Kamala Harris releases new details of her health care plan

WASHINGTON (AP) — Kamala Harris is filling in the details of how she would move 330 million Americans onto a single government health insurance system, her fullest statements on an issue that's getting top billing in the Democratic presidential primary.

The issue also has posed some problems for the California senator.

Harris is a supporter of Vermont Sen. Bernie Sanders' "Medicare for All" legislation, but she still envisions a role for the private system — just as long as it takes its lead from the government. Medicare for All would replace the Affordable Care Act with a single-payer health plan for all Americans.

Harris is splitting with Sanders, a rival for the 2020 Democratic nomination, in slowing the transition to a single-payer system to 10 years instead of the four he has proposed. And Harris is, for the first time, addressing how she would pay for a sweeping health care overhaul that Sanders has estimated could cost as much as $40 trillion over one decade.

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UNITED STATES - MAY 22: Sen. Kamala Harris, D-Calif., makes her way to the Senate Policy luncheons in the Capitol on May 22, 2018. (Photo By Tom Williams/CQ Roll Call)
U.S. Senator Kamala Harris (D-CA) arrives for a town hall meeting in Sacramento, California, U.S., April 5, 2018. REUTERS/Bob Strong
WASHINGTON, DC - MARCH 14: Senate Judiciary Committee members Sen. Cory Booker (D-NJ) (L) and Sen. Kamala Harris (D-CA) talk during a hearing about the massacre at Marjory Stoneman Douglas High School in the Hart Senate Office Building on Capitol Hill March 14, 2018 in Washington, DC. Federal Bureau of Investigation Acting Deputy Director David Bowdich testified that the FBI could have and should have done more to stop the school shooter Nikolas Cruz after it receieved several tips about him. (Photo by Chip Somodevilla/Getty Images)
U.S. Senator Kamala Harris (D-CA) holds a town hall meeting in Sacramento, California, U.S., April 5, 2018. REUTERS/Bob Strong
Senator Kamala Harris (D-CA) speaks about the Senate Intelligence Committee findings and recommendations on threats to election infrastructure on Capitol Hill in Washington, U.S., March 20, 2018. REUTERS/Joshua Roberts
California gubernatorial candidate, Lieutenant Governor Gavin Newsom arrives with Senator Kamala D. Harris (D-CA) at a campaign rally in Burbank, California, U.S. May 30, 2018. REUTERS/Lucy Nicholson
WASHINGTON, DC - MAY 23: U.S. Sen. Kamala Harris (D-CA) (2nd L) shares a moment with Sen. Catherine Cortez Masto (D-NV) (R) as Rep. Michelle Lujan Grisham (D-NM) (L) looks on during a news conference on immigration in front of the U.S. Capitol May 23, 2018 in Washington, DC. Sen. Harris, joined by other female Democratic congressional members, held a news conference 'to show support for immigration and refugee policies that protect the rights and safety of women and children.' (Photo by Alex Wong/Getty Images)
WASHINGTON, DC - MAY 23: U.S. Sen. Kamala Harris (D-CA) (C) speaks during a news conference on immigration in front of the U.S. Capitol May 23, 2018 in Washington, DC. Sen. Harris, joined by other female Democratic congressional members, held a news conference 'to show support for immigration and refugee policies that protect the rights and safety of women and children.' (Photo by Alex Wong/Getty Images)
US Senator Kamala Harris attends the United State of Women Summit at the Shrine Auditorium in Los Angeles, on May 5, 2018. (Photo by CHRIS DELMAS / AFP) (Photo credit should read CHRIS DELMAS/AFP/Getty Images)
WASHINGTON, DC - MARCH 14: Senate Judiciary Committee member Sen. Kamala Harris (D-CA) questions witnesses during a hearing about the massacre at Marjory Stoneman Douglas High School in the Hart Senate Office Building on Capitol Hill March 14, 2018 in Washington, DC. Federal Bureau of Investigation Acting Deputy Director David Bowdich testified that the FBI could have and should have done more to stop the school shooter Nikolas Cruz after it receieved several tips about him. (Photo by Chip Somodevilla/Getty Images)
WASHINGTON, DC - OCTOBER 25: Sen. Kamala Harris (D-CA) speaks during a news conference with fellow Democrats, 'Dreamers' and university presidents and chancellors to call for passage of the Dream Act at the U.S. Capitol October 25, 2017 in Washington, DC. President Donald Trump said he will end the Deferred Action for Childhood Arrivals program (DACA) and has asked Congress to find a solution for the status of the beneficiaries of the program, called 'Dreamers.' (Photo by Chip Somodevilla/Getty Images)
WASHINGTON, DC - OCTOBER 18: Sen. Kamala Harris (D-CA) walks to the Senate chamber for a series of 6 roll call votes regarding the Fiscal Year 2018 Budget Resolution on Capitol Hill, on October 18, 2017 in Washington, DC. (Photo by Mark Wilson/Getty Images)
WASHINGTON, DC - JULY 13: Senate Intelligence Committee members Sen. Kamala Harris (D-CA) (C) and Sen. Marco Rubio (R-FL) (R) arrive for a closed-door committee meeting in the Hart Senate Office Building on Capitol Hill July 13, 2017 in Washington, DC. Some members of the committee have demanded that Donald Trump, Jr. testify before the intelligence committee after it was revealed that he and Jared Kushner and Paul Manafort met with a Russian lawyer in hopes of getting opposition information on Hillary Clinton during the 2016 election. (Photo by Chip Somodevilla/Getty Images)
WASHINGTON, DC - APRIL 27: Sen. Dianne Feinstein (D-CA)(L) walks with Sen. Kamala Harris (D-CA) and Sen. Mark Warner (D-VA) (C), to a Senate Select Committee on Intelligence closed door meeting at the U.S. Capitol, on April 27, 2017 in Washington, DC. The committee is investigation possible Russian interference in the U.S. presidential election. (Photo by Mark Wilson/Getty Images)
WASHINGTON, DC - MAY 16: Sen. Kamala Harris (D-CA) heads for her party's weekly policy luncheon at the U.S. Capitol May 16, 2017 in Washington, DC. Many Republican and Democratic senators expressed frustration and concern about how President Donald Trump may have shared classified intelligence with the Russian foreign minister last week at the White House. (Photo by Chip Somodevilla/Getty Images)
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The debate over national health care policy has been one of the most animating features of the race for the Democratic presidential nomination. And for Harris, it has been one that has put on display the tension between her pragmatic inclinations and a desire to meet the demands of an energized progressive base seeking a liberal agenda to counter President Donald Trump.

