Those who are buying into Sanders and Warren’s story on this should be aware the two are selling something that is bad politics for Democrats…
…from Sabato’s Crystal Ball….
— “Medicare for All” has been a major issue in the Democratic primary race. But it also came up a lot in the 2018 cycle.
— A regression analysis comparing the performance of 2018 Democratic House candidates shows that those who supported Medicare for All performed worse than those who did not, even when controlling for other factors.
— Democratic presidential candidates would do well to take heed of these results, particularly as the eventual nominee determines what he or she wishes to emphasize in the general election.
Medicare for All: A warning from 2018
“Medicare for All” has emerged as a key issue in the 2020 Democratic presidential nomination campaign. Two of the leading candidates, Sens. Bernie Sanders (I-VT) and Elizabeth Warren (D-MA), have made Medicare for All a central issue in their campaigns. Warren’s and Sanders’ proposals would abolish private health insurance in the U.S. within a few years and move all Americans into a government health plan based on the current Medicare program but with no copayments or deductibles.
Several Democratic candidates, including former Vice President Joe Biden, who has led in most national polls, have been highly critical of this idea. These candidates, along with a number of health policy experts and pundits, have attacked Sanders’ and Warren’s Medicare for All proposal as prohibitively expensive and politically unrealistic. They have also argued that embracing Medicare for All would alienate many independents and moderate Democrats and risk costing Democrats the electoral votes of several key swing states.
But 2020 is not the first election in which Medicare for All was an important campaign issue. It was also debated extensively during the 2018 midterm elections. By examining the impact of Medicare for All on the results of the 2018 U.S. House elections, we may gain some insights into how this issue could affect the 2020 presidential election.
Fortunately, we have very good information about the positions taken by Democratic House candidates on Medicare for All based on their responses to a survey conducted by a group advocating for this policy, National Nurses United. According to the results of this survey, 51% (219 of 429 districts included in the survey) of Democratic House candidates endorsed a version of Medicare for All supported by NNU — one that is fairly close to that proposed by Sanders and Warren.
Table 1: Support for Medicare for All among Democratic House candidates by district partisanship
Source: Survey of Democratic House candidates by National Nurses United and data compiled by author.
Not surprisingly, support for Medicare for All was most prevalent among Democratic candidates running in safe Democratic districts. As the data in Table 1 show, fully 73% of Democratic candidates in districts that Hillary Clinton won by a margin of at least 20 points supported Medicare for All. However, the data in Table 1 show that the lowest level of support for Medicare for All was not in strongly Republican districts but in districts that leaned Republican — those that voted narrowly for Donald Trump in 2016. These findings suggest that Democratic candidates were least likely to support Medicare for All in marginally Republican districts where it could reduce their chances of winning.
Table 2: Outcomes of House elections by candidate position on Medicare for All for Democratic challengers and open seat candidates in competitive districts
The evidence in Table 2 suggests that Democrats in marginal House districts were right to be concerned about the potential impact of Medicare for All on their electoral prospects…
These results should also been seen as a confirmation of the Democratic establishment’s unease with progressive ‘dreamers’ Sanders and Warren healthcare and other plans…
This also has significance for House Democrats in marginally safe Democratic districts , whose recent wins have allowed Democrats to regain a majority in the House….