THURSDAY, AUGUST 1 , 2019. THE WASHINGTON POST EZ M2 A
campaign 2020
block de Blasio from taking
action.“We are on our way in just a
handful of years of literally
spending 20 percent of our
economy — one out of every five
dollars spent — on health care.
And we spend more than every
other nation.”
— Booker
Booker is correct. As a share of
the nation’s gross domestic
product, health spending
accounted for 17.9 percent in
2017, according to the Centers for
Medicare & Medicaid Services.
CMS Office of the Actuary
projects it will be 19.4 percent in
2027, though that is slightly
lower than the 19.7 percent
projected a year earlier.
The United States, on a per
capita basis, spends much more
on health care than other
developed countries do,
according to a study from a team
led by a Johns Hopkins
Bloomberg School of Public
Health researcher. Per capita
health-care spending for the
United States in 2016 was
$9,892, 25 percent higher than
second-place Switzerland’s
$7,919.“The bill he talks about is a bill
that in my, our administration,
we passed. We passed that bill
that you added onto. That’s the
bill, in fact, you passed.”
— Biden to Booker
Biden appeared to claim that
the First Step Act, signed into
law by President Trump in 2018,
was merely an add-on to a bill
passed during the Obama
administration. The law was a
bipartisan project, led by
senators such as Booker, which
overhauled federal mandatory
minimum sentencing laws as
well as some aspects of the
federal prison system. It was
intended to address problems
identified in the 1994 crime bill
signed by President Bill Clinton
and long championed by then-
Sen. Biden as the “Biden Crime
bill.”
Booker looked at Biden with
disbelief, and it’s easy to see why.
A Biden aide said he was
referring to a 2010 law passed
under President Barack Obama
that addressed the “100-1” rule,
so named because it required a
five-year mandatory minimum
sentence for trafficking in 500
grams of powder cocaine or five
grams of crack. The 2010 law
narrowed it to 18-1, and the First
Step Act made it retroactive.
But the First Step Act was a
much broader piece of legislation
— far more than an add-on to the
2010 law.
[email protected]100,000 before ordering the
withdrawal in 2011.“[The Eric Garner family is]
going to get justice. There’s
finally going to be justice. I have
confidence in that — in the next
30 days, in New York. You know
why? Because for the first time,
we are not waiting on the federal
Justice Department, which told
the city of New York that we
could not proceed because the
Justice Department was
pursuing their prosecution, and
years went by, and a lot of pain
accrued.”
— New York Mayor Bill de
Blasio
De Blasio has been criticized
for inaction on the Eric Garner
case, and this defense he gave at
the debate was false.
Garner, an African American
man, died in 2014 after an
encounter with New York City
police officer Daniel Pantaleo,
who used a chokehold prohibited
by the department.
Five years later, Pantaleo
remains a New York police
officer. The state of New York did
not charge him. The U.S. Justice
Department investigated the
case and declined to bring
charges.
De Blasio said he held off on
taking action on the case because
the Justice Department “told the
city of New York that we could
not proceed.” That’s false. The
Justice Department requested
that the city hold off but did notoversight of the U.S. troop
withdrawal from Iraq. Biden
chaired a committee that made
sensitive decisions about the
pace and scope of the withdrawal
of nearly 150,000 troops.
But before withdrawing forces
in 2011, Obama’s administration
tried to persuade Iraqi political
leaders to allow a residual force
of about 3,500 U.S. troops to
remain. Some high-level officials
in the Obama administration
argued that a total withdrawal
would open up a power vacuum
in Iraq and erase the gains
secured by U.S. forces and
international allies. One of them
was Defense Secretary Leon
Panetta. Biden argued to keep a
residual force in Iraq, rather
than pull all troops, according to
the U.S. ambassador to the
country at the time.
We gave the former vice
president Two Pinocchios for a
similar claim last week.
By 2014, with no U.S. forces in
the picture, the Islamic State
terrorist group began to take
control of parts of Iraq. Obama,
by 2016, had sent 5,000 U.S.
troops back into the country to
reverse the Islamic State tide.
Biden was still the vice president,
but he does not mention this
inconvenient history in debates
or public remarks.
At Wednesday’s debate, he
added that he “opposed the surge
in Afghanistan.” Obama
increased troop levels from
nearly 30,000 to more thanfacing civil cases, whether they
are in facilities run by U.S.
Customs and Border Protection
or migrant detention centers
overseen by the Office of Refugee
Resettlement in the Department
of Health and Human Services.“I went to a place in Florida
called Homestead, and there is a
private detention facility being
paid for by your taxpayer
dollars — a private detention
facility — that currently houses
2,700 children.”
— Harris
Harris is speaking about the
capacity of the facility. But the
number of children is far lower.
