with states to provide military
families with a one-stop shop where they can review licensing requirements
before a move.
I’ll also work with Congress to expand and better
communicate about special hiring preferences for on-base jobs for military
spouses and at American Job Centers. These preferences not only benefit
spouses, they help build communities on military installations.
We’ll expand educational opportunities like MyCAA for
military spouses, and provide targeted training for high-demand, high-growth
sectors and to help military spouses find careers that can move with
Military spouses bring unique strengths to the workforce —
it’s time we leverage those strengths to benefit not only our military families
but our economy.
Ensuring High Quality Childcare and Education
As a young working mother, child care almost sank me —
until my Aunt Bee stepped in to help. But finding affordable and high-quality
child care has gotten even harder since my children were growing up, and not
everyone is lucky enough to have an Aunt Bee of their own.
That’s why I have a plan to provide universal child
care for every single one of our babies from birth to school
age. It will be free for millions of American families, and affordable for
everyone. The federal government will partner with local providers to create a
network of child care options that would be available to every family. These
options would be held to high federal standards, and we’ll pay child care and
preschool workers the wages they deserve. And rather than diverting funding from
military daycare programs for a needless wall, I’ll invest again in growing DOD
child care centers and modernizing schools on base.
We’ll move forward with efforts to
introduce more flexibility into the personnel system for families who want to
limit moves for assignments, while ensuring that option does not hamper the
service member’s ability to get promoted and advance their military career.
We’ll invest the resources necessary to ensure families (and their household
goods) are no longer subjected to chaos and mistakes that
can impact the experience of transitioning to a new assignment. And we’ll seek
to limit family moves during the academic year — when they must occur, we’ll
provide dedicated support to families as they navigate transferring educational
Every military family is unique, and some have unique needs.
I’ll work to improve oversight and standardize DOD’s
Exceptional Family Member Program to care for dependents with special needs. We
need to do more to empower military families to make informed decisions,
taking their individual circumstances into account during relocation and
providing dedicated case management to help military families identify
appropriate programs and interventions regardless of their location. Supporting
these families isn’t just the right thing to do, it’s also good for military
Wounded Warriors and their Families
About 30% of
veterans between the ages of 21 and 64 have a disability. As president, I will
keep fighting for the rights of people with disabilities and to ensure their
full inclusion through policy reforms and enforcement priorities. This includes
prioritizing the unique challenges that face veterans with disabilities.
As part of my plan to empower American workers,
I have committed to substantially increasing funding for the Equal Employment
Opportunity Commission to uphold the rights
of veterans with disabilities at work. I will also ensure that the Department
of Labor is enforcing the law to protect disabled
veterans againist work discrimination. I support the Raise the Wage Act to
guarantee workers with disabilities a minimum wage of $15 an hour, and I will
push to pass the Transformation to Competitive
Employment Act, which would provide grants and assistance to support
a transition towards competitive, integrated employment for people with
It is often family members who care for injured service
members and veterans — in some cases, putting aside careers and other
opportunities to provide assistance to our wounded warriors. According to a
2014 report, there were approximately 5.5 million military
caregivers in the United States — but the physical and emotional strain on
this population is understudied and overlooked.
Medicare for All will expand access to long-term home and
community-based care, offering critical support and relieving the financial
burden on veterans and their families. A Warren Administration will also
empower our nation’s military caregivers by fully implementing the recommendations of
the federal advisory panel on caregiving. We’ll create an office within VA
focused on the needs of caregivers, ensuring that their voices are heard in the
policymaking process and that VA is fully communicating available resources.
We’ll ensure that caregivers are formally designated in a patient’s medical
record, so that they can be consistently included in medical planning about the
course of care. We’ll collect better data on the caregiver population and their
needs, including the impact on military children. And we’ll make sure we’re
also caring for the caregivers, themselves, including respite care.
To recognize caregiving for the valuable work it is, my plan to expand Social Security creates
a new credit for caregiving for people who qualify for Social Security
benefits. This credit raises Social Security benefits for people who take time
out of the workforce to care for a family member at least 80 hours a month,
including designated “primary family caregivers” of eligible veterans in the
Caregiver Support Program. For every month of caregiving that meets these
requirements, the caregiver will be credited for Social Security purposes with
a month of income equal to the monthly average of that year’s median annual
Lastly, I support eliminating the so-called “Widow’s Tax” and efforts
to ensure that all families of veterans who died or became totally disabled
from a service-connected condition receive the Dependency and Indemnity
Compensation (DIC) benefits that they are entitled to.
Providing Safe and Affordable Housing
In the mid-1990s, the Department of Defense agreed to
privatize the majority of the 300,000 houses it owned and operated on base,
many of which were in need of renovation after
decades of neglect. It was a good deal for the private developers, but this
system has turned out to be a lousy bargain for military families. With their
focus on short-term payoffs, private developers failed to
invest in and maintain the properties with which they were entrusted. That’s
why earlier this year, I released my plan to improve military housing by
ensuring that every base has a housing office staffed with advocates for the
service member and establishing a “bill of rights” that all military tenants
will receive when they move in.
And for those families who choose to live off base, and for
veterans, my plan to increase affordable housing makes
a historic federal investment to increase affordable housing supply, lowering
rents around the country by 10%. And while cost is a major challenge to finding
safe and affordable housing, too many service members and veterans face
additional obstacles, including landlords who don’t understand the
housing benefits they receive for their service and those who turn away service
members and veterans because of discriminatory stereotypes. My affordable
housing plan extends protection against discrimination under the Fair Housing
Act to include veteran status, which would include those using HUD-VASH
vouchers. I have also pushed hard for more resources for programs to end
veterans’ homelessness, including the successful Tribal HUD-VASH program to
assist Native American veterans who are homeless or at risk of homelessness
find homes in Indian country.
Putting Service Members and Veterans First
Nearly two decades of combat has put significant stress on
the force, and this will continue to manifest itself long after combat
operations are over. Our first priority must be the care and safety of those
who serve or have served in uniform.
Eliminating Military Sexual Assault
For decades, the military has affirmed a “zero tolerance
policy” — and yet reports of sexual assault in the military have spiked. In
2018 alone, the Department of Defense estimated that more than 20,000 service
members experienced assault or unwanted sexual contact. These statistics are a
shameful breach of trust with those who serve. Annual promises from senior
military leaders to address the issue increasingly ring hollow — we owe it to
our service members to make real change.
Currently, skilled military prosecutors make an
evidence-based recommendation on whether or not a case should proceed to trial,
but then military commanders get to decide whether or not they want to listen.
That’s why I supported Senator Gillibrand’s effort to
remove cases of sexual assault from the chain of command and place trained
prosecutors in charge instead. It’s simple – if evidence of a crime warrants a
trial, then the case should go to trial. We need to reform the military justice
system so that the lawyers and judges trying cases have the necessary
experience and expertise, and so that every victim of a sexually-based crime
benefits from a competent, empowered advocate from the very first day they
We need to change the culture. Sexual harassment and sexual
assault are correlated— and 24% of
military women and 6% of military men said they had been sexually harassed in
the past year. In the
Senate, I worked to make so-called “revenge pornography”
prosecutable under the Uniform Code of Military Justice. We should also
prosecute sexual harassment as a stand-alone crime under military law. We
should push to expose and prevent sexual harassment in the civilian workforce as
well, recognizing that our entire culture has work to do.
And we need to invest in survivors, helping them to get the
care they need so that they can recover, and so they can continue to serve.
Often, survivors worry that reporting a sexual assault may also bring to light
other misconduct, such as underage drinking or fraternization. Sometimes,
military commanders will distribute punishment for these offenses by survivors
while the sexual assault itself goes unaddressed. Even worse, more than 20% of
those who reported an assault also reported experiencing retaliation. If we
want to increase reporting and hold perpetrators of sexual assault accountable,
we need to exercise much wider discretion in the way we approach collateral
misconduct as part of instances of sexual assault. Until reporting an assault
is not perceived as a possible end to someone’s career, we will never fully
address this scourge.
Ending Veteran and Military Suicide
Our service members are resilient, but even the strongest
warriors need care. In 2017, 6,139 U.S. veterans
died by suicide, an average of nearly 17 each day, and 1.5 times the rate for
non-veteran adults. But only half of veterans
of the wars in Iraq and Afghanistan who may need mental health services —
including many with diagnoses that increase the risk of suicide, like PTSD, traumatic brain injury, substance use disorders,
or depression —
actually access them.
Every single one of these deaths is a tragedy that could
have been prevented. As President, I will set a goal of cutting veteran
suicides in half within my first term — and pursue a suite of concrete
policies to make sure we get there.
To get there, we need to invest more in research into the
causes of suicide, with a specific focus on contributing factors that are
specific to the military experience and a concerted effort to collect the data
that will save lives. We should conduct research targeting subgroups of
veterans who may be at higher risk of suicide, and evaluate the efficacy of
suicide prevention pilot programs and invest in those that make a meaningful
Veterans account for one in five firearm
suicides. My plan to prevent gun violence includes
a waiting period before purchase and a federal extreme risk protection law,
both of which have been shown to reduce suicides by gun.
We also need to provide consistent, accessible, high-quality mental
health care for all of our service members and veterans. Under Medicare for All
every person will have this essential care covered. But we must also address
the shortfall of mental health providers at DOD and VA, and in the areas where
In the last Congress, I led the fight to prevent budget cuts
to the Mental Health Block Grant and secured an additional $160 million for the
program, and I urged appropriators to designate $1 billion to mental health
programs through the Substance Abuse and Mental Health Administration. I have
also proposed significant
expansions of Community Health Centers and the National Health Service Corps,
which would help increase the supply of primary care and mental health
providers in underserved areas. We need to make it easier for service members
and veterans to see a mental health professional, including by significantly increasing
the number of mental health specialists at DOD and VA, streamlining appointment
processes, and enhancing access to telehealth options for those who cannot come
to a VA facility.
