On Medicare For All, CNN's Enten Is Ridin' With Biden

Corporate press hostility to the Medicare For All healthcare plan favored by progressives--and to pretty much everything else favored by progressives--is as inevitable as death and taxes, and on Saturday, Harry Enten ground out a tendentious CNN article that makes a complete hash of the issue at every turn. At this week's Democratic presidential debate, candidates Elizabeth Warren and Bernie Sanders pointed out that people like their doctors, not their insurance companies. Enten sets out to "correct" this under the headline, "Warren and Sanders Say Americans Don't Like Their Health Insurance. Polls Don't Back That Up."

Some background here: As part of his presidential campaign, former Vice President Joe Biden has been attempting to counter calls for M4A by propagating a "healthcare plan" that merely tinkers around the edges of the Affordable Care Act (and like the ACA, leaves millions of Americans with nothing). Biden has embraced Donald Trump's Orwellian mischaracterization of M4A as a thing that takes away health coverage from millions of people (because private insurance for the services covered by the program would be eliminated). Perhaps most egregiously, he's been falsely insisting that progressives want to repeal the ACA and leave people with nothing while they spend years trying, with a questionable chance of success, to pass a M4A plan. In this way, he equates the advocacy for M4A with Republican efforts to simply do away with the ACA. He presents himself as the defender of the ACA and Obama's legacy and says he prefers to build on the ACA instead.

M4A doesn't take away anyone's coverage, of course; it extends coverage to everyone. No one has even suggested the course of action re:passing M4A that Biden describes. M4A is meant to succeed the ACA and, progressives have argued, build on it, and it provides health coverage for everyone. The ACA's supporters don't see this sharp dichotomy Biden has tried to foster; more than 2/3rds of the ACA's co-sponsors in congress are now supporting M4A and Barack Obama himself has said M4A is a "good, new idea."[1]

Biden's entire narrative is just a politically-motivated fiction.

That brings us to Enten, who isn't interested in details like this. Rather, he seems to see his job as merely being to sell that Biden narrative. He leads by focusing on an awful question Kaiser asked in a new poll

"A new Kaiser Family Foundation poll finds that when it comes to expanding coverage and lowering health care costs 55% of Democrats and Democratic leaning independents prefer to vote for a candidate who does so by building on the Affordable Care Act. Only 40% want do so by voting for voting for a candidate who replaces the ACA with Medicare for All."[2]

Using the completely dishonest Biden framing of the issue, the only thing this question's responses revealed is the reason Biden is peddling that false narrative in the first place: if he can get people to believe it, more of them side with him. As progressives see it, they are building on the ACA with M4A. Bernie Sanders and Elizabeth Warren have explicitly said so. One can certainly debate the soundness of that proposition--there are arguments to be made on both sides--but the decision to represent the issue in the way Kaiser did is strictly ideological. It's choosing a side and pretending as if the other doesn't exist.  Besides being so problematic in itself, this also makes mincemeat out of the results. Those who don't see their advocacy of M4A as some effort to do away with the ACA--at a time when the ACA is at the height of its popularity--will be resistant to characterizing their own view as doing so. Kaiser generally does excellent work when it comes to the polling on these matters. That question was definitely an exception. Enten, who never does excellent work on anything, understands all of this. He's a pollster. He doesn't question the reasonableness of framing the issue in this way though, merely goes with it as if it's a legitimate measure of what people think. It reaches the conclusion he prefers.

Though Enten's headline sounds rather immediate, he primarily relies, for its conclusion, on a Kaiser poll from over 6 years ago:

"It turns out that Kaiser posed this question to Americans back in 2013 'Do you have a generally favorable or generally unfavorable opinion of your own health insurance company?'

"In that poll, 72% of Democrats they had a favorable view of their health insurance company. That's triple the 24% who said they had an unfavorable view."

Some points:

--That same poll found that a plurality of respondents--49%--had a negative opinion of health insurance companies in general, with only 43% saying they had a positive view of them.

--Significantly, the poll also suggests that opinions about insurance companies are tied to the extent to which people have to deal with them. Among those who had tried to purchase insurance in the three years previous to the poll, 59% expressed an unfavorable opinion of the companies.

--Enten misrepresents the finding about those who have a favorable opinion of their health insurance; that question was asked of the insured, not of "Democrats."

