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On expanding health coverage, Democrats’ 2020 hopefuls have agreed to disagree. Joe Biden says he would let people buy into Medicare and will build upon the Affordable Care Act, signed into law while he was vice president. Sen. Bernie Sanders of Vermont backs a government-run system called Medicare for All that would replace private insurance. Sen. Kamala Harris of California wants Medicare for All too, but would keep some pieces of the current setup including employer-based coverage. (Armour and Hughes, 4/30)

Joe Biden on Monday endorsed a public option that would allow all Americans to buy into a Medicare-like health insurance plan, as allies of both the former vice president and 2020 presidential rival Sen. Bernie Sanders (I-Vt.) begin to debate the Democratic Party’s health-care agenda. “Whether you’re covered through your employer or on your own or not, you should have the choice to buy into a public option plan for Medicare — your choice,” Biden said during a campaign event in Pittsburgh. “If the insurance company isn’t doing right by you, you should have another choice.” (Stein, 4/29)

That Biden is stopping short of Sanders’s plan is not surprising given that the former vice president is expected to run in a more moderate lane than Sanders’s progressive approach. The move, though, could still open Biden up to disappointment from some Medicare for All supporters in the primary. Biden’s position is similar to that of fellow candidates such as former Rep. Beto O’Rourke (D-Texas) and South Bend, Ind., Mayor Pete Buttigieg (D), who has called for "Medicare for all who want it." (Sullivan, 4/29)

Speaker Nancy Pelosi is guiding House Democrats along a narrow path as she seeks to convince party progressives that the idea of providing Medicare for everyone in the U.S. is being taken seriously, while assuring moderates that the House won’t move too far, too fast. The House on Tuesday will gavel in the first-ever hearing on a sweeping Medicare for All proposal, an idea that’s energized the Democratic left, which is pushing to make it a central part of the 2020 campaigns for the White House and Congress. (Wasson and Ruoff, 4/30)

Through Medicare, the U.S. health-insurance program created in 1965 to help older Americans afford their medical bills, the government helps 1-in-5 citizens pay for doctor visits, blood tests, prescription drugs, stays in hospitals or nursing facilities, and hospice care. Why not offer those benefits to everybody? “Medicare for All” has emerged as a rallying cry among potential challengers to President Donald Trump’s 2020 re-election bid, though it means different things to different people. (Tozzi and Parnass, 4/29)

Three and a half years after then-Gov. Peter Shumlin of Vermont signed into law a vision for the nation’s first single-payer health system, his small team was still struggling to find a way to pay for it. With a deadline bearing down, they worked through a frozen, mid-December weekend, trying one computer model Friday night, another Saturday night, yet another Sunday morning. If they kept going, the governor asked his exhausted team on Monday, could they arrive at a tax plan that would be politically palatable? No, they told him. They could not. (Goldstein, 4/29)

A crowd of roughly 200 progressive protestors planted themselves on the ground in the middle of a normally bumper-to-bumper four-lane corridor here Monday with a firm message for the drug industry: get out of our way. The crowd wasn’t there — in front of the trade association PhRMA’s headquarters — to protest a specific drug’s price spike or an unsafe drug. Instead, they were seated in solidarity with the speaker at the front of the crowd: Ady Barkan, a 34-year old activist with ALS confined to a wheelchair. (Florko, 4/29)

When she ponders U.S. healthcare, Democratic Rep. Debbie Dingell thinks about how the automakers of her native Detroit had to become "healthcare providers who happened to make cars." She thinks a lot about employer insurance, the unwieldy bedrock of the American system. She knows all about it from her decades of working for the Michigan auto industry and—most recently—from navigating hospitals during late husband and legendary congressman John Dingell's illness. (Luthi, 4/29)