‘Exact Details’
“There have been many estimates about what the cost would be and many different payment streams,” Warren told reporters on her most recent trip to Iowa. “I’ve been working on how to give the exact details to make that work.”

Warren is in second place to Biden in the RealClearPolitics average of national Democratic primary polls for 2020. She leads narrowly in Iowa and New Hampshire, which hold the first two nominating contests.

The release of her plan comes on the eve of the Iowa Democratic Party Liberty and Justice Celebration, a longstanding tradition in the first-in-the-nation nominating contest that’s well-attended by presidential hopefuls. The timing is aimed at preventing an onslaught of attacks at the Iowa event, though her rivals are sure to debate the numbers.

Health-care policy always forces politically thorny trade-offs, but the give-and-take with Medicare for All is breathtaking in its scope. The Sanders-Warren plan would end private coverage for the roughly 150 million people who now get insurance through an employer, and put all those Americans into Medicare over four years, letting them see their doctor or hospital of choice. And Warren hopes it will finally achieve universal coverage.

Industry Blowback
It’s certain to face ferocious opposition from a health-care industry that’s proven adept at blocking major legislation it doesn’t like.

And even if Democrats win the White House, keep control of the House of Representatives, and win a Senate majority in 2020, Medicare for All is still unlikely to pass. It faces strong resistance from many Democrats in both chambers. It’s a nonstarter for Republicans, who, after suffering political blowback for trying to repeal Obamacare, are salivating at the notion of campaigning against a disruptive liberal proposal.

Moderate Democrats believe suburban voters and union workers don’t want to give up their private health insurance, although Warren has tried to reframe the issue. At a Democratic debate in September she said that although Americans may like their doctors, nurses and other health providers, “I have never met anyone who likes their health insurance company.”

The proposal represents a new approach to governing embodied by Warren -- and Sanders. By proposing an extremely aggressive plan at the outset, they believe they can shift the debate and nudge the final bill by Congress in a more progressive direction than they’d get if they began with a compromise position that could become law.

Citing Obama
In her medium.com post, Warren said that “there’s a reason former President Barack Obama has called Medicare for All a good idea” -- potentially previewing a line of attack on Biden, Obama’s vice president, who’s hugged the popular Democrat closely during his campaign. “There’s a reason the American people support it.”

Warren is calling to double her wealth tax on billionaires, so they’d owe 6% on their accumulated wealth more than $1 billion. She’d previously proposed a 3% tax on assets more than $1 billion. A 2% tax would still kick in on fortunes worth more than $50 million.