In the debate over how to best ensure optimal healthcare for Americans, former Vice President Joe Biden is rooted on not allowing the Affordable Care Act (ACA) to be whittled away in the courts by the Trump Administration. Biden instead wants the signature legislative achievement of the Obama Administration to stay in place.
The marquee item in Biden's healthcare pitch, officially released Monday, is to supplement ACA coverage, colloquially called Obamacare, by adding a "public option" for Americans to be able to buy into a Medicare-like system already available to those at least 65 years old.
This public option would also cover the "full scope of Medicaid benefits" for nearly 5 million low-income Americans in states that did not accept the ACA's expansion of Medicaid, the government program used by more than 70 million people under the age of 65 who cannot afford coverage, a senior campaign official said.
With seemingly a hard-boiled, Obama-era sentimentality, the former vice president is more hesitant than some of his Democratic rivals for a wholesale policy shift as they support, which would move all Americans to the same government-run healthcare plan and, in most plans, eliminate private insurance entirely.
"I, you know, admire the rest of the field from Bernie [Sanders] to Elizabeth [Warren] to Kamala [Harris] who want, you know, Medicare for all..." Biden said Saturday in Atkinson, New Hampshire, about his opponents' "$3 trillion" plans, "I don't know why we'd get rid of what in fact was working and move to something totally new."
"So, folks, I'm against anybody who wants to do away with it and start over," he summed up in a separate speech in Londonderry, New Hampshire.
Through a "combination" of executive actions and legislatives goals, the plan would also increase the amount of current healthcare tax credits for Americans already on an ACA plan to ensure "no family buying insurance on the [ACA] individual marketplace, regardless of income, will have to spend more than 8.5 percent of their income on health insurance."
Lower deductibles are targeted by adjusting rates to a higher category ACA plan — from the "silver" to the "gold" plan — and for low-income Americans.
The total price tag of the "Biden Plan to Protect & Build on the Affordable Care Act" is $750 billion over 10 years, according to a senior campaign official, and would be paid for by raising the top tax rate to 39.6 percent and increasing taxes on the stock income of wealthy Americans.
The Democratic differences over healthcare come as theis tested by the Trump Administration in federal court due to the taxation provision of the law, a move that could ultimately place its fate in the hands of the Supreme Court.
That uncertainty has Biden uneasy on the campaign trail as he hopes to both defend the law from Republican-led efforts to dismantle it and talk up the 2010 Obama feat to Democrats who have somewhat adopted "Medicare for all" as seemingly a requirement for candidates.
Biden regularly reminds his audience that the ACA's passage has allowed 20 million more Americans access to healthcare coverage, a fact supported by healthcare researcher Kaiser Family Foundation and quips about when he told Obama on hot mic the ACA was a "big f**king deal" — language for which he now performs the Sign of the Cross during his stump speech, to his audience's delight.
Biden's official plan was revealed shortly before the second primary Democratic debate set for the end of July. The debate presents a potential opportunity for Biden and handful of other candidates like Sen. Amy Klobuchar, former Rep. Beto O'Rourke, and Rep. John Delaney to name a few, who take issue with "Medicare for all" to address their healthcare policy differences more in depth.
"If that means in the primary on the debate stage, they need to call each other out and explain the smaller details of their plans, I think that's a fair thing to do in the primary," former Democratic Congressional Campaign Committee Executive Director Dan Sena, who advises Sen. Michael Bennet's campaign, told CBS News:
"Because I assure you Donald Trump and the Republicans' media machine will do it."
As Biden, 76, heads to Iowa this week to address AARP voters and talk about rural healthcare access, the three-time presidential candidate will have the opportunity to explain additional elements of his policy, including repealing existing laws which prohibit Medicare from negotiating lower prices with drug corporations, allowing Americans to buy prescription drugs from other countries, and doubling the investment in community health centers.
Biden's newly released plan also put into writing his recent change in opinion over repealing the Hyde Amendment, which bans using taxpayer money for abortion access. His plan also outlines his call to codify Roe v. Wade, the Supreme Court decision that legalized abortion nationwide and explains the proposed public option would also "cover contraception and a woman's constitutional right to choose."
Tim Perry, Nicole Sganga and Emily Alff contributed to this story.