MARY LOUISE KELLY, HOST:
Vermont Senator Bernie Sanders made the case today for eliminating private health insurance and shifting the country to a single-payer Medicare system.
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BERNIE SANDERS: The time is now to go forward. The time is now to expand Medicare to every man, woman and child in this country.
KELLY: Of course, if that sounds familiar, it might be because Sanders has been making this same case for years that is now the central policy debate in a presidential race where Sanders is struggling to maintain the momentum he built up with progressives for the last four years. NPR's Scott Detrow is covering the presidential campaign. He is here in the studio now. Hey, Scott.
SCOTT DETROW, BYLINE: Hey, good afternoon.
KELLY: Hi. So as we noted, we have heard Bernie Sanders make the case for "Medicare for All." I think we could all recite it in our sleep at this point. Did he shake it up at all? Did he, you know, spice up this message in his speech today?
DETROW: Yeah. There was definitely a focus. You know, as you mentioned, this has become a focal point in the campaign. And one of the main points of contention between Sanders and former Vice President Joe Biden and one of the main criticisms has been something that Sanders readily acknowledges, that this plan would lead to a major tax increase as part of it. So Sanders spent a lot of time arguing today that that would be worth it because it would lower health care costs, and it would eliminate insurance payments.
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SANDERS: Oh, my God, dear. The insurance premium is here. What a wonderful day. Oh, wow.
SANDERS: Let's celebrate. Hey, another $2,000 a month for insurance, and small businesses, they just love it, every month paying those insurance premiums.
DETROW: So kind of in more of his Larry David mode there making fun of the idea that nobody likes to pay insurance payments. You know, there's no question this would be a massive shift to the American health insurance system. And that is another one of Joe Biden's big criticisms. He said, look; I was part of the fight to pass the Affordable Care Act, Obamacare - incredibly hard to pass. This is so much beyond that. It would be near impossible to pass. And you need to remember that whether it's Sanders or Biden or any other Democrat taking office, best-case scenario for them is a very narrow Senate majority and very likely Republicans would be in charge of the Senate.
KELLY: I'm thinking of the biggest obvious difference between now and 2016, which is that Bernie Sanders is running in a very crowded field of Democrats, some of whom also support Medicare for All. How did he contrast his plan with the others that are out there?
DETROW: What's been interesting is that he really hasn't made that contrast at all on Medicare for All, on any other front. He's instead just criticized Joe Biden a lot. And, you know, both Elizabeth Warren and Kamala Harris, who are gaining on him in the polls, have co-sponsored his Medicare for All bill, but both have been a lot more hesitant than Sanders at several points when it comes to the idea of totally eliminating private health insurance. Warren finally did embrace that position fully in the debate last month. Sanders did issue a challenge today to other candidates to refuse campaign contributions from the insurance and drug industry - not just PACs but individual executives in that field as well.
KELLY: Step back from health care, Scott. On other issues when you look at this campaign as a whole, how is Sanders trying to distinguish himself in this, again, very crowded field?
DETROW: You know, there's no question that he's really lost a lot of momentum in recent weeks. For much of the year, he and Biden were far ahead of any other candidate. But Elizabeth Warren has been steadily gaining ground for months now focusing on a lot of big policy plans that are very similar to what Bernie Sanders is talking about. And, of course, Kamala Harris had that big moment at the debate last month where she took on Joe Biden. Bernie Sanders was standing right between them, but he didn't really have that breakout moment in the debate. So this has been - you've seen his poll numbers be stagnant as Harris and Warren have gained. Sanders' campaign insists that they're not worried. I talked to his campaign manager, Faiz Shakir, about this.
FAIZ SHAKIR: They are new candidates in the race, and that is a credit to them. Most people do not know who they are there. They're out there campaigning more. They're advertising themselves. They're raising money. They're fresher to the scene for that reason. And so you're seeing other candidates get a little more support, which is good. It's healthy. It's fine.
DETROW: So they insist that this trend will go away. But if it continues, it cuts into a main argument Sanders is making, that he can bring the progressive change but also can be the person best positioned to defeat Donald Trump.
KELLY: Scott, we've mentioned Joe Biden a couple of times, which is inevitable if you're covering this field of Democrats. He also rolled out a health care plan this week. What is it?
DETROW: Yeah. The short version of that is he keeps Obamacare in place, and he builds on it by doing an optional plan like what Sanders is talking about for people who want to opt in to that government-run health insurance plan. This is the public option that you may remember from the original Obamacare debate. Biden wants to do that. And his a political argument here is that the plan that Sanders, Harris and Warren want to do does away with the current Obamacare system that, of course, has gotten more popular after Biden and Obama left office.
KELLY: Thank you, Scott.
DETROW: Thank you.
KELLY: NPR's Scott Detrow. Transcript provided by NPR, Copyright NPR.