MICHEL MARTIN, HOST:
We're going to revisit the two Democratic debates held earlier this week, where 20 people hoping to challenge President Trump met over the course of two nights. By now, you've probably heard a lot of hot takes on who won and who lost and who had a breakout moment and who didn't. Instead, we're going to do what we did after the last set of debates. We're going to dig into some of the policy differences that emerged.
We decided to do that because even though the candidates only had a few minutes - really, a minute or two on each topic - that minute or two did allow the candidates to point up some real differences on issues like health care and climate policy as well as bigger questions about how Democrats should approach the quest for the presidency, like should they put up visionary ideas and try to create momentum behind them? Or should they stick to more modest goals to try to hold the middle, as it were? Of course, we aren't going to be able to get to every issue that came up or that is important, but we're going to start with health care.
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BERNIE SANDERS: Under "Medicare for All," the hospitals will save substantial sums of money because they're not going to be spending a fortune doing billing and the other bureaucratic things that they have to do today. Second of all...
JOHN DELANEY: It doesn't add up.
SANDERS: Maybe you'll do that and make money off of health care, but our job is to run a non-profit health care system.
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MARTIN: Of course, that was Senator Bernie Sanders and former Congressman John Delaney talking about health care. Here to tell us more is Shefali Luthra. She is a correspondent for Kaiser Health News.
Shefali, welcome back. Thanks for joining us once again.
SHEFALI LUTHRA: Thanks for having me.
MARTIN: So this time around, the candidates seemed to articulate some distinct proposals on health care - "Medicare for All," improve on the Affordable Care Act or Obamacare or add a public option. Can you break those down for us?
LUTHRA: Certainly. So this is a really interesting sort of natural development in how we think about ways to expand access to health care. And you could break this down into the "Medicare for All" single-payer plan that Bernie Sanders has put forward that's now also backed by Elizabeth Warren in which everyone would get their health care from this one, big government program.
They would call it Medicare. It looks very different from Medicare as we know it, right? It would cover dental. It would cover prescription drugs. It would cover vision. Basically, everything that you can think of would be taken care of. You would pay nothing at the point of service, so when you go to the doctor, no copay. It would eliminate private insurance. They say that would make it more efficient.
Then you have someone like former Vice President Joe Biden, who says he wants to add to the Affordable Care Act, create what's called a public option in which if you don't have access to health care, you can buy into a government program. He would also add some other consumer protections here and there and try and put a cap on how much we pay out-of-pocket for health care.
Then you also have plans from folks like Kamala Harris, who has said that she backs "Medicare for All" but has been sort of trying to thread the needle on maintaining a private insurance option. And she rolled out a plan just this past week looking at the idea of expanding Medicare to everyone but giving the option of either getting it from this government program or letting private insurance companies contract with the government. And she says that she would put stricter standards on those companies than exist today said that you have better plans but you have choice.
MARTIN: Is what we heard earlier this week, though, at the debates - was this a clearer articulation of positions that the candidates have put forward already? Or did they offer us some new ideas to consider?
LUTHRA: We're definitely hearing new ideas. Kamala Harris hadn't put out a plan before. And the idea of "Medicare for All" that maintains Medicare Advantage, which is what we call it when Medicare contracts with these private insurance plans - no one has really talked about a plan in that form. This is very new. Vice President Biden hadn't put out his own health reform plan by the previous debate. Now he has. And it is very different from either the single-payer or "Medicare for All"-esque (ph) plans that we're talking about. It would certainly expand coverage. It would certainly be far too radical compared to what was passed in the Affordable Care Act. It would also leave, you know, more people uninsured than those other ones. But it would cost less.
MARTIN: And where are the voters on this? Are they intrigued by the idea of a single-payer system? Are they afraid of it? What do we know?
