Kamala Harris has long said she supports Medicare for All. It’s now clearer than ever that she really wants anything but.

Her new health-care plan — which steals the name of Bernie Sanders’s popular single-payer bill despite looking nothing like it — is a slap in the face to single-payer supporters. Phased in over ten years, the plan ultimately expands the role of private insurers in Medicare by massively increasing the number of private Medicare Advantage plans sold.

In her Medium post about the proposal, Harris describes the US health-care system as a “patchwork of plans, providers and costs that have left people frustrated” and says we need to “finally fix this broken system for good.” But her plan — KamalaCare, for lack of a better name — does no such thing. Instead, it reinforces our patchwork system by ensuring private plans can operate within and around Medicare in perpetuity.

KamalaCare would:

• Further privatize Medicare. Medicare has long been under attack by private insurers. From its beginning it has 1) lacked coverage for important items like dental, vision, and hearing, and 2) saddled its recipients with significant out-of-pocket costs. This has allowed private companies to offer highly profitable “Medicare Advantage” plans as supplements. Harris’s proposal keeps these plans around instead of strengthening Medicare to the point where they become unnecessary. Such an expansion of Medicare Advantage erodes the public Medicare program rather than strengthening it.
• Keep the waste and inefficiency of our current multi-payer system. One of the things that makes Medicare for All so affordable is the massive savings that would result from consolidating everyone onto a single, public plan. Dividing people into competing private plans allows for incredible administrative waste while diverting patients’ health-care dollars toward company profits. Private companies currently spend as much as 18 percent on administrative overhead, compared to just 2 percent for Medicare. Moreover, Medicare Advantage plans are notorious for overbilling the government by billions of dollars a year. A single, public program will lead to a drastic reduction in overall health spending in a way that KamalaCare cannot.
• Cost families more than Medicare for All. Harris’s new attack on Sanders’s bill is that it will raise taxes on the middle class, while her plan won’t. And it’s true — Sanders’s staff has suggested a tax on income above $29,000 to help pay for Medicare for All, while Harris promises not to tax income below $100,000. But she neglects to explain how much middle-income families would spend on premiums and out-of-pocket costs under KamalaCare. Currently, families earning $60,000 often spend over $10,000 a year on such costs. Medicare for All will replace these costs with small tax, saving these families thousands. It’s completely unclear what savings KamalaCare would bring.
• Continue to deny patients necessary care. The driving goal of a private company is to maximize profits. This is in direct opposition to what should be the function of a health-care system, which is to provide care when it is needed. If a doctor’s expert medical decision stands in the way of this goal, a private company will deny the claim — and, indeed, private insurers denied 1 in 5 claims in 2017. Under KamalaCare, private companies remain in charge of your care, rather than doctors and nurses. The only way to stop this from happening is to remove the profit motive from health care altogether by eliminating private insurance.
• Fall apart before it’s implemented. Ten years. That’s potentially three presidencies. It’s a huge amount of time to give private insurers an opportunity to throw the plan off course by carving out a more significant role for themselves. KamalaCare hints at getting rid of copays and deductibles (this major detail receives just one short mention in Harris’s write-up of the plan), but without getting rid of wasteful private spending it’s unclear how this is possible. KamalaCare would entail similar initial costs to single-payer by massively expanding coverage, but would bring none of the substantial administrative savings. As the nation’s health care bill continues to rise, it’s inevitable that the program would ultimately cut back on the promises Harris makes, resulting in a much weaker system than what’s being proposed.

Harris says keeping private insurers involved in Medicare is what the public wants. She points to Medicare’s enduring popularity in her Medium post, while her team (with help from centrist think tank Center for American Progress) has taken to Twitter to argue that private insurers’ role in Medicare is part of what makes the program so popular. This is, of course, disingenuous. Medicare is popular because everyone gets it, not because its recipients are forced to spend their social security checks on supplemental private plans.

Sanders’s Medicare for All bill would double down on Medicare’s principle of universality by expanding it to the entire US population, regardless of age, income, or physical condition. This is what the public wants — not a ten-year phase-in for a plan that ultimately won’t solve their health-care woes.

Harris has long masqueraded as a supporter of Medicare for All, but the rollout of KamalaCare finally gives us clarity: she will fight on behalf of insurance companies, not against them. This proves that simply stating support for Sanders’s bill — as has been the case with Elizabeth Warren and, until now, Harris — means very little. A candidate needs to demonstrate that support by fighting relentlessly for an uncompromising single-payer program and taking every opportunity to antagonize the private insurance industry. So far, only Sanders himself has proven willing to take up that fight.