In a Medium post published on Monday, she said her focus was on finding a way to lower health care costs.

"Right now, the American health care system is a patchwork of plans, providers and costs that have left people frustrated, powerless and insurance companies in charge," Harris said in the post. "And the bottom line is that health care just costs too much."

Harris has repeatedly been forced to clarify her stance on Medicare for All. During the first set of presidential debates she appeared to suggest that she supported abolishing private insurance, later clarifying that she does not. And prior to releasing her own health care plan, she was criticized for saying that she opposes a middle-class tax hike to pay for Medicare for All without making clear how she would pay for it.

Harris is releasing her plan days before Democrats meet in Detroit for the second set of presidential debates. Harris will appear on stage with former Vice President Joe Biden, the most high-profile candidate in the sprawling field to opposed Medicare for All in favor of a so-called "public option" that would allow people to decide between a government-financed plan or a private one.

Biden, with whom Harris memorably clashed during the first Democratic debates in Miami, has warned that a transition to a Medicare for All system could present coverage risks for Americans who defend on the Affordable Care Act.

Biden also has seized on Harris' recent comments, in an interview with CNN, that she opposes a middle-class tax hike to pay for Medicare for All. Biden said Harris was not being realistic about what it would take to pay for Medicare for All.

"You have a lot of people out there supporting that plan and are running and saying, 'But I'm not for that tax,'" Biden said recently in Las Vegas. "There's no way to pay for it."

Sanders has said as recently as this month that the sweeping overhaul of the U.S. health system he envisions could cost up to $40 trillion over a decade, and he has said that one option for paying for it would be a 4% tax hike on families making more than $29,000 each year.

Harris said that "hits the middle class too hard," and she is calling for exempting households making less than $100,000 each year from that 4% tax, with "a higher income threshold for middle-class families living in high-cost areas."

Sanders estimated that the tax increase he proposed would raise $3.5 trillion over 10 years. Harris did not specify how much revenue would be raised in the scenario she's proposing.

To pay for the difference, Harris wants to tax stock trades at 0.2% of the value of the transaction, 0.1% for bonds and 0.002% for derivatives.

Harris argues that by making the transition period from current policy to Medicare for All 10 years instead of four, the overall cost of Medicare for All will be lower than in Sanders' bill.

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