We should also focus on preventive care — early and often
throughout a military career, including by incorporating annual mental health
exams for service members in the same way they receive annual physical exams.
We should clearly communicate benefits and eligibility, raising awareness about
available care. And we must continue to remove the stigma around warfighters
seeking help, and do more to support military families who lose someone to
Treating the Opioid and Addiction Crisis
In 2017, over 70,000 people died
from a drug overdose — the highest year on record, with the majority due to opioids.
And the opioid crisis that has devastated so many American families has not
spared our military community. Stressors including deployment, combat exposure,
injury, and post-deployment reintegration have been shown to increase the risk
of substance abuse. Our military population has a higher risk of
substance use disorders, with 11% of veterans
from Afghanistan and Iraq treated by the VA being diagnosed with a substance use
My CARE Act to end the
opioid crisis — introduced in partnership with my late friend Congressman
Elijah Cummings of Baltimore — is a comprehensive plan to provide the
resources needed to begin treating this epidemic like the public health crisis
that it is. It would provide $100 billion in federal funding to states and
communities over the next ten years, because that’s what’s needed to make sure
every single person gets the treatment they need.
Under my plan, VA facilities will be able to participate in
planning councils to address the opioid crisis in order to ensure that veterans
are prioritized in our response and organizations serving veterans have a voice
in how the funding is spent. We will expand the number of inpatient beds
available to veterans for treatment and recovery. We’ll fund community-based
organizations, including eligible veteran-serving nonprofits, working to help
prevent and treat addicted veterans. And we’ll provide vocational training for
people struggling with addiction, helping them to get back into the civilian
workforce after their military careers.
Addressing the “Invisible Wounds” of War
17% of post-9/11
military veterans experience some form of traumatic brain injury during their
military service. TBI is associated with higher rates of PTSD, depression, and
substance abuse. While our knowledge of these conditions has improved
dramatically, it is still incomplete. Moreover, too many veterans don’t receive
the treatment they so badly need. While TBI is often associated with blunt
physical injuries to the head, research has shown that the blast wave produced
by even minor explosions, such as firing heavy weapons,
can result in TBI — even if the individual does not exhibit outward physical
signs of head injury.
In the Senate, I worked with my Republican colleagues to
establish a longitudinal study at
DOD to track the impact of blast exposure and brain health over time, and to
push DOD to track service member blast exposure.
We’ll use this data to improve our understanding of blast exposure injuries,
improve protective equipment, and develop innovative new treatments. We’ll also
use it to inform the safety guidance provided to our troops, including by
limiting non-combat exposure during training exercises.
Many states have established veterans’ courts or other
diversion programs to provide treatment rather than incarceration for veterans
with behavioral issues as a result of trauma, and I support the expansion of
these programs. I also support legalizing marijuana. I’ve co-sponsored
legislation to study the use of medical cannabis to treat veterans as an
alternative to opioids, because we need to pursue all evidence-based
opportunities for treatment and response.
The prevalence of certain rare cancers has been increasing steadily among
military personnel and veterans who have served overseas. It took years for
Vietnam veterans to receive treatment for exposure to Agent Orange — and some,
including Blue Water Navy veterans,
are still fighting for healthcare and benefits. Some veterans of more recent
wars attribute their illness to exposure to toxic burn pits used
by the military to dispose of waste, and at least one veterans group has projected that
deaths from cancer and other illnesses could outpace suicide deaths in the
military population by 2020.
As President, I will ensure that DOD tracks and records
potential toxic exposure by integrating it into the post-deployment checklist.
We need to ensure that adequate funding is allocated to research diseases that
may be connected to certain kinds of exposure. And we must treat those affected
without delay — we cannot allow today’s veterans to wait for earned health
Equal Treatment For All Who Serve
The diversity of our force is one of its unique strengths —
it allows us to incorporate different perspectives and experiences and to look
at problems in new ways. The data are clear: inclusive, diverse militaries
simply perform better. When we
discriminate or treat classes of service members as less worthy than their
peers, we fail to honor that diversity and we do enormous harm to our ability
to recruit a strong future force. Minority communities in the military —
particularly LGBTQ+, women, Black and Latinx service
members — are significantly under-represented in the leadership ranks. Here’s
what I’ll do to protect and honor everyone who volunteers to serve.
LGBTQ+ Service Members
The only thing that should matter when it comes to allowing
military personnel to serve is whether or not they can handle the job. Our
national security community is weaker when LGBTQ+ Americans are excluded. I
have opposed the Trump Administration’s shameful ban on transgender service
members from the start —
and I’ll reverse it on the first day of my presidency. In addition, advances
in care and treatment have
made it possible for individuals living with HIV to serve and deploy, and the
Pentagon’s policies should be updated to reflect these advances in medical
I’ve also supported efforts to review and correct the
military records of service members discharged solely due to their sexual
orientation, both before and during the Don’t Ask Don’t Tell era. As
Commander-in-Chief, I’ll prioritize this effort, ensuring that we reflect their
honorable service and reinstate the benefits they earned.
I’ll include the LGBTQ+ population in the VA’s Center for
Minority Veterans, ensuring that they receive targeted outreach and equal care
and are treated with dignity and respect. A Warren VA will ensure that every
LGBTQ+ person can get the equitable, gender-affirming, and culturally-competent
health care they need. That means providing all medically necessary care related
to the health of transgender people, including transition-related surgery,
and allowing providers discretion to deem gender-affirming procedures as
medically necessary based on an individualized assessment. This care will also
be available under Medicare for All.
Professional medical associations recognize the need for transition-related
surgery. VA’s blanket exclusion policy of medically necessary treatment is not
grounded in medicine; it should be repealed.
Empowering Women Service Members
Women make up 17.5% of the total
force. But they can face unique professional and personal challenges over the
course of a military career, including higher rates of sexual harassment and assault, higher rates
of divorce, challenges
starting a family, and fewer opportunities for career advancement.
I supported then-Defense Secretary Carter’s decision
to open combat positions to women across
the services, because the only thing that should matter is an individual’s
ability to meet the standards. I’m proud of the women who have risen to that challenge.
Now we must do more to recruit women into service, and then ensure that they
are given equal opportunities to compete for command and promotions. We’ll
invest in research on appropriate gear and injury prevention for women — over one
hundred years after being allowed to enlist, women still perform their duties
wearing equipment that doesn’t fit them, and therefore doesn’t adequately
protect them. And both DOD and VA should enhance the quality of and access to
care for women service members, including for preventive and reproductive care
and mental health.
A 21st century VA must also adapt to the modern fabric of
our veteran population, ensuring that gender-specific care is the norm. There
are about 2 million women veterans today,
and women represent the fastest growing veteran subgroup — that’s why I
successfully fought to ensure VA
has sufficient resources and expertise in its peer counseling program for women
veterans. I’ll also ensure that VA provides full reproductive health care for
all veterans, in addition to the full reproductive health coverage they will
have under Medicare for All. This includes IVF, which is currently only available to
married veterans with service-connected infertility who don’t need donor sperm
or eggs — discriminating against
unmarried veterans, those who delayed pregnancy during their service, and
same-sex couples. It also includes contraception, for which VA continues to charge veterans
despite the fact that the Affordable Care Act made it available without cost to
their civilian counterparts. This also includes abortions. I’ve called to
repeal the Hyde Amendment, which
blocks federal funds from being used to pay for abortions except in cases of
rape, incest, or the life of the woman. VA’s restrictions go even further,
prohibiting coverage for all abortions and all abortion counseling with no
exemptions, an extreme policy I will eliminate.
Too often, women veterans experience sexually explicit
comments and other forms of harassment that
make them feel unsafe and unwelcome and cause them to delay seeking care at
their local VA or miss appointments altogether. This is shameful and it has to
stop. I’ll ensure that a Warren VA has a comprehensive policy to eliminate
sexual harassment and assault and hold perpetrators — VA personnel or anyone
else — accountable, so that women veterans do not have to feel unsafe at their
VA medical center when they seek the care they’ve earned.
Immigrant Service Members
Immigrants to our country have a proud history of honorable
military service and often become citizens. But the Trump Administration has
done everything it can to make these patriotic individuals who volunteer to
serve and defend the United States of America feel unwelcome in our ranks.
In recent years, ICE has deported noncitizen veterans in
violation of its own policies, which require additional review before
proceeding with a removal case against a veteran. The Trump Administration has
taken steps to withdraw deportation protections from military family members,
including family of service members deployed in combat overseas. And under
DOD’s current policies, immigrant troops are being denied citizenship at
a rate higher than their civilian counterparts, and applications for
naturalization as a result of military service dropped 72% between 2017
This is a disgrace. It also undermines military readiness.
It’s not reasonable to expect service members to be able to concentrate on
their jobs when their families are being deported, which is why I’ve used my
position as a member of the Senate Armed Services Committee to urge the Trump
Administration to maintain critical programs like Parole in Place and Deferred
Action for undocumented family members of service members. Further, many
noncitizen veterans come to the attention of immigration enforcement as a
result of PTSD or other trauma associated with their military service; others
fear seeking treatment for that reason. Everyone who serves our country
deserves equal treatment and benefits, regardless of their citizenship status.
A Warren Administration will make it clear that we will
protect veterans and family members of serving military personnel from
deportation, and we will review the cases of those who have been deported for
possible return to the United States. Consistent with our national security
interests, I’ll restart the
Military Accessions Vital to the National Interest (MAVNI) program, which
recruits non-citizens with specialized skills or language abilities, paired
with appropriate security and counterintelligence protections. I’ll also make
it easier for noncitizens who serve honorably in our military to naturalize and
become citizens. And we will heed the call of veterans to honor our commitment
to translators and
others who supported them in combat by re-launching the Direct Access Program
for these vulnerable refugees.
