Harris vs Sanders on Medicare for All: Key differences between the plans

California Sen. Kamala Harris unveiled her vision for a single-payer health care system on Monday, which differs in some key ways from the plan detailed by her 2020 rival, Vermont Sen. Bernie Sanders.

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The issue has become a hot topic in the 2020 election cycle, as Americans named health care a top priority. Democrats, however, are divided on the best way to reform the system.

Harris has supported Sanders’ plan – but during the first round of Democratic debates in Miami, Harris backtracked after initially joining Sanders in saying she supported eliminating private health insurance altogether.

A deputy campaign manager for Vice President Joe Biden’s campaign on Monday criticized Harris’ approach to Medicare for All, citing the fact that she wavered on key issues and her refusal to admit that taxes would likely have to rise for the middle class. She referred to Harris’ plan as a “Bernie Sanders-lite Medicare for All.”

Both plans aim to lower health care costs among all Americans, expand access to coverage and lower the costs of prescription drugs.

Harris said on Monday that existing plans did not offer what she wanted.

While much of Harris’ Medium blog post sounded like a page right out of Sanders’ playbook, here’s a look at some of the key differences between their visions:

Phase-in period:

Sanders’ plan calls for a transition period of four years.

Harris’ vision would shift the country to a single-payer system over the course of 10 years, which she said will decrease costs compared to Sanders’ option. Similar to her 2020 rival, she will offer an immediate buy-in option.


Sanders has said middle-class taxes would rise to pay for his proposal.

Harris said taxes would not rise for anyone making less than $100,000.

Other ways to foot the bill:

Sanders’ plan involves a 4 percent income-based premium on households earning above $29,000, an income-based premium paid by employers, higher taxes on the wealthy, and taxing capital gains at the same rate as ordinary income.

Harris said a Wall Street transaction tax – levied on trades of stocks, bonds and derivatives – would help cover some of the costs, in addition to the aforementioned taxes on the wealthy. She also indicated support for an income-based premium paid by employers and changing the rate of the capital gains tax.

Private insurance:

Sanders wants to eliminate the role of private insurers entirely.

Harris says she still thinks the private health insurance industry has a role – they would, for example, be able to offer certain Medicare plans that are to be held to stricter consumer protection standards.

What will be covered?

Hospital visits, primary care, medical devices, lab services, maternity care and prescription drugs would all fall under the scope of covered services for Sanders. He has promised to cover dental care, hearing aids and vision as well as long-term care.

Harris said all medically necessary services will be covered, including emergency room visits, doctor visits, dental, hearing aids, mental health, substance use treatment and comprehensive reproductive health care services.


Harris’ plan was unveiled just days before she is set to take the stage during the second round of Democratic debates in Detroit on Wednesday. Sanders will appear in a separate round that will take place Tuesday evening.