--Maybe most importantly, while that overwhelming majority did say they had a favorable view of their own insurance company, the same poll also asked respondents what was most important to them in an insurance plan, and at the top of the responses sits choice of doctors, coverage for a wide range of services, being able to go to the hospital you prefer without paying more, etc.--all things also provided by M4A. Progressives have argued that when people say they like their insurance coverage, this is what they're actually valuing, not their insurance company itself--they like having health care, not necessarily private insurance--and this data suggests that is correct. Enten never outlines any of this, the very argument advanced by Warren and Sanders; he just represents the poll as refuting Warren and Sanders!

It gets worse:

"Polls like the one I just cited indicate that the candidates who favor a public option hold the majority opinion within the Democratic Party."

Though Enten forgets to mention it while making that kind of sweeping statement, the same Kaiser poll with which he began asked about this and found that very large majorities of Democrats support both "Medicare For All" and the "public option" approach, and by lopsided margins.:

To note the obvious, that's going to be mostly the same people supporting both. Most Democratic respondents don't see them as either/or. They see both as policies that would improve healthcare. The public option performs slightly better among them because it also draws in some people who aren't comfortable with M4A and is probably seen as more immediately doable, as that's how it's rather relentlessly sold to the public. That puts the ball in the court of M4A advocates to explain their idea and make a case for it being the best. Most Americans have already accepted the premise of the policy, that health care is a human right and that it is the responsibility of the government to ensure people have it.

Enten never acknowledges that. He never acknowledges M4A's overwhelming popularity among Democrats either, though he does try to undermine it and suggest it--whatever it is--is all a mirage:

"Our CNN poll from late June directly posed the question to potential Democratic primary voters. We asked whether there should be a national health care plan and whether it should replace private insurance. The plurality, 49%, said there should be a government health care plan but it shouldn't eliminate private insurance. Just 30% said there should be a national health care plan and it should eliminate private insurance. A mere 13% didn't want a government run health care plan."[3]

To elicit those responses, that CNN poll specifically asked, "if the government instituted a national health insurance program for all Americans, do you think that program should or should not completely replace private health insurance?" But Medicare For All doesn't "completely replace private health insurance"; it replaces private health insurance that duplicates coverage provided by the M4A program. Insurance companies could continue to offer coverage for services outside those covered by M4A. "Completely replace" misrepresents the policy in a prejudicial way and is also very strong language, both of which queer results--again, all things Enten, as a pollster, knows. If--perish the thought--one suspected Enten was dishonest, one may even suspect he left that "completely" out of his recitation of the results on purpose.

Medicare For All has enjoyed majority public support for years now and Democratic support for it is staggering. That CNN poll also asked, "Do you think the government should provide a national health insurance program for all Americans, even if this would require higher taxes?" Even with that "taxes" language, 56% of respondents, 87% of Democrats and 85% of Democratic leaners answered in the affirmative. What people mean when they say they support "Medicare For All" is obviously a legitimate question. It just isn't one with which Enten, while pretending to address the matter, ever properly engages.

In July, Morning Consult released the best recent poll we have on this. It asked respondents if they would support a Medicare For All system, a M4A system that diminishes the role of private insurance and a M4A system that diminishes the role of private insurance but allowed you to keep your doctor and hospital. The results:

The third option, which is the most accurate and detailed description, polls the strongest across the board, and the results add weight to that progressive argument around which Entent attempted an end-run, that when people say they like their insurance company, they're really just saying they like their doctors, hospitals, etc. Enten doesn't reference the Morning Consult poll.

Enten wears his purpose on his sleeve perhaps most prominently in his big finale:

"This polling ... might also explain why Biden continues to lead the Democratic race. He's closer to the median voter on the marquee issue this primary season than either his two leading competitors Sanders or Warren.

"If Sanders or Warren win the nomination, it will be in spite of their health care positions, not because of them... Perhaps the best hope for Sanders and Warren is to not make health care personal... But when you propose eliminating private insurance, it's pretty hard not to make it personal to the many voters who rely on it."

Enten sells himself as a "data journalist" but while that label conjures images of some disinterested scientist who carefully crunches numbers and draws conclusions from them, Enten is selective in his use of numbers, outright terrible in his analysis, sloppy in his writing and what he's peddling under that "data journalist" label is, more often than not, just unacknowledged ideology.

--j.

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[1] It isn't really a new idea--such systems first began appearing in the 19th century. It isn't new for Obama either. In 2003, before he was elected to the U.S. Senate, Obama himself supported it.

[2] All the weird errors there--duplicating words, leaving out words--are in the original.

[3] By the way, the CNN poll in question is located here; the link Enten erroneously provides goes to a story written months before the poll had even been conducted.