Easing the Transition for Veterans
Nearly 200,000 personnel
separate from military service every year. The initial transition away from
military service can be a challenging period, as veterans work to start school
or find a job, and readjust to family after time overseas. Many new veterans
struggle to find a sense of purpose or connection in new civilian careers and
communities. While DOD has improved its transition counseling in recent years,
we can do more to prepare service members to return to civilian life.
Ensuring a “Warm Hand-Off”
The key to an effective transition is a seamless connection
between DOD and the VA — but too often, veterans fall through the cracks. I’ll
direct DOD to require that service members pre-enroll and complete processing
at the VA before they leave active service. I’ll set a goal of completing
interoperable electronic records between DOD and VA by the end of my first
term. And I’ll direct VA to expand the vets.gov online
portal for veterans and provide veterans access to a VA-provided email, so that
the government can continue to communicate with them about their eligibility
even if they move physical addresses over time.
Eliminating the Benefits Backlog
While the VA has made progress in addressing its backlog of
benefits cases waiting for adjudication, today there are over 70,000 veterans
who have been waiting more than 125 days for a status determination. Moreover,
VA itself acknowledges it takes between 12-18 months to
review a new appeal, and 5-7 years to get a decision from a Veterans Law Judge.
As President, I’ll fully eliminate the initial claims and appeals backlog. And
in the interim, we’ll provide a presumption of eligibility for certain interim
benefits to all those waiting for a final status determination.
Our understanding of traumatic brain injury and other
complex injuries has improved dramatically in recent years, but VA’s disability
compensation process has not kept pace with those developments. I’ll task the
National Academy of Public Administration to review and overhaul the disability
ratings system to better accommodate “invisible” wounds like TBI. I’ll direct
them to take into account recommendations for best practices,
including training additional staff to evaluate cases and taking into account
symptoms that are closely-associated with undiagnosed TBI.
A key concern among veterans is that the benefits
adjudication process is byzantine and lacks transparency. I’ll make sure that
veterans automatically get full access to the results of their examinations and
put in place rigorous processes to ensure claims are granted consistently
nationwide. And to help veterans navigate the system and obtain the benefits
they deserve, I’ll also establish a grant program to fund additional
caseworkers at Veterans Service Organizations and other community-based
Clearing “Bad Paper” Discharges
As the research into PTSD and traumatic brain injuries has
improved, we’ve come to learn that these often invisible injuries lie behind
many less-than-honorable discharges. Nearly 6% of post-9/11
discharges have been other-than-honorable — and one study estimated that 62% of service
members separated for misconduct had been diagnosed within the 2 years prior to
separation with PTSD, TBI, or related conditions. These so-called “bad paper”
discharges can have a lasting negative impact, preventing the most vulnerable
veterans from accessing benefits, obtaining employment, and other earned and
I’ll create a DOD appeals board for veterans seeking to upgrade
their discharges to give those denied by the services another opportunity for
review and to ensure consistency across the services. I’ll direct that board to
expand “liberal consideration”
and consider a broader array of potentially mitigating evidence. I’ll direct
the VA to provide certain interim benefits to individuals with
other-than-honorable discharges until their appeals are adjudicated. And I’ll
direct DOD to establish guidance for commanders to ensure that individuals
first receive care for underlying conditions that may be contributing to
behavioral problems, rather than merely processed for administrative discharge.
Providing Good Jobs
Service members gain valuable skills in the military, but
often don’t know how to translate their skills into civilian life or receive
appropriate “credit” for military service in a civilian context. And while
public-private partnerships and other efforts have broken down the stigma
around hiring veterans, we can do more to set veterans up for long-term
It starts by making it easier for civilian employers to
identify military skill sets that most closely match their needs, and helping
veterans to describe their military experiences in language that resonates with
civilian employers. In the Senate, I’ve prioritized improving the employment
transition for retiring service members, for example by passing a bipartisan bill
that made it easier for service members to use their experience operating large
military vehicles to obtain a commercial driver’s license.
As President, I’ll direct DOD to expand resume and career
coaching opportunities for military personnel considering transition. To
encourage veteran entrepreneurship, I’m proposing a new program to allow
veterans to cash out their GI education benefits for a small business loan. And
we’ll invest in collaborative programs — like labor’s Helmets to Hardhats program
— to connect transitioning service members with federally-recognized
apprenticeship opportunities and good, union jobs.
Ending Veterans’ Homelessness
While the number of veterans experiencing homelessness has
dropped over the last decade, nearly 38,000 were still
homeless in January 2018. Veterans constituted nearly 9% of the total
adult homeless population. Even one homeless veteran is one too many. I’ll
restore SNAP benefits that the Trump administration seeks to cut that
support 1.4 million low-income
veterans, including those who are unemployed or with disabilities. SNAP is a
particularly critical support for young veterans and those recently who have
recently transitioned from active service. We’ll fully fund rapid re-housing
and permanent supportive housing through Supportive Services for Veteran
Families (SSVF) and HUD-VASH. And we’ll create a new competitive grant program
for communities to provide wrap-around services for veterans and their
families. We know that access to housing can be a barrier to many veterans –
and can enhance the scale of other challenges they face. By strengthening
and expanding programs like HUD-VASH, we can end veteran homelessness and allow
our veterans to focus on finding meaningful employment, receiving healthcare
for service-connected conditions, and building resilient lives.
Creating a 21st Century VA Health Care System
The Veterans Health Administration is America’s largest health care
system, providing care at over 1,200 health care facilities nationwide and
serving 9 million enrolled veterans each year.
In recent years, attacks on VA have intensified as
Republicans have pressed to privatize large chunks of VA service. My
Administration will be clear-eyed about leadership challenges at VA. We will
hold accountable leaders who fail to put veterans first or misuse resources,
and we will empower whistleblowers who report wrongdoing to address their
concerns and protect them from retaliation. But the truth is that care provided
by VA outperforms care at non-VA hospitals, as multiplestudies have shown.
And in a recent survey, 91% of veterans who
use VA care said they would recommend it to their fellow veterans. VA has
pioneered innovations in medical care and service delivery. It provides
world-class care for uniquely service-connected injuries, including treatment
for polytrauma, amputations, and spinal cord injuries.
While community care is appropriate where specialists are
unavailable or geographically inaccessible, let me be clear: a Warren
Administration will invest in the VA, not further dismantle it. We will not cut
the high-quality, evidence-based, culturally competent programs that our
veterans rely on. And under Medicare for All, veterans will all have
high-quality health coverage that gives them the option to seek care from
non-VA doctors and hospitals for no additional cost. If there isn’t a VA close
to where they live, Medicare for All will ensure that veterans still get the
care they need when they need it.
In the immediate-term, here’s what we can do to revitalize
our VA for the 21st century–
Work with Congress to implement more flexible hiring
authorities, with a goal of filling the nearly 49,000 staffing
vacancies, the vast majority of which are in the health administration.
Expand the number of physician recruiters and provide
additional financial incentives for physicians in hard-to-recruit specialties
and rural VA centers or those near tribal lands.
Reinvigorate VA’s training partnership program — nearly 70%
of U.S. doctors receive some training at a VA facility, but VA is hindered from
converting those into full-time positions because of the cumbersome hiring
Fully implement the VA MISSION Act — on-time, and in collaboration
with veteran’s groups, ensuring community providers are held to the same high
standards of care as VA providers and that the direct care system is not
weakened by siphoning away money into the private sector.
We’ll invest in modernizing aging infrastructure and
state-of-the-art medical equipment.
We’ll work to fill gaps in care, benefits, or other services
in underserved regions, including on tribal lands; and further integrating
federally-qualified health centers, DOD facilities, and the Indian Health
System as appropriate.
Read more about Warren’s plan for service members, veterans and military families here:
President Joe Biden, in a hotly contested race for President, attacked Donald
Trump for his failed foreign policy in the wake of yet another missile test by
North Korea. Foreign policy is Biden’s
greatest strength among the Democratic rivals for 2020. Here is his statement:
This morning, North Korea fired two missiles in a
deliberate attempt to provoke its neighbors and intimidate the United States —
again. It was the 12th such test the regime has conducted since May in
violation of UN resolutions, and which President Trump has down-played. After
the latest round of denuclearization talks collapsed almost immediately in
Stockholm earlier this month, these tests are a stark reminder that Donald
Trump — a self-proclaimed deal maker — has achieved nothing but a string of
spectacular diplomatic failures that are making the American people less safe.
His “love letters” to murderous dictator Kim Jong Un have delivered little more
than made-for-TV moments. North Korea today has more fissile material and more
capability than when talks began, and Trump has given away our leverage —
including suspending military exercises with our allies and granting Kim
co-equal status at two summits with the president of the United States of
America — for practically nothing in return. Now a more confident Kim is
ticking up the pace of his violations because he believes he can pressure Trump
to bend to his will. There is no deal, because there is no strategy and no
patience for the kind of tough, hard diplomacy that actually produces results.
It’s a pattern we see over and over again. Donald Trump talks a big game,
promises the greatest deal ever, then gives away America’s best negotiating
tools in exchange for a photo op for himself. He only cares about his own
self-aggrandizement and self-enrichment. And every single time, it’s the
American people who end up paying.
He pulled us out of the successful Iran nuclear deal, promising he’d get a
better one. He hasn’t. And now, Iran has taken its nuclear program out of the
deep-freeze and ramped up its aggressive acts across the region — and Trump has
no strategy to deal with these predictable responses.
He pulled us out of the Paris climate accord and dismisses climate change as a
hoax. In less than a week, we will officially notify our departure from Paris,
even as California is on fire and states throughout the Midwest are still
recovering from record flooding over the summer.
