Published 4:25 PM EDT Oct 23, 2018
WASHINGTON – Democratic candidates for the House are backing a Medicare for all approach to the nation’s health care system in just over half the races in which a Democrat is on the ballot, according to a new survey provided first to USA TODAY.
The tally by National Nurses United, which supports a government-run, single-payer system, shows how the idea has risen in popularity even as Republicans attack the plan as socialized medicine.
"This is historic," said Ken Zinn, the group's political director. "The campaign has really picked up steam."
But polls show the public is still fuzzy on the details of “Medicare for all,” and support drops when they’re given more information. The nonpartisan Kaiser Family Foundation defines the program as one that would replace virtually all other sources of private health coverage and most public programs.
“When you talk about policy details, that whole discussion is something different,” said Mollyann Brodie, senior vice president of public opinion and survey research at Kaiser Family Foundation. “And we don’t know entirely how things will play out.”
Plus, Democrats will need to win a lot of races where they’re the underdog to substantially increase the number of House members backing the plan. Just under two-thirds of the 193 Democrats in the House are already co-sponsors of a Medicare for all bill.
House Minority Leader Nancy Pelosi, who is not a co-sponsor, said in June that Medicare for all will be one of the proposals considered if Democrats take the House. But, noting that she has always been for a “public option,” Pelosi said all proposals would “have to be evaluated in terms of the access that they give, the affordability of it and how we pay for it.”
“It’s all on the table,” she said.
Democrats have made health care one of their top campaign issues this cycle after many Republicans voted for failed legislation last year that would have removed millions of Americans from the rolls of the insured. Many are pledging to fix the flaws in Obamacare while targeting GOP attempts to “sabotage” it. But Republicans in battleground districts are trying to tie Democrats to Medicare for all, even in some cases where the candidates say they don't support the approach.
“Voters have and will continue to reject a complete government takeover of the health care system," said Jesse Hunt, national press secretary at the National Republican Congressional Committee.
In an op-ed for USA TODAY, President Donald Trump ripped apart Medicare for all as “just the beginning” of a socialist agenda for Democrats. He said the program would cost an “astonishing” $32.6 trillion during its first 10 years, a reference to a study by the Mercatus Center of George Mason University of a health care plan proposed by Sen. Bernie Sanders, I-Vt., a 2016 Democratic presidential candidate who may run in 2020.
Politifact found that Americans in the aggregate would pay more to the government to fund health care but less overall than they pay now. The fact-checking site also noted the study forecast that total health care spending would drop by about $2 trillion over 10 years.
Sanders, in an interview with USA TODAY, said the president is “a pathological liar” who can’t be trusted.
“This is a president who, by sabotaging the Affordable Care Act, has driven premiums up in many parts of the country,” he said. “So when he talks about my bill – Medicare for all – people, I think, should be highly dubious about what he says.”
Medicare for all is one of the top issues at the heart of a divide between its progressive advocates and centrist Democrats who say the proposal is a political loser and who would rather focus on shoring up the Affordable Care Act.
The division played out in the red state of Indiana last week with two Democratic candidates campaigning on opposite sides of the issue. While 9th district congressional candidate Liz Watson campaigned with Sanders in favor of it, Democratic Sen. Joe Donnelly cut an ad saying “socialists” will turn health care over to the government “over my dead body.”
Tracking polls from the Kaiser Family Foundation show a modest increase in support for the idea of a national health plan since Sanders made it part of his rallying cry during the 2016 presidential campaign.
About 6 in 10 adults favor a national health plan or Medicare for all system. Less than half did a decade ago.
Progressives say they have polling on their side.
“This is a solution that resonates with the American people,” said Zinn, with National Nurses United. “But it is also a reflection of the absolute crisis that so many are facing (with health care).”
But the surveys also show that support erodes when people hear the arguments that the plan could increase taxes or government control. And nearly half of adults surveyed last October falsely assumed they could keep their current insurance under a single-payer plan.
“The notion that it’s popular is premised upon people knowing almost nothing about it,” said Matt Bennett, co-founder of the centrist Democratic think tank Third Way. “That’s a problem for a very complicated thing that would transform one-fifth of our entire economy.”
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In the National Nurses United survey, candidates were not counted in support of Medicare for all if they merely said they were open to considering the idea or that they support "universal health care," which may still include private insurers. They also were not included if they backed a scaled-back version, such as expanding Medicare to those over 49 or allowing it as a “public option” that would still have to compete against private plans.
By that definition, the group found Democratic candidates supporting Medicare for all in 223 of the 431 House contests in which a Democratic candidate is running. But Republicans are likely to win 79 of those races, according to the nonpartisan Cook Political Report. Democrats are expected to win 127. The remaining 17 are highly competitive.
There are 123 co-sponsors of the pending Medicare for all legislation in the House. In July, Democrats in July launched a Medicare for all congressional caucus with 70 founding members.
But even caucus members like New Jersey Rep. Bonnie Watson Coleman say the process for achieving such a program may be gradual, such as first allowing Medicare as an option.
"I don’t know who’s actually running on just Medicare for all as the be-all end-all," Watson Coleman told the USA TODAY Network. "Even if we are pursuing it, it may be a bit of a journey to get there."
Bennett said a single-payer health care system certainly won’t happen while Trump is president, and it’s unlikely that a Democratic president would attempt such “a radical transformation” of the system.
In the Senate, however, Sanders’ bill has 16 Democratic co-sponsors, including other potential 2020 presidential candidates: Sens. Elizabeth Warren of Massachusetts, Kirsten Gillibrand of New York, Kamala Harris of California and Cory Booker of New Jersey.
“That’s not a coincidence,” Zinn said. “They understand that to be viable in a Democratic primary, they have to be on the right side of this issue.”
Contributing: Herb Jackson, USA TODAY Network