Fewer than 10 Democratic presidential candidates may qualify for the September debate at Texas Southern University, which could make it the perfect opportunity to switch the format from a smorgasbord of topics to one that decided key midterm races and could decide the 2020 election — health care.
A show of hands during the first two-part debate indicated most of the 20 participants did not support Bernie Sanders' plan to replace private insurers with a single-payer, government-run program dubbed Medicare for All. But little time was provided for the candidates to discuss alternatives, nor is there much information on most of the candidates' websites.
Time may not be a problem for the Sept. 12-13 debate in Houston, which will require participants to meet more stringent qualification standards. The Democratic National Committee says qualifying candidates must receive 2% or more support in at least four major polls and have at least 130,000 unique donors.
An analysis by the poll data website FiveThirtyEight showed only five candidates have reached the qualifying threshold: Sanders, Joe Biden, Kamala Harris, Elizabeth Warren and Pete Buttigieg. Within striking distance, however, are Beto O'Rourke, Julian Castro, Andrew Yang, Cory Booker, and Amy Klobuchar.
Health care is too important a topic for each debater to be given a minute or two to talk about it. More than 20 million Americans have health insurance thanks to the Affordable Care Act, but 44 million still have no health insurance and 38 million have inadequate coverage.
Ever since Obamacare was enacted nine years ago, Republicans have tried to kill it. The ACA's biggest threat now is a lawsuit filed by a number of states that contend the law became null and void two years ago when Congress removed its requirement that people either buy health insurance or pay a tax.
It makes no sense that Texas Attorney General Ken Paxton is spearheading the court fight to invalidate the ACA, which would unnecessarily risk the health of more than 900,000 Texans who have purchased health insurance through Obamacare.
The case was heard two weeks ago by the U.S. Court of Appeals for the 5th Circuit in New Orleans. Its ruling will undoubtedly be appealed to the Supreme Court, which in 2012 and 2015 issued rulings that upheld the ACA. The court is even more conservative now, however, so the case's outcome is even harder to predict.
Paxton claims his litigation "will give President Trump and Congress the opportunity to replace the failed social experiment with a plan that ensures Texans and all Americans will again have greater choice about what health coverage they need and who will be their doctor."
Since neither Congress nor the president have shown any signs of working hard on an Obamacare replacement, the more likely outcome if Paxton's suit succeeds would be millions of Americans going without health insurance for months or longer until a viable option is found. That was the situation before Democrats passed the Affordable Care Act in 2010.
Medicare for All doesn't appear to be the immediate answer. The infrastructure Sanders envisions will take years to build. Millions of Americans can't wait that long, which is why the Democratic candidates who didn't raise their hands in support for Sanders' idea need to explain their plans, if they have one. Many others are comfortable keeping the private, employer-provided policies in which more than 50 million Americans are enrolled.
Sanders, Warren and Bill de Blasio want to end private insurance almost immediately while Buttigieg, Yang, Kirsten Gillibrand and Marianne Williamson said competition from Medicare for All would eventually drive private insurers out of business. Other candidates said private insurance should remain an option, including Biden, who said improving Obamacare would provide the best option.
If the ACA survives judicial review, it definitely will need to be upgraded. Voters need to know what upgrades the candidates would make. Would they bring back the tax penalty? Would they restore the subsidies Trump dumped, which had encouraged insurance companies to enroll Obamacare patients?
If they know well in advance that health care is going to be the main topic of the Texas Southern debate, the Democratic contenders who make the cut will have plenty of time to prepare for a discussion of their own health care plans instead of raising their hands to respond to someone else's idea.