He scuttled negotiations with the Taliban that might have opened the door to a
peace settlement, reportedly because he didn’t get the Camp David moment of
glory he wanted. Meanwhile he’s significantly weakened our negotiating position
by imposing a possibly politically-motivated timeline for removing our troops
from Afghanistan, without extracting any concessions from the Taliban in
His vaunted Middle East peace deal has yet to emerge. He gave away our
strongest asset to take on ISIS by precipitously withdrawing our troops from
Northeast Syria. He promised to get tough with China, saying trade wars
were “good and easy to win.” But at more than a year in, what do we have to
show for it? Nothing but pain for American farming and manufacturing, and vague
promises that would only restore trade levels with China back to where they
were before Trump’s irresponsible trade war.
The American people can’t afford four more years of Donald Trump’s art of no
Senator Elizabeth Warren, Democratic candidate for President, has released details of her most controversial proposal, Medicare for All, promising that it will cover every person in America with health care, including long-term care, vision and dental, without increasing taxes on middle class families. Warren focuses on an overall restructuring taxes and spending – going after the loopholes and tax cheats and reining in military spending as well as drug costs and cutting healthcare costs by removing the for-profit insurance companies (gatekeepers) as middlemen. What her plan misses, though, is the obvious: collect the Medicare tax (1.45%, plus an extra 0.9% on income over $200,000) on all income, not just wages, and, if necessary raise the surcharge for incomes over $250,000. Interestingly, while employers would no longer pick and choose the private health insurance they subsidize, employers would still subsidize their employees’ Medicare cost. Health care is considered the leading issue for voters in 2020. Here is the detailed plan, from the Warren campaign: –Karen Rubin/news-photos-features.com.
– Today, Senator Elizabeth
Warren, candidate for President, released her plan to finance Medicare for All.
The coverage is identical to the coverage in the Medicare for All legislation
in the Senate and it will cover every single person in America with excellent,
high-quality health care, including long-term care and vision and dental.
Elizabeth will pay
for this plan without raising taxes one penny on middle class families. Instead, she will put about $11
trillion in the pockets of American families by eliminating what they would pay
in premiums, deductibles, co-pays, and other out-of-pocket costs over the next
Her numbers add up and
are backed by experts including:
Simon Johnson, the
former Chief Economist at the International Monetary Fund and a professor at
Dr. Donald Berwick,
one of the nation’s top experts in health system management and improvement,
who ran the Medicare and Medicaid programs under President Barack Obama
Mark Zandi, Chief
Economist of Moody’s Analytics
former Chief Economist for the Obama Labor Department
Elizabeth’s plan to
dramatically improve health care and cut family costs would cost the United
States less than our current broken system. It would require $20.5 trillion in
new revenue, nearly half of which comes simply from having employers pay
Medicare instead of private insurance companies.
Elizabeth will finance
the remainder of Medicare for All with targeted defense spending cuts, new
taxes on financial firms, giant corporations, and the richest 1% of Americans,
and by cracking down on tax evasion and fraud. The $11 trillion in household
insurance and out-of-pocket expenses projected under our current system goes
right back into the pockets of America’s working people — substantially larger than the
largest tax cut in American history — and no middle class tax increases.
My daddy’s heart attack nearly sent our family skidding over
a financial cliff. Today I think about all the kids this year who will face the
double blow of nearly losing a parent and then watching their lives turn upside
down as their families struggle to pay a growing stack of medical
I spent my career studying why so many hard-working middle
class families were going broke. For years, my research partners and I traveled
the country from bankruptcy courtroom to bankruptcy courtroom, talking directly
to people who’d seen their lives turned upside down. We interviewed lawyers,
judges, and families involved in bankruptcy cases. To save on printing costs,
we lugged around a Xerox machine (I nicknamed him “R2-D2”) to save money on
photocopying court records.
Eventually, we built the largest and most comprehensive
database of consumer bankruptcy data ever assembled. That first study surprised
us: we found that 90% of families went bankrupt because of job loss, medical
problems, and marital disruption. That finding was confirmed in 2007 by my
later research, which found that the number one reason
families were going broke was health care – and three quarters of
those who declared bankruptcy after an illness were people who already had
It’s been nearly thirty years since we published that first
groundbreaking study. And after all that time, here’s where we are: between
2013 and 2016, the number one reason families
went broke was still because of health care – even though 91.2% of Americans
had health insurance in 2016.
Families are getting crushed by health costs. Just look at
how much an average family of four with employer-sponsored insurance personally
spent per year on employee premium contributions and out-of-pocket
costs in 2018. And this figure has increased each
87 million. That’s
how many American adults in 2018 were uninsured or “underinsured” – meaning
either they have no insurance or their so-called health insurance is like a car
with the engine missing. It looks fine sitting on the lot, but inadequate if
they actually need to use it. Nearly one in every
two adults not currently on Medicare has no insurance or unreliable insurance.
adults didn’t fill a prescription last year because of costs. 36 millionpeopleskipped
a recommended test, treatment, or follow-up because of costs. 40 millionpeople
didn’t go to a doctor to check out a health problem because of costs. 57 millionpeople
had trouble covering their medical bills.
Today, in 2019, in the United States of America, the
wealthiest nation in the history of the world, inadequate health coverage is
crushing the finances and ruining the lives of tens of millions of American
I’m running for President based on a radical idea – calling
out what’s broken and speaking plainly about how to fix it.
All my plans start with our shared values. There are two
absolute non-negotiables when it comes to health care:
One: No American should ever, ever die or go bankrupt
because of health care costs. No more GoFundMe campaigns to pay for care. No
more rationing insulin. No more choosing between medicine and groceries.
Two: Every American should be able to see the doctors they
need and get their recommended treatments, without having to figure out who is
in-network. No for-profit insurance company should be able to stop anyone from
seeing the expert or getting the treatment they need.
Health care is a human right, and we need a system that
reflects our values. That system is Medicare for All.
Let’s be clear: America’s medical professionals are among
the best in the world. Health care in America is world-class. Medicare for All
isn’t about changing any of that.
It’s about fixing what is broken – how we pay for that care.
And when it comes to health care, what’s broken is obvious.
A fractured system that allows private interests to profiteer off the health
crises of the American people. A system that crushes our families with costs
they can’t possibly bear, forcing tens of millions to go without coverage or
to choose between basic
necessities like food, rent, and health – or bankruptcy.
We must fix this system. And over the long-term, the best
way to achieve that goal is to move from the system we have now to a system of
Medicare for All.
Medicare for All is about where doctors, hospitals, and care
providers send the bill – to a collection of private insurance companies who make billions off
denying people care or to the Medicare program for fair compensation. Under
Medicare for All, everyone gets the care they need, when they need it, and
nobody goes broke.
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. This task
is made a hundred times harder by powerful health insurance and drug companies
that makebillions of dollars
off the current bloated, inadequate system – and would be perfectly happy to
leave things exactly the way they are.
In 2017 alone, health industry players whose profiteering
would end under Medicare for All unleashed more than 2,500 lobbyists on
Washington. These industries will spendfreely on shady TV
ads and lobbying to convince people that a program that saves them massive
sums of money will somehow cost them money.
That being able to see the doctors and get the treatments they need regardless
of what their employer or
their insurance company thinks
is somehow actually a loss of choice. That a program that covers more services,
more people, and costs the American people less than what we
currently spend on health care is somehow too expensive.
Meanwhile, where are the 2,500 lobbyists for the people who
get sick and can’t pay their medical bills? Where are the hundreds of
millions being spent so that people who are trying to balance a budget around
rising health care premiums and growing deductibles and copays can make their
voices heard in Washington? Washington hears plenty from the giant health
insurance and giant drug industries, but not so much from families being
squeezed to the breaking point.
So let’s focus on families’ expenses and families’ health
Start with the Medicare for All Act – which
I have cosponsored. The bill provides a detailed proposal for how to achieve
our end goal. But as economists and advocates have noted, the legislation
leaves open a number of key design decisions that will affect its overall cost,
and the bill does not directly incorporate specific revenue measures. While
much of this ambiguity results from the reasonable choice to delegate
significant implementation discretion to the Executive Branch, it has also
allowed opponents of
Medicare for All to make up their own price tags and try to scare middle class
families about the prospect of tax increases – despite the conclusions of expert after expert after expert that it is
possible to eventually move to a Medicare for All system that gives both high
quality coverage for everybody and dramatically lowers costs for middle class
The best way to fight misinformation is with facts. That’s
why today, I’m filling in the details and releasing a plan that describes how I
would implement the long-term policy prescriptions of the Medicare for
All Act and how to pay for it.
Under my plan, Medicare for All will cover the full list of
benefits outlined in the Medicare for All Act, including long-term
care, audio, vision, and dental benefits. My plan will cover every single
person in the U.S., and includes common-sense payment reforms that make
Medicare for All possible without spending any more money overall than we spend
My plan reflects careful, detailed analyses from key
national experts in health policy, tax policy, and economics. By filling in the
details, we can strip away all the misleading political attacks and make plain
the choice facing the American people:
Option 1: Maintain our current system, which will cost
the country $52 trillion over ten years. And under that current system
63 million have
coverage gaps or substandard coverage that could break down if they actually
get sick. And millions who have
health insurance will end up going broke at least in part from medical costs
Together, the American people will pay $11 trillion of
that bill themselves in the form of premiums, deductibles, copays,
out-of-network, and other expensive medical equipment and care they pay for
out-of-pocket – all while America’s wealthiest individuals and
biggest companies pay far
less in taxes than in other major countries.
Option 2: Switch to my approach to Medicare for All,
which would cost the country just under $52 trillion over ten
years. Under this new system –
Every person in America – all 331 million people
– will have full health coverage, and coverage for long-term care.
Everybody gets the doctors and the treatments they need,
when they need them. No more restrictive provider networks, no more insurance
companies denying coverage for prescribed treatments, and no more going broke
over medical bills.
