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Elizabeth Warren is promising to spend more than $20 trillion over the next decade to provide government-funded health care to every American without raising middle class taxes.

The stakes are high since Warren spent weeks, and two straight Democratic presidential primary debates, refusing to provide a straight answer on if she’d have to increase middle class to pay for her “Medicare for All” plan.

The issue has meant sustained tough headlines for Warren, who had ridden a steady summer rise in the polls to catch former Vice President Joe Biden atop the crowded 2020 primary field. Detailed in a 20-page online post, Warren’s proposal relies on employers transferring to the government nearly all of what they currently spend on private health insurance for employees.

Former Iowa Gov. Tom Vilsack says Massachusetts Sen. Elizabeth Warren’s increase in taxes on wealthy Americans to finance her health care proposal is unrealistic. During a panel discussion on rural politics in Iowa Friday, Vilsack said Warren’s plan wrongly suggests voters will accept that an increase in her proposed tax on the wealthiest Americans won’t affect their own pocketbooks. Vilsack, a former U.S. secretary of agriculture, says “One sliver of society isn’t going to pay for the rest of us.”
Vilsack, who has not endorsed a candidate, also says it’s unlikely there will be sufficient support in the Senate to pass such a measure, even if Democrats take control of the GOP-controlled Senate after the 2020 elections. Vilsack, who has consulted Warren on rural policy, adds “and then there’s the practical application of getting 60 people in the Senate who are going to vote for this.”