As of July 22, there were 990
unaccompanied children at
Homestead, according to the
Department of Health and
Human Services. HHS said the
average length of stay for such
children at Homestead is 36
days.“I was asked by the president
in the first meeting we had on
Iraq; he turned and said, ‘Joe, get
our combat troops out,’ in front
of the entire national security
team. One of the proudest
moments of my life was to stand
there in [Iraq]... and tell
everyone that we’re coming —
that all our combat troops are
coming home. I opposed the surge
in Afghanistan.”
— Biden
In his first term, President
Barack Obama gave BidenA variety of estimates for
Medicare-for-all have concluded
that it would increase federal
expenditures by more than
$30 trillion over 10 years. A 2016
estimate by the Urban Institute
of an earlier version of Sanders’s
Medicare-for-all plan said it
would cause federal
expenditures to increase by
$32 trillion.
The Mercatus Center at
George Mason University in 2018
released a working paper on the
10-year fiscal impact of the
Medicare-for-all plan, and
concluded it would raise
government expenditures by
$32.6 trillion even if proposed
provider cuts were enacted.
Without squeezing hospitals and
other providers as planned, the
report estimated the additional
federal budget cost at nearly
$40 trillion over 10 years. (The
10-year budget windows for the
two estimates are slightly
different.)
Sanders has proposed a
variety of ways to help pay for
the plan, but many analysts say
revenue would still fall short.“An unlawful crossing is an
unlawful crossing if you do it
[through] the civil courts or if
you do it through the criminal
courts. But the criminal courts is
what is giving Donald Trump the
ability to truly violate the
human rights of the people
coming to our country, who — no
one surrenders their human
rights. And so, doing it through
the civil courts means you won’t
need these awful detention
facilities.”
— Sen. Cory Booker (N.J.)
Booker, who supports
decriminalizing the act of
crossing the border, claimed that
migrant detention facilities
would not be needed if
unauthorized entry to the United
States was treated as a civil
violation. He did not elaborate,
and his website says only that he
would be “ending private
detention facilities,” without
giving details.
Booker mischaracterized how
the immigration system works.
Those who are apprehended for
the crime of crossing the border
without authorization are held at
jails, not migrant detention
facilities. U.S. Immigration and
Customs Enforcement contracts
with many local jails to hold
border-crossers while their cases
are pending. The Essex County
jail in Newark, for example,
where Booker was mayor before
being a senator, provides
significant jail space to ICE
under contract.
The migrants who are placed
in detention facilities are allIn the second
night of the
second
Democratic
debate, the
candidates often
made complex
claims and
counterclaims
about each other’s
records, some of
which are not
easily fact-checked. Here is a
roundup of the more policy-
oriented claims that caught our
attention, written with the help
of my colleagues Salvador Rizzo
and Meg Kelly.
“The [Harris] plan ... will
require middle-class taxes to go
up, not down.”
— Former vice president Joe
Biden
Biden’s claim that middle-class
taxes would go up under the plan
from Sen. Kamala D. Harris
(Calif.) is better aimed at Sen.
Bernie Sanders’s version. Harris
tried to inoculate against this type
of attack by making a significant
change earlier this week.
Sanders (I-Vt.) would propose
a 4 percent income-based
premium paid by households.
Sanders estimated that this
would raise $3.5 trillion over 10
years, but the “typical middle-
class family” would save more
than $4,400 a year. But it would
kick in on income of more than
$29,000 for a family of four.
Harris claims this proposal
“hits the middle class too hard.”
Instead, she would keep the first
$100,000 in income from
taxation and instead levy a new
tax on stock, bond and derivative
transactions. A stock trade worth
$1,000 would be subject to a $
tax, for instance. She claims that
“these proposals would raise well
over $2 trillion over 10 years,
more than enough to make up
the difference from raising the
middle-class income threshold.”
Indeed, if enacted, Harris’s
$100,000 level would protect
most American households from
additional tax. The Census
Bureau says about 30 percent of
U.S. households had income
above $100,000 in 2017, but
adjusted gross income for tax
filing purposes could mean all
but 20 percent of tax filers would
be subject to the premium tax.
“We need to be honest about
what’s in this plan. It bans
employer-based insurance and
taxes the middle class to the tune
of $30 trillion.”
— Sen. Michael F. Bennet
(Colo.)
“The plan, no matter how you
cut it, costs $3 trillion [per year].”
— Biden
Mischaracterizations of immigration system, Iraq troop withdrawals, crime bill
The Fact
Checker
GLENN
KESSLER
PAUL SANCYA/ASSOCIATED PRESS
New York Mayor Bill de Blasio has been criticized for his handling of the death of Eric Garner at the
hands of police. During Wednesday’s debate, de Blasio inaccurately described his actions in the case.BY JEFF STEIN
AND YASMEEN ABUTALEBFormer vice president Joe
Biden and Sen. Kamala D. Harris
(D-Calif.) muddled through key
details of their health policies
Wednesday night at the Demo-
cratic presidential debate, health-
care experts said, leading to a
confusing series of disagree-
ments over their proposals.
