Races to Watch: Medicare for All Becomes a Defining Issue for Democrats

October 26, 2018

With the majority of Democrats running for U.S. House seats supporting some type of single-payer health care system, the issue could become supercharged in the next Congress.

225 Democratic House candidates support single payer, according to a recent survey by National Nurses United.  

Surprising alliances:  More than half of registered Republicans support providing Medicare to all Americans, per a poll published this week.  How Republicans and Independents embrace the idea of moving closer to a single-payer system could be a deciding factor in many races.  

The leading single-payer bill, the Medicare for All Act, would essentially outlaw employer-sponsored plans as well as private ones.  Senator Bernie Sanders’ (I-VT) bill states that "no employee benefit plan may provide benefits that duplicate payment for any items or services for which payment may be made under Medicare."  The bill has 123 cosponsors, up from 49 in 2015.

However, opinions differ on the best way to achieve universal health care.  Sen. Sanders does not hold a trademark on "Medicare for All" and there are a number of different plans circulating, such as the Center for American Progress' “Medicare Extra for All” proposal, which would allow employer-sponsored insurance to continue and would give employers and employees the choice to buy into the Medicare program.

Major federal changes are unlikely in the short term because President Trump would surely veto any leftward-moving legislation.  But Democratic leaders have a longer-term strategy in mind to build support for some form of a single-payer health care system and propel a progressive candidate into the White House in 2020. 

In the states, a different story:  State-led single payer proposals are making noise.  For example, during his primary campaign, Gavin Newsom, the Democratic frontrunner to be California’s next governor, was a vocal supporter of SB562, which would implement a single-payer system in the nation’s largest state.  However, since winning the Democratic primary, he has become quieter on the issue.