Which candidates say health care plan requires middle-class tax hike?

The ideological schism between factions within the Democratic Party quickly emerged during the first minutes of the second Democratic debate, with the progressive firebrands on stage strongly defending their “Medicare-for-all” single-payer healthcare plans and the more centrist candidates casting their proposals as unrealistic and too extreme. 

When the CNN moderators for the debate on Tuesday night in Detroit pressed the more progressive White House hopefuls on whether their healthcare proposals involve a tax hike for the middle class, most candidates skirted the question. 

Sens. Bernie Sanders of Vermont and Elizabeth Warren of Massachusetts — two high-profile progressives who frequently tout their strong and early support for Medicare-for-all — said their health care plans involve tax hikes, but for billionaires and large corporations.  

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“Costs will go up for billionaires and go up for corporations. For middle-class families, costs, total costs, will go down,” Warren told the audience, though she did not directly say that these families would not see their taxes go up.

Sen. Amy Klobuchar, D-Minn., from left, South Bend Mayor Pete Buttigieg, Sen. Bernie Sanders, I-Vt., and Sen. Elizabeth Warren, D-Mass., participate in the first of two Democratic presidential primary debates hosted by CNN Tuesday, July 30, 2019, in the Fox Theatre in Detroit. Paul Sancya / AP

Sanders offered a more forceful response when pressed by CNN’s Jake Tapper to explicitly say whether his proposal would require middle class Americans to pay more in taxes. The self-described democratic socialist stressed that his plan involves no deductibles and no co-pays, but that it is has been mischaracterized by Republicans and the private healthcare industry. 

“Jake, your question is a Republican talking point,” Sanders said, eliciting applause and cheers from some in the audience. “By the way, the healthcare industry will be advertising tonight on this program … they will be advertising tonight with that talking point.”

South Bend Indiana Mayor Pete Buttigieg did not explicitly say whether he supports a middle-class tax hike to partly pay for his health care plan, which he portrayed as a more incremental proposal that would eventually lead to the creation of a single-payer system. 

“This is a distinction without a difference, whether you’re paying the same money in the form of taxes or premiums,” Buttigieg said. “Look, in this country … if you don’t have health coverage, you’re paying too much for care. And if you do have health coverage, you’re paying too much for care.”

Former Texas Rep. Beto O’Rourke offered the only clear-cut answer to the moderator’s question: “The answer is no. The middle class will not pay more in taxes in order to ensure that every American is guaranteed world-class healthcare.”

Meanwhile, the more moderate candidates — including Montana Gov. Steve Bullock, former Maryland Rep. John Delaney, former Colorado Gov. John Hickenlooper and Ohio Rep. Tim Ryan — singled out Sanders and Warren, denouncing their Medicare-for-all plans as anti-capitalist and too ambitious and saying their proposals would strip some of Americans of the healthcare provided by their employers. 

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