Moneybox

Is Amy Klobuchar’s Health Care Plan Really Just a Post-It Note?

Amy Klobuchar walks across the debate stage.
Her plan would probably require a few Post-its, honestly.
Ethan Miller/Getty Images

Sen. Amy Klobuchar ended up on the receiving end of a memorable zinger during Wednesday’s Democratic debate, when Sen. Elizabeth Warren ripped into her for lacking a detailed health care plan. “It’s like a Post-it note: Insert plan here,” Warren said. Klobuchar tried to laugh off the line (“I must say I take personal offense since Post-it notes were invented in my state”) and told the crowd that she supported a public option that would reduce premiums for millions. But Warren doubled down on the wonk-shaming. “Amy, I looked online at your plan. It’s two paragraphs.”

It was a cutting line. But whether it’s strictly true kind of depends on how you define “health care plan.” If you pop over to Klobuchar’s website, you’ll find a to-do list with dozens of health care priorities. A lot of them are important but narrow items like improving mental health care coverage, undoing the Trump administration’s regulatory sabotage of the Affordable Care Act, and saving rural hospitals. It highlights the many bills she has introduced aimed at reducing prescription drug prices and promises she will sign them. But when it comes to the central question about health care that has dominated this primary race—how the heck do we get the country to universal coverage?—that section really just is about two paragraphs.

Propose legislation to get us to universal health care. Senator Klobuchar will propose legislation that gets us to universal health care, which includes creating a public health care option by expanding either Medicare or Medicaid, as well as improving the Affordable Care Act to help bring down costs to consumers through reinsurance, providing cost-sharing reductions, expanding premium subsidies, and continuing delivery system reform. Her legislation will also provide additional consumer protections and lower the costs of prescription drugs through aggressive reforms including lifting the ban that prohibits Medicare from negotiating the best possible price. These programs significantly reduce cost to consumers and help promote choice.

To pay for these investments Senator Klobuchar will increase the income tax rates for the top two brackets to the rates that were in place before the 2017 Republican tax law, further raise the income tax rate for the highest tax bracket and implement prescription drug reforms.

Indeed, that might as well just say plan TBD. The issue here isn’t so much the length; you could probably outline the core of a basic health care proposal based on a public option in six bullet points or less. But Klobuchar doesn’t even really cover the fundamentals. It doesn’t come down on whether we should create a public option through Medicaid or Medicare, which is an actually important policy difference. It says she’d expand Obamacare’s premium subsidies, but not by how much (Pete Buttigieg and Joe Biden, by comparison, say they’d cap payments for all families at 8.5 percent of income). It doesn’t make any note about levels of coverage (again, Biden and Buttigieg both say they’d calculate subsidies based on the cost of a gold plan, instead of the less generous silver plans they’re based on today). You get the idea. I emailed Klobuchar’s campaign asking if she’s released additional material elsewhere that I’m unaware of but have not heard back yet.

What’s a little weird about these blank spots is that, early on, Klobuchar was actually ahead of the pack when it came to talking about the details of her health care agenda. She helped introduce multiple prescription drug price proposals last year, and while other candidates were making vague noises about supporting “Medicare for All” or something similar, she said she was particularly interested in the Medicaid buy-in bill written by Sen. Brian Schatz of Hawaii. As health care commentator Charles Gaba points out, she was also one of six co-sponsors on Warren’s own early plan to fix and expand Obamacare, often referred to as ACA 2.0. You can see why Klobuchar wouldn’t necessarily want to draw attention to that on her campaign page or during a debate (“I personally support Elizabeth Warren’s least ambitious ideas to improve health insurance” is not a particularly inspiring line). But she could have easily cribbed some of its details.

In other words: Klobuchar doesn’t appear to be lazy or uninformed about health care policy. She’s demonstrated a pretty clear sense of the different ideas floating around Capitol Hill and has even tried to shape some of them. So why hasn’t she bothered sketching out more details of what she’d do as president? It could be neglect. But she may also just be tacitly admitting that the details of health care reform are going to largely be decided by Congress, and so she doesn’t think there’s much point getting bogged down in them on the campaign trail. (See: Warren’s own troubles with Medicare for All.) It’s a bit deflating. And it might not even be the right strategy to pass legislation (there’s something to be said for presidents planting a flag and trying to draw Congress left, the way Sanders and Warren want to). But clear-eyed realism is supposed to be Klobuchar’s brand. As she put it while attacking Sanders’ and Warren’s health care proposals Wednesday, “You don’t put your money on a number that’s not even on the wheel.” Her real plan is to not set anybody’s expectations too high, which, in the end, is an idea that could certainly fit on a Post-it note.