The $11 trillion in
household insurance and out-of-pocket expenses projected under our current
system goes right back into the pockets of America’s working people. And we
make up the difference with targeted spending cuts, new taxes on giant corporations
and the richest 1% of Americans, and by cracking down on tax evasion and
fraud. Not one penny in middle-class tax increases.
That’s it. That’s the choice. A broken system that leaves
millions behind while costs keep going up and insurance companies keep sucking
billions of dollars in profits out of the system – or, for about the same
amount of money, a new system that drives down overall health costs and, on
average, relieves the typical middle class families of $12,400 in insurance
premiums and other related health care costs.
No middle class tax increases. $11 trillion in household
expenses back in the pockets of American families. That’s substantially larger than the
largest tax cut in American history.
Not every candidate for president supports moving to a
system of Medicare for All. Some who support Medicare for All will have
different ideas about how to finance and structure it. And everybody knows that
there must be a real transition. But you don’t get what you don’t fight for –
and my view is clear.
Every candidate who opposes my long-term goal of Medicare
for All should explain why the “choice” of private insurance plans is
more important than being able to choose the doctor that’s best for you without
worrying about whether they are in-network or not. Why it’s more important than
being able to choose the right prescription drug for you without worrying about
massive differences in copays. Why it’s more important than being able to
choose to start a small business or choose the job you want without worrying
about where your health care coverage will be coming from and how much it will
Every candidate who opposes my long-term goal of Medicare
for All should put forward their own plan to cover everyone, without costing
the country anything more in health care spending, and while putting $11
trillion back in the pockets of the American people by eliminating premiums and
virtually eliminating out-of-pocket costs. Or, if they are unwilling to do
that, they should concede that they think it’s more important to protect the
eye-popping profits of private insurers and drug companies and the immense
fortunes of the top 1% and giant corporations, rather than provide
transformative financial relief for hundreds of millions of American
And every candidate who opposes my long-term goal of
Medicare for All should put forward their own plan to make sure every single
person in America can get high-quality health care and won’t go broke – and
fully explain how they intend to pay for it. Or, if they are unwilling to do
that, concede that their half-measures will leave millions behind.
And make no mistake – any candidate who opposes my long-term
goal of Medicare for All and refuses to answer these questions directly should
concede that they have no real strategy for helping the American people address
the crushing costs of health care in this country. We need plans, not
THE COST OF MEDICARE FOR ALL
A serious conversation about how to pay for Medicare for All
requires, first, determining how much such a system would cost.
In recent years, several economists and think tanks have
attempted to estimate the cost of a single-payer system in the United States.
Those estimates consider how much our nation’s health care spending will change
over a ten year window, and range from a $12.5 trillion decrease
to a $7 trillion increase.
They also consider how much additional money the federal government would need
to fund this system, and those estimates range from a low of $13.5 trillion to a
high of $34 trillion over
Because nobody can actually see the future, some of this
variation results from different assumptions about how parts of our health care
system might work differently under Medicare for All. But most of the
difference comes from policy choices. And while the Medicare for All
Act is clear about some of these choices – for example, generous
benefits, long-term care coverage, and virtually no out-of-pocket expenses – it
is silent on a number of really important ones. How much will we pay for
medical care and for prescription drugs? What do we do with the existing money
that states spend on Medicaid? How aggressively will we cut administrative
costs? Aggressive choices mean a lower total cost. Less aggressive choices
result in a higher total cost.
Serious candidates for president should speak plainly about
these issues and set out their plans for cost control – especially those who
are skeptical of Medicare for All. Because whether or not we make modest or
transformative changes to our health care system, cancer, diabetes, strokes,
Alzheimer’s, and Parkinson’s aren’t going to simply disappear. And without
leadership from the top, neither will the mushrooming cost of care in America
that’s bankrupting our families.
I’ve asked top experts to consider the long-term cost of my
plan to implement Medicare for All over ten years – Dr. Donald Berwick, one of
the nation’s top experts in health system improvement and who ran the Medicare
and Medicaid programs under President Obama; and Simon Johnson, the former
Chief Economist at the International Monetary Fund and a professor at MIT.
Their analysis begins with the assumptions of a recent study by the Urban
Institute and then examines how that cost estimate would change as certain new
key policy choices are applied. These experts conclude that my plan would slightly
reduce the projected amount of money that the United States would otherwise
spend on health care over the next 10 years, while covering everyone and giving
them vastly better coverage.
REDUCING INSURER ADMINISTRATIVE COSTS
The business model of private insurers is straightforward:
pay out less for medical care than they take in as premiums. This model is
located right in the center of our health care system, wasting huge amounts of
time and money documenting and arguing over who is owed what. Incredibly,
insurance companies spend a whopping $350 billion on
administration costs annually—and then, in turn, push huge additional
administrative costs onto hospitals, doctors, and millions of other health care
professionals in the from of complex billing—and then, in turn, drive up costs
incurred by employers as they attempt to navigate the complexity of providing
their employees with insurance.
Medicare for All will save money by bringing down the
staggering administrative costs for insurers in our current system. As the
experts I asked to evaluate my plan noted, private insurers had administrative
costs of 12% of premiums collected in 2017, while Medicare kept its
administrative costs down to 2.3%. My plan will ensure that Medicare for All
functions just as efficiently as traditional Medicare by setting net
administrative spending at 2.3%.
COMPREHENSIVE PAYMENT REFORM
In 2016, the United States spent nearly twice as
much on health care as ten high-income countries, and these costs have
been steadily rising for
decades, growing from 5.2%
of U.S. GDP in 1963 to 17.9% in 2017. But
instead of resulting in better health outcomes, Americans have the lowest
life expectancy of residents in high-income countries, the highest infant
mortality rate, and the highest obesity rates.
Why? As a group of health economists famously wrote, “It’s the prices,
Studieshave continued to
show that it’s not how much people use the health care system, often referred
to as “utilization,” but rather how much people pay that drives our high spending.
Compared to other high income countries, Americans simply pay more for health
care. We pay more for physicians and nurses. We pay more in administrative
costs. We pay more for prescription drugs.
A heart bypass surgery that costs nearly
$16,000 in the Netherlands costs an average of $75,000 in the United States. A
CT scan that costs $97 in Canada
costs an average of $896 here. And in the United States, hospitals can charge new parents
for holding their newborn after delivery.
Meanwhile, private equity firms fight bipartisan
legislation in Washington that might undermine the profitability of their
investments or prevent their hospitals from sending patients surprise bills.
And health care CEO salaries continue to soar. Between 2005 and 2015,
non-profit hospital CEO salaries increased by 93% to
an average of over $3 million, and last year, 62 health care CEOs raked in a
combined $1.1 billion – more
than the CDC spent on chronic disease prevention.
If we expect the American people to be able to afford health
care, we need to rein in these costs. Comprehensive payment reform, as part of
Medicare for All, will reduce this component of health care spending. Under my
approach, Medicare for All will sharply reduce administrative spending
and reimburse physicians and other non-hospital providers at current Medicare
rates. My plan will also rebalance rates in a budget neutral way that
increases reimbursements for primary care providers and lowers reimbursements
for overpaid specialties.
While private insurance companies pay higher rates, this system would be
expected to continue compensating providers at roughly the same overall rate
that they are currently receiving. Why? This is partially because providers
will now get paid Medicare rates for their Medicaid patients – a substantial
raise. But it’s also because providers spend an enormous amount of time on
billing and interacting with insurance companies that reduces their efficiency
and takes away from time with patients. Some estimate that hospitals will spend $210 billion on
average annually on these costs.
The nonpartisan Institute of Medicine estimates that
these wasted expenses account
for 13% of the revenue for physician practices, 8.5% for hospitals, and 10% for
other providers. Together, the improved efficiency will save doctors time and
money – helping significantly offset the revenue they will lose from
getting rid of higher private insurance rates.
Under my approach, Medicare for All will sharply
reduce administrative spending and reimburse hospitals at an average of 110% of
current Medicare rates, with appropriate adjustments for rural hospitals,
teaching hospitals, and other care providers with challenging cost structures.
In 2017, hospitals that treated Medicare patients were paid about 9.9% less than
what it cost to care for that patient. The increase I am proposing under
Medicare for All will cover hospitals’ current costs of care – but hospital
costs will also substantially decrease as a result of simpler administrative
processes, lower prescription drug prices, the end of bad debt from
uncompensated care, and more patients with insurance seeking care.
Of course, as Medicare currently recognizes,
not every provider situation is the same, and my Medicare for All program
maintains these base rate adjustments for geography and other factors. In
my plan for Rural
America, for example, I have committed to creating a new designation under
Medicare for rural hospitals due to the unique challenges health systems face
in rural communities. That’s why my plan allows for adjustments above the 110%
average rate for certain hospitals, like rural and teaching hospitals, and
below this amount for hospitals that are already doing fine with current
Medicare rates.Universal coverage will also have a
disproportionately positive effect on rural hospitals. Because people living in
rural counties are more likely to be
uninsured than people living in urban counties, these hospitals currently
provide a lot of uncompensated care. Medicare for All fixes that problem. And
I’ve previously laid out additional
investments to increase the number of Community Health Centers and grow our
health care workforce in rural and Native American communities, while cracking
down on anti-competitive mergers that lead to worse outcomes and higher costs
for rural communities.
