Elizabeth Warren took a pounding from fellow Democrats in a recent primary debate for not having a plan to pay for her single biggest proposal, the sweeping health care overhaul known as “Medicare for All.”
Warren said at a campaign stop in Indianola, Iowa, that she would release a plan in a few weeks.
“This is something I’ve been working on for months and months, and it’s got just a little more work until it’s finished," Warren said Oct. 20. "But there’s the promise I make to you, and make every chance I get. And that is, I will not sign a bill into law that does not reduce the cost of health care for middle-class families, because it is the cost of health care that is hurting families.”
For all of the attention on the trillions required for Medicare for All, Warren has dozens of policy proposals — by our count, over 40 that involve new spending and revenues. (See our table with the details on the larger proposals.)
Many come with big dollars attached. Warren’s plan to provide universal child care and pre-school would cost over $1 trillion over 10 years.
In some cases, Warren ties new spending to a new revenue source. For example, she would impose a tax on wealth beyond the $50 million mark, raising an estimated $2.75 trillion over 10 years. She’d use that to pay for child care, opioid treatment, student debt cancellation, universal public college, election security and a small business start-up fund.
For some proposals, she gives only the broadest suggestion of how she’d pay for them. Take her $1 trillion clean energy plan, borrowed from former candidate Jay Inslee: She offers to pay for it by "reversing Trump’s tax cuts for the wealthiest individuals and giant corporations."
We asked for details and got none. That doesn’t mean the funding source wouldn’t cover the costs. But we have no way to tell if it would.
Warren’s signature call to Americans is "dream big." With the first caucus and primary votes only a few months away, we thought it was time to see how much her dreams cost.
We went through her plans with an eye toward tallying the total price tag and the money to pay for it.
All told, we counted $7 trillion in new spending over a 10-year period, and that’s without Medicare for All. On the flip side, Warren offered specific tax proposals that came to $4.55 trillion. All numbers reflect face-value amounts, with no adjustments for how tax collections or economic activity might change.
The new spending included $1.3 trillion that came with only broadly defined tax changes or no defined funding source at all.
Until she releases her funding plan, we don’t have Warren’s price tag on Medicare for All. To get the best idea we could, we used the latest estimate from the Urban Institute and the Commonwealth Fund, two groups that study health policy. That study puts new spending at $34 trillion, offset by about $2 trillion in existing taxes.
We didn’t include Warren’s estimates of the economic ripple effects of her plans, which could have a substantial impact on the federal budget. For universal child care, for example, child care workers would earn more, and additional income taxes would flow to Washington. They would also spend more money, which generates more economic activity and sends more revenue to federal coffers. Bottom line, the $1 trillion price tag could fall to $700 billion.
All told, modeling by the economic forecasting group Moody's Analytics for Warren's plans on child care, green manufacturing and housing predicts the ultimate cost to taxpayers would be nearly $1 trillion less.
There's another wrinkle to consider for full context, which we did not include in our tally of new spending: Warren's major boost in Social Security benefits. Her proposal would increase every recipient’s monthly check by $200. That, and other changes, would cost $3.4 trillion over 10 years. She would pay for that through higher taxes on the well-to-do, raising about $4.7 trillion. In the 10-year window, that would produce a surplus of $1.3 trillion.
That surplus, though, wouldn’t be money in the bank. It would be there to pay future benefits. While the surplus would be invested in Treasury bonds, Washington would still need to pay it back with interest.
There’s much debate over whether these estimates will hold up. The linchpin wealth tax might bring in far less than Warren’s predicts, perhaps as little as $1.1 trillion. Wealthy people find it pays to hide their wealth, and they would invest heavily in doing that.
Economist Alan Auerbach at the University of California-Berkeley said he takes these numbers with a grain of salt.
"My sense is that the Warren campaign is trying somewhat harder than some others to balance spending and revenue effects, but the numbers are still squishy compared to what a formal analysis by the Joint Committee on Taxation and the Congressional Budget Office would produce," Auerbach said.
The other candidates vary on how many details they provide on funding their bigger plans. Joe Biden and Bernie Sanders, for example, put their numbers on their websites, although Sanders has not committed to a specific way to pay for Medicare for All.
For other candidates, it takes more digging. Andrew Yang’s big plan for a universal basic income –– $12,000 a year to every citizen –– would cost nearly $3 trillion a year, according to the estimate of two economists, but that number isn’t on his FAQ webpage about the program. Yang does offer funding mechanisms, most significantly, a value-added tax.
Pete Buttigieg wrote in an op-ed that his health care plan would cost $1.5 trillion. His campaign told us that just about all of that would come from repealing unnamed corporate tax cuts in the 2017 tax cut law.
At this stage of an election, economist Steve Blitz puts little stock in the numbers. For Blitz, Warren’s estimates are just a general indicator of policy.
“Warren is taking a stand on how she thinks the world should be run,” said Blitz, chief chief economist for the economic consulting firm TS Lombard. “Pencil to paper time comes when she is nominated and hit with it on the campaign trail. Or if elected, trying to get it passed.”
Read more at PolitiFact.com.