The dispute pitted two of the
leading primary contenders
against each other from the be-
ginning of the debate, with Biden
and Harris accusing the other of
mischaracterizing their health-
care policies.
Health-care experts said both
candidates strained to explain
key details.
Biden misled viewers when he
said during a heated exchange
that his proposal would cover
everyone — even though by his
own plan’s admission, it would
leave out 3 percent of Americans,
or about 10 million people.
Harris downplayed the impact
of her proposal on employer-
sponsored plans in an exchange
with Sen. Michael F. Bennet (D-
Colo.), according to health ex-
perts.
Both Harris and Biden have
stopped short of the Medicare-
for-all plan endorsed by Sen. Ber-
nie Sanders (I-Vt.) and Sen. Eliza-
beth Warren (D-Mass.), which
would put all Americans into one
single government insurer with
no premiums, deductibles, or co-
pays. That plan, sometimes called
a single-payer plan, is more far-
reaching, and would require larg-
er middle-class tax increases.
But that plan is also simpler,
and the ones outlined by Biden
and Harris are more difficult to
explain during a national televi-
sion debate, when the amount of
time candidates have to respond
to questions is limited.
“A pure Medicare-for-all plan is
much easier to describe than
these complicated plans that try
to thread the political needle,”
said Larry Levitt, a health policy
expert at the Kaiser Family Foun-
dation. “This was a huge problem
for the Obama administration in
trying to sell the Affordable Care
Act.”
Allison Hoffman, professor of
law at the University of Pennsyl-
vania Law School and a senior
fellow at the Leonard Davis Insti-
tute of Health Economics, said,
“There’s definite discomfort.
They both understand whatthey’re proposing, but I do feel
like they’re both uneasy with the
side-by-side comparison” with
each other’s plan.
After getting into the race,
Biden and Harris were delayed in
introducing their health-care
plans, with Biden initially talking
vaguely about expanding the Af-
fordable Care Act and Harris
voicing support for Sanders’s
Medicare-for-all legislation,
though not committing to all of
its details.
Since then, both candidateshave released more-detailed pol-
icy plans outlining their pre-
ferred health-care proposals.
Biden has proposed expanding
Obamacare by creating a govern-
ment program that all Americans
could purchase if they lacked
health-care insurance or wanted
to switch plans — a so-called
public option.
By creating a new government
insurer that competes with pri-
vate insurance companies,
Biden’s plan is intended to drive
down private insurers’ costswhile also creating a more afford-
able alternative. A similar idea
was pushed as part of President
Barack Obama’s Affordable Care
Act but was ultimately aban-
doned amid industry opposition.
Harris had said she supported
the Sanders Medicare-for-all plan
but backed away from some of the
more dramatic elements of his
legislation. Earlier this week,
Harris released a plan that aims
to move all Americans into a
Medicare program after 10 years
but would allow private, andmore tightly regulated, plans to
continue offering insurance.
The candidates on Wednesday
overlooked the nuances of their
plans, limited by time and com-
peting with eight other candi-
dates on the presidential debate
stage.
When Biden rolled out his
health-care plan earlier this
month, he said it would cover 97
percent of Americans — leaving
out about 10 million Americans.
Harris told Biden, “For a Demo-
crat to be running for president
with a plan that does not cover
everyone, I think is without ex-
cuse.”
Biden retorted that his plan
would cover everyone, despite
the statistics in his own policy
proposal. Biden’s plan promises
that Americans will not pay more
than 8.5 percent of their income
in health-care costs — but that
cost is unaffordable for most low-
income Americans, said Hoff-
man, the Penn Law professor.
Harris faced her own difficult
policy terrain, particularly over
the impact of her plan on the
more than 150 million Americans
who have employer-sponsored
insurance.
After Bennet said Harris’s plan
would eliminate employer-spon-
sored care, Harris deflected and
talked about how private plans
would still be available under her
proposal. That marked a contrast
with Sanders and Warren, who
have acknowledged their single-
payer plan would lead people to
switch to the public system.
“Senator Harris says she
doesn’t ban private insurance,
but all Americans would be get-
ting their primary care through
Medicare,” said Brian Riedl, a
budget expert at the libertarian-
leaning Manhattan Institute. “So
how does that leave much room
for an employer-provided sys-
tem?”
[email protected]
[email protected]Biden and Harris explain their health-care plans with some ‘discomfort’
ANTHONY LANZILOTE/BLOOMBERG NEWS
The audience listened to a pointed health-care debate between Sen. Kamala D. Harris (D-Calif.) and former vice president Joe Biden.