Some have noted that backing sweeping, government-run health reform may play well with Democratic primary voters but prove toxic in the general election. (Photo: Shutterstock)
Marijuana decriminalization. Paid family leave. And, yes, "Medicare for All."
Democrats strayed a little from arguing the intricacies of single-payer health care during their fifth presidential debate on Wednesday, bringing ideas like expunging drug convictions into the discussion.
Just 10 candidates qualified for the two-hour debate in Atlanta as the countdown to 2020 continues.
Related: Health care a hot topic in round 2 of Democratic debates
While Mayor Pete Buttigieg of South Bend, Ind., has taken a recent lead in Iowa, former Vice President Joe Biden remains at the front of the pack in national polls.
After a brief spike in the polls, Massachusetts Sen. Elizabeth Warren is still in second place. And after months of dodging questions about what Medicare for All would look like under her presidency, this time she was ready for the health care question.
Warren quickly ticked off how, on her first day in office, she would bring down the cost of drugs like insulin and EpiPens, two medications that have been the subject of outrage over runaway price hikes. She said she would defend the Affordable Care Act from the Trump administration's "sabotage."
Then Warren elaborated on her plan, saying that in her first 100 days, she would bring "135 million people into Medicare for All at no cost to them," detailing steps to insure children and those with household income under $50,000, as well as lower the Medicare age to 50 and expand coverage for vision, dental and long-term care.
"And then, in the third year, when people have had a chance to feel it and taste it and live with it, we're going to vote and we're going to want Medicare for All," she said.
That question of what Americans want dominated the brief health care conversation.
"We don't have to tear down the system. But we do have to do what the American people want," said Sen. Bernie Sanders, the Vermont independent. "And the American people understand that the current system is not only cruel, it's dysfunctional."
Biden said the appetite for Medicare for All is not there — not among the lawmakers who would have to pass it, not even among Democrats.
"The fact is that right now the vast majority of Democrats do not support Medicare for All," he said. "It couldn't pass the United States Senate right now with Democrats. It couldn't pass the House."
But 77 percent of Democrats strongly or somewhat favor a single-payer, Medicare for All plan, according to a Kaiser Family Foundation poll released earlier on Wednesday. (Kaiser Health News is an editorially independent program of the foundation.)
Support is about 53 percent for Medicare for All among all voters, the poll showed. It found that support softens when respondents are told about the trade-offs they might face in exchange for a single-payer system.
For instance, opinions changed little when respondents were told that it would eliminate private insurance and allow people to choose their providers. But support dropped to 47 percent when respondents were told it could increase their taxes while decreasing their overall health care costs.
Some have noted that backing sweeping, government-run health reform may play well with Democratic primary voters but prove toxic in the general election, when the nominee would hope to attract moderate and even Republican votes.
A September poll of Democratic caucusgoers from The Des Moines Register/CNN found about 69 percent said they were personally "comfortable" with a government-run, Medicare for All system.
But about 28 percent of those comfortable with it said they were also afraid that that position could cost a Democratic candidate the presidential election.
One of the livelier health care exchanges came when New Jersey Sen. Cory Booker accused Biden of opposing marijuana decriminalization, a policy that has become less far-fetched as one state after another has legalized the drug for medical and recreational use.
Booker said the "war on drugs" has been "a war on black and brown people."
"This week I heard him literally say I don't think we should legalize marijuana.' I thought you might have been high when you said it," Booker said to Biden late in the debate. "And let me tell you, because marijuana in our country is already legal for privileged people."
Biden disputed Booker's accusation, saying he supports marijuana decriminalization, as well as releasing offenders from jail and expunging their records. "But I do think it makes sense based on data that we should study what the long-term effects are for the use of marijuana," he added.
Research on marijuana has been significantly limited by the federal government's classification of the drug under Schedule 1 of the Controlled Substances Act, making it difficult to access for experimental purposes. The surgeon general, Jerome Adams, has said it can "prime your brain for addiction to other substances," a claim PolitiFact recently rated "Half True" due to a lack of context.
Sen. Kamala Harris of California and Sen. Amy Klobuchar of Minnesota also described their plans on Wednesday to give people six months and three months of paid family leave, respectively.
Klobuchar decried "things that sound good on a bumper sticker." Democrats have to be ambitious but also honest with voters about how to pay for those ideas, she said.
"And that is everything — sending rich kids to college for free, which I don't support, to kicking 149 million off their current health insurance in four years," she said, a seemingly veiled jab at Warren's phase-in plan for Medicare for All.
The candidates also reaffirmed their commitment to abortion access, with Warren pointing out its economic ramifications.
"When someone makes abortion illegal in America, rich women will still get abortions," she said. "It's just going to fall hard on poor women. It's going to fall hard on girls, women who don't even know that they're pregnant because they have been molested by an uncle."
"I want to be an America where everybody has a chance," Warren said.
The sixth debate will be held on Dec. 19 in Los Angeles. The Democratic National Committee plans to hold a total of 12 primary debates.
Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.
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