Two men in their late seventies, with over 70 years combined experience in Washington, have sat among the top three in the Democratic field for months, taking shots at other candidates—but largely avoiding the other.
That changed in the hours following the Democratic debate in Ohio during which former Vice President Joe Biden took aim at Medicare for All—specifically Sen. Elizabeth Warren’s (D-MA) plan—as expensive and unrealistic.
By the next day, Biden had turned his fire on Sen. Bernie Sanders (I-VT).
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“God love Bernie, and it was really good, I really mean it, to see him so healthy and moving last night,” Biden told reporters outside of an electricians union on Wednesday. “But Bernie doesn't pay for half his plan .... Look, the last thing the Democrats should be doing is playing Trump's game and trying to con the American people to think this is easy. There's nothing easy about it. If you're going to do it, tell us how you're going to do it. It's called truth in speaking.”
Sanders, whose campaign received a much-needed momentum boost in recent days—posting the highest fundraising total of any Democratic contender in the third quarter and scoring an endorsement from progressive firebrand Rep. Alexandria Ocasio-Cortez (D-NY)—shot back quickly, calling Biden’s comments “sad.” The sentiment was quickly echoed by Sanders in a fundraising email.
“It is really sad that Joe Biden is using the talking points of the insurance industry to attack Medicare for All,” Sanders wrote in an email to supporters. “Joe must know that we currently spend twice as much per capita on health care as the people of almost any other major country, and that we pay, by far, the highest prices in the world for prescription drugs.”
What ensued provided a glimpse of what’s to come in the Democratic primary, strategists said, where kitchen table issues dominate discussions outside of Washington and Twitter, meaning health care will once again be center stage. The debate also ushered in a new and aggressive willingness on behalf of the moderate Democrats in the race to take the fight to the progressives and pick apart their plans piece by piece.
The back-and-forth between their respective camps seeks to highlight the profound differences between two of the leading candidates working to the Democratic Party in their direction ahead of the November election. Following his bosses’ comments to reporters, Biden spokesman Andrew Bates said on Twitter that “the industry hates” their own plan, in an apparent move to create distance from pharmaceutical companies.
“In 2020 alone, Medicare for All requires 2.7 trillion of additional federal spending - 34 trillion over 10 years. Overall healthcare spending INCREASES by $719 billion that year,” Bates went on.
In response, Sanders’ communications adviser Mike Casca said that Biden’s proposal “leaves 10 million Americans uncovered and millions more uninsured.”
After the debate, some longtime moderate Democrats who have worked directly with Senate leaders and in health care negotiations praised Biden’s middle-of-the-road approach.
“I think it’s a smart play for the [former] vice president who is desperate to stand out in the field as the centrist,” said Jim Manley, a 21-year veteran of the Senate who helped guide communications efforts during the Obama-era Affordable Care Act.
Asked if Biden going after Sanders on health care is at all risky for him, he offered one word: “No!”
“The last thing [Biden] can afford to do is listen to the online Twitter mobs if he wants to establish himself as the alternative to the hardcore progressives,” Manley said.
Another Democratic strategist involved with health care politics said there’s no evidence that going after other candidates works long term, but speculated that Biden likely has the right strategy for the general election.
“In the large general election scheme of things, I think Biden’s got the politics right,” the strategist said. “He’s probably got the politics right with respect to the primary electorate, but it’s less of an advantage.”
Progressives certainly agree it’s less of a primary advantage. Indeed, they have for months made distinctions about how the former vice president’s centrist messaging is out of touch with a Democratic electorate that has shifted left in recent years. Following the debate, which was notably more contentious between contenders than in previous showings, multiple strategists noted that Biden is running explicitly on a platform that tells people what is hard to achieve, rather than what is ideal.
“While the Obama campaign was about ‘Yes we can,’ Joe Biden is making his campaign’s tagline ‘No we can’t,’” Democratic strategist Rebecca Katz said when presented with Biden’s comments to reporters.
Brian Fallon, an alum of Hillary Clinton’s 2016 presidential campaign, also noted several downsides to attacking Medicare for All in the current primary climate.
“There’s a couple downsides for the centrist-lane politicians looking to make hay over their attacks on Medicare for All. One is that it has the potential to come across as disingenuous,” Fallon said. “It almost comes off as they’re exaggerating the differences to score political points.”
In addition, Fallon said that having a “visionary” approach to an issue affecting millions of Americans provides an opportunity for more engagement from voters, and can ultimately lead to more small dollar donations, one of the central components of a campaign’s longevity.
“Candidates that are bold on health care are generating the stronger shows of support,” he said. “For Biden, the fervor of his support is less impressive and seems a little shallower.”
Biden’s campaign raised approximately $10 million less than Sanders in the third quarter of 2019. He’s sitting on $8.9 million cash on hand, bringing in approximately $15.7 million this quarter and spending $17.6 million. Sanders, in contrast, has $33.7 million on hand, after raising $25.3 million during the same time, while Warren has $25.7 million on hand and took in $24.6 million.
“In a Democratic primary there is something to be said for being the visionary,” Fallon said. “I don’t think it’s a coincidence that people like Warren and Sanders who have been making the case for the change they want to see in the world are also doing the best in terms of small dollar fundraising.”