LUTHRA: This is a really complicated question. On the one hand, "Medicare for All" as a phrase pulls really well. When you tell people they might lose access to private insurance, support drops. When you tell them you might lose private insurance, but you could still keep your doctor, support goes up. It really depends on how you frame it. And this is one area where it seems that voter opinion could be quite malleable going forward.
MARTIN: That is Shefali Luthra. She's a correspondent for Kaiser Health News.
Shefali, thank you so much for clearing this up for us once again.
LUTHRA: Thanks for having me.
MARTIN: And now to climate policy.
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JAY INSLEE: The science tells us we have to get off coal in 10 years.
JOE BIDEN: Yes.
INSLEE: Your plan does not do that. We have to have off of fossil fuels in our electrical grid in 15. Your plan simply does not do that. I've heard you say that we need a realistic plan. Here's what I...
BIDEN: No, I didn't say that.
INSLEE: Here's what I believe. I believe that survival is realistic, and that's the kind of plan we need. And that's the kind I have.
MARTIN: That was Washington Governor Jay Inslee in an exchange with former Vice President Joe Biden. We wanted to hear more about how the candidates are distinguishing themselves with their plans to address the changing climate, so we've called reporter Dino Grandoni. He covers energy and environmental policy for the Washington Post, and he's with us now.
Welcome. Thank you so much for joining us.
DINO GRANDONI: Thank you.
MARTIN: So, Dino, how would you say the candidates distinguish themselves on this issue? Did you see some sort of center of gravity emerging there, or...
GRANDONI: So one of the ways the candidates tried to distinguish themselves was over the date by which they want the country to get off of fossil fuels. You have Governor Jay Inslee from Washington wanting to get off fossil fuels, coal, oil, natural gas by the end of this next decade, 2030, whereas Joe Biden's plan calls for the U.S. to get off of that by the middle of the century, 2050.
MARTIN: So the differences between Democratic candidates on a number of issues this year are being framed as a tension between progressives and moderates, and some people see this as - you know, as a generational divide. So is there a similar divide here between people who are seen as bolder or more hawkish and people who are seen as, say, more moderate in their approach?
GRANDONI: Yeah. There's a divide between the so-called progressives or the left wing of the party and the moderates and Democrats agree that we need to get off of fossil fuels in general, but they disagree over how quickly the nation needs to do that.
MARTIN: Is there any through-line to who takes which position? I mean, is it people who live on the coasts tend to take one position, people who come from other places tend not to be as aggressive in their approach? Or is it just a matter of what you happen to believe?
GRANDONI: There is some regional divide here. You have some people in the moderate camp when it comes to climate change from the center of the country, places like Colorado or Montana that have coal and oil natural gas resources. So in that category, you have Governor Steve Bullock from Montana and former Governor John Hickenlooper from Colorado as well as Senator Michael Bennet from Colorado. This makes up that kind of moderate section of the Democratic Party when it comes to climate change - and other issues - where they want the country to move more towards renewable resources, but they want oil and natural gas to play some sort of role in the energy mix in the foreseeable future.
MARTIN: Do we have a sense of where voters are on these issues?
GRANDONI: So traditionally, environmental issues in general and climate change in particular have not been high-priority issues among Democrats. However, some of the early polling you see, including one poll that's gotten a lot of attention from CNN, indicates that Democratic voters are more concerned about climate change than they've ever been. The CNN poll I'm referring to had it as the number one issue among Democrats, which is much different than we've seen in past Democratic primaries. The real issue is going to be whether in the general election the entire voting base is going to be as interested in seeing candidates move aggressively on climate change.
MARTIN: That's Dino Grandoni. He covers energy and environmental policy for The Washington Post.
Dino, thanks so much for talking to us.
GRANDONI: Thank you so much.
MARTIN: And finally, we want to talk about what you might call the philosophical divide on the stage at this week's debates.
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ELIZABETH WARREN: You know, I don't understand why anybody goes to all the trouble of running for president of the United States just to talk about what we really can't do and shouldn't fight for.
