Health care looms big in 2020, but Dems still divided on solution

This week, the Trump administration took a significant shift in its approach to the Affordable Care Act, saying the entire Obama-era law should be struck down as unconstitutional -- likely setting up health care as a front-and-center issue in the 2020 presidential election.

In a letter to the 5th Circuit Court of Appeals, the Department of Justice said it agreed with a December ruling by a federal judge in Texas that struck down the ACA as unconstitutional.

“The Department of Justice has determined that the district court’s judgment should be affirmed,” the Monday night letter said.

In that particular case, District Judge Reed O’Connor in Fort Worth ruled the ACA was unconstitutional because the individual mandate -- which required Americans to either get health insurance or face a financial penalty -- had already been stripped from the law.

Now, as battle lines are set up surrounding the latest effort to dismantle the ACA, health care is likely to become a key issue in 2020 for Democrats, who are buoyed by their victories in the 2018 midterm elections that some experts attributed to their stance on health care.

Ahead of the midterms, for instance, more than 70 percent of voters said health care was “very important” when deciding which candidates to cast their ballot for this midterm cycle, according to a poll from the Kaiser Family Foundation.

Here’s what you need to know about where key Democratic presidential candidates stand on health care.

Bernie Sanders: The Vermont independent and self-described Democratic socialist rolled out a plan in 2017 that would guarantee health coverage for all Americans by expanding Medicare, essentially shifting toward a single-pay system. The federal government would, via taxes, finance health care costs for people across the board (although individuals would still be on the hook for some out-of-pocket costs).

Elizabeth Warren: The Massachusetts senator backed Sander’s proposal in 2017 and has spoken at length about strengthening the Affordable Care Act. While on Bloomberg, Warren said her goal is “affordable health care for every American.” She’s dodged questions about whether she would support eliminating private insurance companies in favor of a single-payer system.

Kamala Harris: LIke Sanders, the California senator has voiced support for a Medicare-for-all system

“The idea is that everyone gets access to medical care and you don’t have to go through the process of going through an insurance company,” she said during a CNN town hall. “Let’s eliminate all of that, let’s move on.”

Harris and her staff later clarified that she also backs more incremental and less drastic policy plans for expanding health care.

Beto O’Rourke: While campaigning in Iowa, the former Texas congressman backed away from earlier support of Sanders’ Medicare-for-all plan, as reported by Slate. He suggested it might not be the “fastest way” to achieve “guaranteed, high-quality universal health care for all,” instead proposing another piece of legislation: Medicare for America.

That particular health care plan would provide universal coverage through a combination of private and public insurance plans.

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Cory Booker: Booker also signed onto Sanders’s Medicare-for-all plan in 2017, but told reporters in February that he would not eliminate “private health care.” According to the New Jersey Democrat’s website, he supports the ACA’s goal of “ensuring access to quality care” and wants to “improve the law.”