We can also apply a number of common-sense, bipartisan
reforms that have been proposed for Medicare. Today, for example, insurers can
charge dramatically different prices for the exact same service based on where the service was
performed. Under Medicare for All, providers will receive the same
amount for the same procedure, saving hundreds of billions of dollars. We can
also make adjustments to things that we know Medicare currently pays too much
for – like post-acute care – by adjusting those payments down slightly while
accounting for the patient’s health status, bringing health care costs down
We will also shift payment rates so that we are paying for
better outcomes, instead of simply reimbursing for more services. We build on
the success of value-based reforms enabled by the Affordable Care Act,
including by instituting bundled payments for inpatient care and for 90 days of
post-acute care. Instead of paying providers for each individual service,
bundled payments reimburse providers for an entire “episode” of care and have
been shown to both improve outcomes and control costs. These
bundles help ensure that a patient’s different providers all communicate because
they are all tied to the same payment.
RESTORING HEALTH CARE COMPETITION
Health care consolidation has also contributed to
rising health care costs. One analysis found that over 90% of
metropolitan areas had health care provider markets that were either highly
concentrated or super concentrated in 2016. And despite the same kinds of empty
promises we see every time there’s industry consolidation – in this case, that
bigger hospitals would lead to better care – the data have not borne
this out. In fact, it’s theopposite: more
competition between providers creates incentives to improve care, and that
incentive will only increase under a
Medicare for All system where quality, not price, is the main differentiator in
Under Medicare for All, hospitals won’t be able to force
some patients to pay more because the hospital can’t agree with their insurance
company. Instead, because everyone has good insurance, providers will have to
compete on better care and reduced wait times in order to attract more
That’s why I will appoint aggressive antitrust enforcers to
the Department of Justice and Federal Trade Commission and allow hospitals to
voluntarily divest holdings to restore competition to hospital markets. I’ve
also previously committed to
strengthening FTC oversight over health care organizations, including
non-profit hospitals, to crack down on anti-competitive behavior. And I will
direct my FTC to block all future hospital mergers unless the merging companies
can prove that the newly-merged entity will maintain or improve care.
REINING IN OUT-OF-CONTROL PRESCRIPTION DRUG COSTS
Americans pay more for prescription drugs than anyone in the
world – $333 billion in
2017 alone. Americans spent $1,220 per person on
average for prescription drugs, while the next highest spending country,
Switzerland, spent $963 per person. That’s not because Americans use more
prescription medication – it’s because lax laws have allowed pharmaceutical
companies to charge insurance companies and patients exorbitant rates. In a
now-infamous example, when Turing Pharmaceuticals purchased the rights to the
HIV medication Daraprim, the company raised the price of
this life-saving drug from $13.50 per pill to a stunning $750 per tablet overnight.
The price of insulin has skyrocketed, forcing
people to risk their lives by rationing. And as prices continue to rise, more
Americans are turning to Canada in
search of affordable prices.
Reining in prescription drug costs should be a top priority
for any President – and there’s no better way to do it than through Medicare
for All. My administration will use a suite of aggressive policy tools to set a
net savings target that will bring down Medicare prices for brand name
prescription drugs by 70% and prices for generics by 30%, with an initial focus
on more expensive drugs.
Under Medicare for All, the federal government would have
real bargaining power to negotiate lower prices for patients. I will adopt an
altered version of the mechanism outlined in the Lower Prescription
Drug Costs Now Act which leverages excise taxes to bring manufacturers
to the table to negotiate prices for both branded and generic drugs, with no
drug exceeding 110% of the average international market price, but removes the
limit of the number of drugs Medicare can negotiate for and eliminates the
“target price” so Medicare could potentially negotiate prices lower than other
If negotiations fail, I will use two tools – compulsory
licensing and public manufacturing – to allow my administration to ensure
patient access to medicines by either overriding the patent, as modeled in
the Medicare Negotiation and Competitive Licensing Act, or by
providing public funds to support manufacturing of these drugs, as modeled in
my Affordable Drug Manufacturing Act. Medicare for All will also
incentivize pharmaceutical companies to develop the drugs we need – like
antibiotics, cancer cures, and vaccines. And it’s not just about driving down
drug prices. Making sure patients get important drug therapies up front that
keep them healthy and cost a fraction compared to more severe treatment down
the line can save money overall. Insurers, who may only cover individuals for a
few years of their lives, see those investments in long-term health as a cost
they’ll never recoup – so they have a financial incentive to deny patients these
treatments. But Medicare for All covers each patient for their entire lifespan.
There’s no perverse incentive to deny the prescriptions they need today because
the long-term benefits to their health won’t benefit their current private
STEMMING THE GROWTH OF MEDICAL COSTS
Year after year, U.S. health spending has grown at rates
above GDP growth, reaching a whopping 17.9% of GDP in
2017. Experts believe the changes to prescription drug spending and value-based
payment systems that I’ve already outlined will bring growth rates in line with
U.S. GDP, which CBO projects to be an average of 3.9% for
the next decade. And if growth rates exceed this rate, I will use available
policy tools, which include global budgets, population-based budgets, and
automatic rate reductions, to bring it back into line.
REDIRECTING TAXPAYER-FUNDED HEALTH SPENDING
Through Medicaid and public health plans for state
employees, state and local governments play a significant role in financing
health care coverage in America. Under my approach to Medicare for All, we will
redirect $6 trillion in existing state and local government insurance spending
into the Medicare for All system. This is similar to the mechanism that the
George W. Bush Administration used to redirect Medicaid spending to the federal
government under the Medicare prescription drug program.Under this
maintenance-of-effort requirement, state and local governments will redirect
$3.3 trillion of what they currently spend to support Medicaid and the
Children’s Health Insurance Program and $2.7 trillion of what they currently
spend on employer contributions to private insurance premiums for their
employees into Medicare for All. Because we bring down the growth rate of
overall health spending, states will pay less than they would have without
Medicare for All. They’ll also have far more predictable budgets, resulting in
improved long-term planning for state and community priorities.
Together, these policy choices represent significant
reductions in health care spending over current levels. Compared to the
estimate by the Urban Institute, they will save over $7 trillion over ten
years, bringing the expected share of additional federal revenue to just over
$26 trillion for that period. After incorporating the $6 trillion we will
redirect from states to help fund Medicare, the experts conclude that total
new federal spending required to enact Medicare for All will be $20.5 trillion.
PAYING FOR MEDICARE FOR ALL
Medicare for All puts all health care spending on the
government’s books. But Medicare for All is about the same price as our current
path – and cheaper over time. That means the debate isn’t really about
whether the United States should pay more or less. It’s about who should
Right now, America’s total bill for health care is projected
to be $52 trillion for the next ten years. That money will come from four
places: the federal government, state governments, employers, and individuals
who need care. Under my approach to Medicare for All, most of these funding
sources will remain the same, too.
Existing federal spending on Medicare and Medicaid will help
fund Medicare for All.
Existing state spending on health insurance will continue in
the form of payments to Medicare – but states would be better off because
they’d have more long-term predictability, and they’d pay less over time
because these costs will grow more slowly than they do today.
Existing total private sector employer contributions to
health insurance will continue in the form of contributions to Medicare – but
employers would be better off because under the design of my plan, they’d pay
less than they would have otherwise.
Here’s the main difference: Individual health care
Over the next ten years, individuals will spend $11 trillion
on health care in the form of premiums, deductibles, copays, and out-of-pocket
costs. Under my Medicare for All plan, that amount will drop from $11
trillion to practically zero.
I asked top experts – Mark Zandi, the Chief Economist of
Moody’s Analytics; Betsey Stevenson, the former Chief Economist for the Obama
Labor Department; and Simon Johnson – to examine options for how we can make up
that $11 trillion difference. They conclude that it
can be done largely with new taxes on financial firms, giant corporations, and
the top 1% – and making sure the rich stop evading the taxes we already have.
That’s right: We don’t need to raise taxes on the
middle class by one penny to finance Medicare for All.
Here’s how it would work.
REPLACING EMPLOYER HEALTH SPENDING WITH A NEW EMPLOYER
Let’s start with a basic fact: American companies are
already paying a lot for health care for their employees. They are projected to
pay nearly $9 trillion over the next ten years, mostly on employer
contributions for employee health insurance and on health-related expenses for
employees under workers’ compensation and long-term disability. My idea is that
instead of these companies sending those payments to private insurance
companies, they would send payments to the federal government for Medicare in
the form of an Employer Medicare Contribution.
In fact, it’ll be a better deal than what they have
now: companies will pay less than they otherwise would have, saving
$200 billion over the next ten years.
To calculate their new Employer Medicare Contribution,
employers would determine what they spent on health care over the last few
years and divide that by the number of employees of the company in those years
to arrive at an average health care cost per employee at the company.
(Companies would count part-time employees towards the total based on the
number of hours they worked during a year.) Under the first year of Medicare
for All, employers would then take that average cost, adjust it upwards to
account for the overall increase in national health care spending, and multiply
it by their total number of employees that year. Their Employer Medicare
Contribution would be 98% of that amount – ensuring that every company
paying for health care today will pay less than they would have if they were
still offering their employees comparable private insurance.
A similar calculation would apply to pass-through entities,
like law firms or private equity funds, even though many of the people that
work there technically aren’t employees. People who are self-employed would be
exempt from making Employer Medicare Contributions unless they exceed an income
Small businesses – companies with under 50 employees – would
be exempt from this requirement too if they aren’t paying for employee health
care today. When either new or existing firms exceed this employee threshold,
we would phase in a requirement that companies make Employer Medicare Contributions
equal to the national average cost of health care per employee for every
employee at that company. Merging firms would pay the weighted average cost of
health care per employee of the two firms that are merging.
Employers currently offering health benefits under a
collective bargaining agreement will be able to reduce their Employer Medicare
Contribution if they pass along those savings to workers in the form of
increased wages, pensions, or other collectively-bargained benefits. New
companies or existing companies who enter into a collective bargaining
agreement with their employees after the enactment of Medicare for All will be
able to reduce their Employer Medicare Contributions in the same way. Employers
can reduce their contribution requirements all the way down to the national
average health care cost per employee.