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MARTIN: That, of course, was Senator Elizabeth Warren, and it is representative of what you hear political strategists talking about behind the scenes, and that is whether it's better to go big and bold and inspire progressives or try to appeal to the Trump voters - to keep an eye on the general election. In other words, keep it practical. Here to talk about that is Domenico Montanaro, NPR's lead political editor.
Hi, Domenico. Welcome back.
DOMENICO MONTANARO, BYLINE: Hey, Michel. Thanks for having me.
MARTIN: Well, you know, I've framed it a certain way. How would you frame that difference of opinion that we saw playing out on the stage?
MONTANARO: Well, you know, loosely, I think it is the progressives versus the pragmatists - you know, the pragmatists being the types of people like former Vice President Biden, to a lesser extent obviously someone like former Congressman John Delaney, who we heard that big back-and-forth with Senator Elizabeth Warren from Massachusetts. You know, the Biden campaign - I was talking to some of their senior advisers before the second debate while I was in Detroit, and they are very focused on putting forward policies that have majority support in a general election.
That doesn't just mean winning over Trump voters - that means winning over those independents and people who may be swaying. That's through a prism of believing that this is still a persuasion election, which 2016 frankly was. But a lot of liberals in response to Donald Trump don't see that as enough. They want more, and they don't see someone like Vice President Biden as the future of the party.
MARTIN: Is there any evidence that either of these strategies work better with voters? You heard the former Obama chief of staff, former mayor of Chicago Rahm Emanuel was on one of the late-night shows after the debates, and he said that Democrats want to fall in love, Republicans fall in line.
MONTANARO: Right.
MARTIN: And his...
MONTANARO: Certainly we've seen that...
MARTIN: Yeah.
MONTANARO: ...Over the years for sure.
MARTIN: He wasn't making a particular case one way or the other. But the stereotype is that Democrats really want to be inspired by something. That's how you get the Democratic base fired up. Whereas other people say no, that that's not true, and they point to the Obama voters who switched to Trump in 2016.
MONTANARO: Well, you know, this is going to be the argument that we're not going to be able to solve. Is this going to be a persuasion election, or is this an election where it's just a base election? And there's a lot of evidence to suggest that President Trump is trying to get the Democratic base and independents to stay home because his base is solidly behind him.
Now, some would argue, like Rahm Emanuel, that that means that there's an opportunity to win over the people who President Trump has not gone beyond to try to win over and keep on board. Despite the strong economy, the president has mediocre approval ratings, and that is a huge opportunity for Democrats. Now, can a Democratic base only beat a conservative base only? Polling would suggest no because there are fewer people who identify as liberal, and there are more people who identify as conservative. So Democrats have to win over a degree more of moderate voters.
MARTIN: And, finally, did you observe a difference of opinion about whether this election is a referendum on President Trump, or is it a referendum about the plans and the biographies of the Democratic candidates?
MONTANARO: Well, look - all of these candidates are Democrats, and they're looking in, you know, moving the country in a direction that's a little more liberal than where it is now - or a lot more liberal, depending on which candidate you're talking about. But when you talk to these voters on the campaign trail, over and over again, they say their main priority is beating Donald Trump. They just want him out whatever way that they can effect that.
MARTIN: So what that seems to suggest - that there was - that Democratic primary voters are willing to give wide latitude to very different policy procedures as long as the person is fit.
MONTANARO: I think that's absolutely true. I mean, you have something like 80% of Democratic voters saying they're not decided on who the candidate is, but they definitely know that they want to win. And they're worried about it because the economy is strong. There's no hot war where you have a rising death toll every day. And with those circumstances, generally a president is re-elected. And I think there's a lot of Democrats biting their nails and even more so watching these debates not sure who it is that they think is definitely that person that they think, you know, can really take him on.
MARTIN: That is NPR's Domenico Montanaro.
Domenico, thank you.
MONTANARO: You're so welcome. Transcript provided by NPR, Copyright NPR.