That way, my plan helps unions that have bargained
for good health care already, and creates a significant new incentive for
unionization generally by making collective bargaining appealing for both
workers and employers as a way of potentially reducing the employer’s Employer
Over time, an employer’s health care cost-per-employee would
be gradually shifted to converge at the average health care cost-per-employee
nationally. That helps make sure the system is fair but also gives
employers and employees time to adapt to the new system.
If we’re falling short of the $8.8 trillion revenue target
for the next ten years, we will make up lost revenue with a Supplemental
Employer Medicare Contribution requirement for big companies with extremely
high executive compensation and stock buyback rates.
There are a variety of ways to structure an employer
contribution to Medicare for All. This particular approach has the benefit of
helping American employers in a few ways:
Employers would collectively save $200 billion over the next
Employers receive far more certainty about how their health
care costs will vary over time and affect their finances.
Small businesses – who often suffer when competing for
employees because they can’t afford to
offer health care coverage – would no longer be at a competitive disadvantage
against bigger businesses.
Employers can reduce their Employer Medicare Contribution by
supporting unionization efforts and negotiating with workers to provide better
wages and benefits – reducing costs and promoting collective bargaining at the
Because my plan holds health care cost growth to GDP levels,
businesses will have stable balance sheets that grow with the economy instead
of crowding out other priorities.
By asking employers to pay a little less than what they
are already projected to pay for health care, we can get almost halfway to
where we need to go to cover the cost of my Medicare for All plan.
Automatic Increases in Take-Home Pay
Medicare for All puts a whole lot of money back in the
American people’s pockets. One way it does that is by taking the share of
premiums employees are responsible for paying through employer-sponsored
insurance – that line on pay stubs each week or month that says “health
insurance” – and returning it to working people. Congratulations on the
And higher take-home pay for workers also means additional
tax revenue just from applying our existing taxes – approximately $1.15
trillion if we apply average effective tax rates.
Medicare for All saves people money in other ways too. With
Medicare for All, nobody would need to put money in Health Savings Accounts or
medical savings accounts to try and protect themselves against the unthinkable.
And because individual spending on premiums, deductibles, copays, and
out-of-pocket costs will basically disappear, the tax break for medical
expenses in excess of 10% of Adjusted Gross Income becomes irrelevant.
Together, those changes would generate another
$250 billion in revenue.
All told, another $1.4 trillion in funding for Medicare for
All is generated automatically through existing taxes on the enormous amount of
money that will now be returned to individuals’ pockets from moving to a
Medicare for All system with virtually no individual spending on health
Here’s what that means: we can generate almost half
of what we need to cover Medicare for All just by asking employers to pay
slightly less than what they are projected to pay today, and through existing
So where does the rest of the money come from that allows us
to eliminate premiums, deductibles, copays, and most out-of-pocket spending for
every American? Four sources: (1) better enforcement of our existing tax laws
so we stop letting people evade their tax obligations; (2) targeted taxes on
the financial sector, large corporations, and the top 1% of individuals; (3) my
approach to immigration; and (4) shutting down a slush fund for defense
CRACKING DOWN ON TAX EVASION AND FRAUD
The federal government has a nearly 15% “tax gap”
between what it collects in taxes what is actually owed because of systematic
under-enforcement of our tax laws, tax evasion, and fraud. If that 15% gap
persists for the next ten years, we will collect a whopping $7.7 trillion less in
federal taxes than the law requires. By investing in stronger
enforcement and adopting best practices on tax reporting, withholding, and
filing, experts predict that we can close the tax gap by a third – generating
about $2.3 trillion in additional federal revenue without a single new
A big part of our current tax gap problem is that we’re letting
wealthier taxpayers get away with paying less than what they owe. Studies show that the
wealthiest 5% of taxpayers misrepresent their income more frequently than the
The wealthy and their allies in Washington have worked
to slash the IRS
budget, leaving it without the resources it needs. The agency today has about the
same number of revenue agents as it did when the economy was one-seventh its
current size in the 1950s. And the IRS insists on targeting low-income
taxpayers rather than wealthy ones, even though the amount of revenue we can
recover from wealthy taxpayers is far more.
We know how to fix this problem. We can draw lessons from
what works in other countries with much lower tax gaps and rely on the
recommendations of tax experts. Here’s a game plan:
Substantially increase funding for the IRS, including the
Criminal Investigation Division. The Treasury Department estimated in its
Fiscal Year 2017 budget request that every $1 invested in IRS enforcement
brings in nearly $6 in additional revenue – not even including an indirect
deterrence effect three times that amount.
Expand third-party reporting and withholding requirements.
Research shows that third-party reporting and withholding cuts down on the
tax misreporting rate substantially.
Strengthen enforcement of the Foreign Account Tax Compliance
Act (FATCA). FATCA requires foreign financial institutions to report the
holdings and income of U.S. taxpayers, but the IRS is generally not systematically matching these
reports to individual tax returns. We also don’t hold foreign financial firms
truly accountable for ignoring their reporting obligations. Automatically
matching FATCA reports to tax returns and instituting sanctions for
non-compliant foreign financial institutions would help narrow the tax gap.
Increase the nonfiler compliance program, strengthen
reporting requirements for international income, use existing currency
transaction reports to enforce cash income compliance, and increase reporting
requirements for virtual- or crypto-currencies, as suggested by the
Treasury Department’s Inspector General.
Allow employees who
disclose tax evasion and abuse to use the protections of the False Claims Act
and other whistleblower protections.
The experts who reviewed these ideas estimated that if we
implemented them, we could close the tax gap by one-third from 15% to 10%,
bringing us closer to the tax gap in countries like the United Kingdom (5.6%). That will
produce another $2.3 trillion in net federal revenue – without imposing a
single new tax.
TARGETED TAXES ON THE FINANCIAL SECTOR, LARGE
CORPORATIONS, AND THE TOP 1%
We can generate a whole lot of the remaining revenue we need
for Medicare for All just by eliminating bad incentives in our current tax
system and asking those who have done really well in the last few decades to
pay their fair share.
Let’s start with the financial sector. It’s been more than
ten years since the 2008 financial crisis, and while a lot of families
are still dealing with
the aftereffects, the financial sector is making record, eye-popping profits.
Meanwhile, the risk of another financial crisis remains unacceptably high. By
imposing targeted taxes and fees on financial firms, we can generate needed
revenue and also make our financial system safer and more secure.
For example, a small tax on financial transactions –
one-tenth of one percent on the sale of bonds, stocks, or derivatives – would
generate about $800 billion in
revenue over the next ten years. The tax would be assessed on and
collected from financial firms, and would likely have little to no effect on
most investors. Instead, according to experts, the tax could
help decrease what Americans pay in fees for their investments and reduce the
size of relatively unproductive parts of the financial sector.
We can also impose a fee on big banks that encourages them
to take on fewer liabilities and reduce the risk they pose to the financial
system. A small fee that applies only to the forty or so largest banks in the
country would generate an additional $100 billion over
the next ten years – while making our financial system more safe and
Next, we can make some basic changes to ensure that large
corporations pay their fair share and to fix some fundamental problems with our
current approach that actually encourage companies to shift jobs and investment
overseas. These changes will generate an estimated $2.9 trillion over
the next ten years.
For instance, our current tax system lets companies deduct
the cost of certain investments they make in assets faster than those assets
actually lose value. That means that if a company buys a machine for a million
dollars, it gets to deduct a million dollars from its taxes that same year –
even if the machine only loses $100,000 in value a year. Letting the company
write off the extra $900,000 all at once is like giving them an interest-free loan from
That might be worth it if the company responded to this tax
break by investing more and building out their businesses. But the datasuggest this isn’t
happening because companies don’t actually value these tax deferrals as much as
policymakers assume. Companies are mostly making the same investments they
would’ve made anyways – sometimes with small changes in timing – and getting a
write-off in exchange. Some experts even suggest that
accelerated expensing could induce less domestic investment,
That’s why I’m proposing to get rid of this loophole. Under
my plan, businesses will still write off the depreciation of their assets –
they’ll just do it in a way that more accurately reflects the actual loss in
value. This would generate $1.25 trillion over
We can also stop giant multinational corporations from
calling themselves American companies while sheltering their profits in foreign
tax havens to avoid paying their share for American investments.
Currently, a U.S. multinational corporation can make
billions in profits and attribute it to a company it set up in a tax haven like
the Cayman Islands, which has no corporate taxes. The Trump tax bill claimed to
address that problem by creating a global minimum tax rate for corporations,
but that minimum tax – the result of heavy lobbying by
multinationals – is too low and easily gamed. While Trump and congressional
Republicans claimed their
minimum tax would keep companies from shifting profits to tax havens and limit
offshoring, the opposite is happening. The current
approach bothencourages companies
to shift their profits to tax havens and actually incentivizes American
companies to outsource their operations overseas.
That’s why I’m proposing to institute a country-by-country minimum
tax on foreign earnings of 35% – equal to a restored top corporate tax rate for
U.S. firms – without permitting corporations to defer those payments. Under
my plan, corporations would have to pay the difference between the minimum tax
and the rate in the countries where they book their profits. For example, an
American corporation booking a billion dollars in profits in the Cayman
Islands, taxed at 0% there, would need to pay the federal government a 35% tax
rate – the difference between the new minimum rate (35%) and the foreign rate
(0%) – on the billion dollars in profits.
My plan would also collect America’s fair share of profits
that foreign companies make by selling their products to Americans. Today, we
have a “global tax deficit”: companies that sell their goods abroad don’t have
to pay the extra taxes that they would have to pay if they were subject to a
minimum effective tax rate in each country they operated in. Making U.S. firms
pay a country-by-country minimum tax effectively collects their whole global
tax deficit – but foreign companies should have to pay their fair share, too.
That’s why I’m proposing that the U.S. collect the fraction of this global tax
deficit that corresponds to the percentage of that company’s sales in the U.S.
In other words, if a foreign company should owe an additional $1 billion in
taxes if it were subject to a country-by-country minimum tax, the U.S. would
collect a fraction of that $1 billion based on the amount of sales that company
made in the United States.
Together, the country-by-country minimum tax and the
taxation of foreign firms based on their domestic sales would result in an
additional $1.65 trillion in
Finally, we can raise another $3 trillion over ten years by
asking the top 1% of households in America to pay a little more.
The tax burden on ultra-millionaires and billionaires is
less than half that of working families in the United States. In 2019, the
bottom 99% of families will pay 7.2% of their wealth
in taxes, while the top 0.1% of households will pay just 3.2%. My Ultra-Millionaire Tax, a
2-cent tax on the wealth of fortunes above $50 million, tackles this head on.
Under this tax, the top 0.1% – the wealthiest 75,000 Americans – would have to
pitch in two cents for every dollar of net worth above $50 million and three
cents for every dollar on net worth over $1 billion. With this version of the
Ultra-Millionaire Tax in place, the tax burden on the wealthiest households
would increase from 3.2% to 4.3% of total
wealth – better, but still below the 7.2% that the bottom 99% are projected to
Today, I’m going one step further. By asking
billionaires to pitch in six cents on each dollar of net worth above $1
billion, we can raise an additional $1 trillion in revenue and further close
the gap between what middle-class families pay as a percentage of their wealth
and what the top one-tenth of one percent pay.
Yes, billionaires will have to pay a little more, but they
will still likely pay less than what they would earn just from putting their
assets into an index fund and doing nothing. The average annual rate of return
of the S&P 500 has regularly topped 10%. And billionaires
have access to the kinds of fancy investment opportunities that can generate
even higher returns on average. Put it this way – should we ask billionaires to
pitch in an extra three cents on every dollar above $1 billion, or force
middle-class families to bear another $1 trillion in health care costs?
We can also change the way the government taxes investment
income for the top 1%. Today, taxes are only assessed on capital gains when securities are sold.
That means wealthy investors can put their money in the stock market, see it
grow, and not pay a dime in
taxes on those earnings unless or until it is taken out of the market. Under
the current system, they can then pass along those shares to their heirs when
they die and their heirs will be able to pay even less when
they choose to sell.
I’ve already proposed closing that loophole for how capital
gains are treated when shares are passed on to heirs. But we can go a step
further. Under a “mark-to-market” system for
the wealthiest 1% of households, we will tax capital gains income (excluding
retirement accounts) annually, rather than at the time of sale, and raise the
rates on capital gains to match the tax rates for labor income. Individuals
would still only pay taxes on gains and could use current losses to offset
Under this system, investment income will no longer be
treated differently than labor income for the top 1% of households.
Ultra-millionaires and billionaires won’t be able to earn income on giant
fortunes year after year without paying a penny in taxes. Andwe
can raise another $2 trillion over
ten years to pay for my Medicare for All plan.
I support immigration reform that’s consistent with our
values, including a pathway to citizenship for undocumented immigrants and
expanded legal immigration consistent with my principles. That’s not only the
right thing to do – it also increases federal revenue we can dedicate to
Medicare for All as new people come into the system and pay taxes. Based on
CBO’s analysis of the 2013 comprehensive immigration reform bill, experts
project that immigration reform would generate an additional $400 billion in
direct federal revenue.
REINING IN DEFENSE SPENDING
Since the attacks of 9/11, the United States has
appropriated $2 trillion to fund
combat and counterterrorism operations around the world via the Overseas
Contingency Operations fund, or OCO. On average this spending has amounted
to $116 billion per
year – and in total, an amount equivalent to nearly 10 percent of all
federal discretionary spending over that same time period.
including the President’s current Chief of Staff – and Democrats alike
agree that OCO is a budget gimmick that masks the true impact of war spending.
The emergency supplemental funding mechanism was never intended to fund the
costs of long-scale, long-term operations outside of the normal appropriations
process. And in recent years, OCO has also been used to fund so-called “base”
requirements unrelated to the wars, outside of the Budget Control Act caps – in
effect acting as a slush fund for increased Pentagon spending. And as
everything from more F-35s to massive bombs never
used in combat have migrated into the OCO account, the Department of Defense
has been spared from having to prioritize or live
within its means. It’s not just bad budgetary practice – it’s wasteful
I’ve called out this
slush fund for what it is. I’ve also called for an end to endless
combat engagements in places like Afghanistan, Iraq, and Syria, and to
responsibly bring our combat troops home from these nations. These open-ended
commitments are not necessary to advance American foreign policy or
counterterrorism interests, their human cost has been staggering, and their
financial cost has created a drag on our economy by diverting money better
invested in critical domestic priorities.
I’ve also called to reduce defense spending overall.
The Pentagon budget will cost more this year than
everything else in the discretionary budget put together. That’s wrong, and
it’s unsustainable. We need to identify which programs actually benefit American
security in the 21st century, and which programs merely line the pockets of
defense contractors – then pull out a sharp knife and make some cuts.
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. 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.
America’s middle class is facing a crisis. For a generation,
wages have remained largely flat while family costs have exploded. I’ve spent
decades sounding the alarm about it. I’m running for President to fix it. That
means doing whatever we can to reduce the overall strain on family budgets.
Medicare for All can be a huge part of the solution. When
fully implemented, my approach to Medicare for All would mark one of the
greatest federal expansions of middle class wealth in our history. And
if Medicare for All can be financed without any new taxes on the middle class,
and instead by asking giant corporations, the wealthy, and the well-connected
to pay their fair share, that’s exactly what we should do.
ACHIEVING MEDICARE FOR ALL
Of course, moving to this kind of system will not be easy and
will not happen overnight. This is why every serious proposal for Medicare for
All contemplates a significant transition period.
In the weeks ahead, I will propose a transition plan that
will specifically address how I would use this time to begin providing
immediate financial relief to struggling families, rein in out-of-control
health care costs, increase coverage, and save lives. My transition plan will
take seriously and address substantively the concerns of unions, individuals
with private insurance, hospitals, people who work for private health insurers,
and medical professionals who worry about what a new system will mean for them.
It will also grapple directly with the entrenched political and economic
interests that would spend freely, as they havethroughout modern
American history, to influence politicians and
try to frighten the
American people into rejecting a plan that would save them thousands of dollars a year on
premiums and deductibles while making sure they can always see the health care
providers they need with false claims and scare tactics.
But there’s a reason former President Barack Obama has called Medicare for
All a good idea. There’s a reason the American people support it. It’s
because when it comes to the cost of health care, we are in the middle of a
We are paying twice as much as
any other major nation for care – even as tens of millions lack
coverage, and even as family after family sees its finances destroyed by a
health issue. And the American people know that in the
long-term, a simple system that covers everybody, provides the care they need
when they need it, puts $11 trillion back in their pockets and uses all of the
public’s leverage to keep costs as low as possible is the best option for their
family budgets and for the health of their loved ones.
As President, I’ll fight to get it done.
Read the plan here
Read expert letter on cost estimate of Medicare for All here
Read expert letter on financing Medicare for All here
Vice President Joe Biden, candidate for the 2020 candidate
for President, issued a statement criticizing Trump’s “lack of strategy to
secure our nation against terrorist threats.”
successful operation to take Abu Bakr al-Baghdadi off the battlefield was a win
for American national security. And it’s an important reminder of the skill and
commitment of our military, intelligence, and national security professionals.
They are beyond compare.
I’m glad President Trump ordered the mission. But as more details of the raid
emerge, it’s clear that this victory was not due to Donald Trump’s leadership.
It happened despite his ineptitude as Commander-in-Chief.
It’s been reported that Trump’s reckless decision to withdraw our troops from
northern Syria forced the planning for the mission to be accelerated and the
timeline compressed. His erratic behavior made it harder and more dangerous for
the special forces carrying it out. And they had to fly through territory that
is now hostile to the U.S., taking fire along the way—including territory we
controlled just weeks ago.
Trump has also made it less likely we will be able to successfully replicate a
mission like this in the future. The operation leveraged a limited presence of
U.S. counterterrorism capabilities in the region, which he keeps trying to
dismantle. It was made possible by the work of intelligence professionals, who
he has relentlessly attacked. It relied on allies he has belittled, undermined,
and in some cases betrayed and abandoned.
Trump’s total disregard for our alliances and partnerships endanger any future
intelligence sharing or cooperation. In fact, the first people he saw fit to
thank after our brave troops were the Russians and the Iranian-backed Syrian
government. All this makes us less safe and less prepared for whatever
terrorist leader emerges next.
And make no mistake, the threat is not gone. One man does not constitute an
organization, and Trump has opened a path for ISIS to reconstitute itself under
new leadership by withdrawing troops from the region. In doing so, he has given
up our best asset to keep the pressure on ISIS during a dangerous period of
organizational chaos. His fixation on keeping troops in the region to defend
the oil fields betrays his true priorities—profit seeking—and will surely serve
as a tool for future terrorist recruitment. And with his decision to slash
humanitarian assistance to the region, it’s more likely that ISIS will be able
to insinuate itself back into areas where we had successfully rooted it
There is a difference between deploying hundreds of thousands of U.S. troops to
the Middle East indefinitely, and keeping small numbers of special operations
and intelligence assets in place to maintain local partnerships and keep
pressure on terrorists. That’s the smart, strong, and sustainable strategy we
pioneered during the Obama-Biden Administration. That’s the effective policy we
put in place, which laid the groundwork to end ISIS’s territorial caliphate.
That’s the way we built the very relationships that ultimately delivered this
Now, Trump wants to tear it all down and walk away.
He has no strategy for securing our nation against terrorist threats. He has no
strategy for anything. Every day that Donald Trump directs American national
security is a dangerous day for the United States.