Opinion writer

Several of the Democratic presidential candidates, including Sens. Bernie Sanders (I-Vt.), Kamala D. Harris (D-Calif.) and Elizabeth Warren (D-Mass.), have supported Medicare-for-all, which essentially would abolish private health insurance, including employer-provided health-care coverage. They might want think twice about such a plan’s popularity — once voters figure out what it is.

The Kaiser Family Foundation’s latest poll finds that voters really don’t understand how their coverage would change. “For example, majorities say people would continue to pay deductibles and co-pays (69 percent) and continue to pay premiums (54 percent) under a Medicare-for-all plan. Likewise, majorities say people with employer-sponsored or self-purchased insurance would be able to keep their plans (55 percent each) under a Medicare-for-all plan.” Neither is correct.

Moreover, “In focus groups, many participants expressed skepticism about the idea that private insurance companies would cease to exist under a Medicare-for-all plan. Some thought these companies were just too powerful, and others thought they would continue to exist for people who want to buy extra coverage beyond what a national plan would offer.” Previous polling shows that support for Medicare-for-all plummets when voters find out they don’t get to keep their plan.

And even within the Democratic Party, enthusiasm for Medicare-for-all isn’t uniform. “One-fourth of liberal Democrats and Democratic-leaning independents (23 percent) offer implementing a single-payer or Medicare-for-all system when asked what health care issue they want to hear the candidates discuss, making it among the top health care issues offered by this group along with increasing access (27 percent) and lowering the amount people pay for health care (24 percent)." However: “Among moderate Democrats and Democratic-leaning independents, more than three times as many offer lowering the amount people pay for health care (34 percent) than implementing a Medicare-for-all system (9 percent).”

What candidates are talking about in the Medicare-for-all vs. public option discussion isn’t necessarily what voters care about. Health care is certainly a very important issue for most Democrats (with 87 percent saying it is), more than other issues, such as gun policy (72 percent) and immigration (66 percent). But the largest share of respondents care more about cost, not coverage. Affordability emerges as a top issue, with nearly 3 in 10 Democrats and Democratic-leaning independents mentioning lowering the amount people pay for health care (28 percent). A further 8 percent mention lowering the cost of prescription drugs. Access to health care is key for only 18 percent, and implementing a single-payer system draws only 15 percent.

When it comes to the Affordable Care Act, “Nearly half of the public (46 percent) hold favorable opinions of the ACA while four in ten hold a negative opinion of the law. Across partisans, nearly eight in ten Democrats (79 percent) have a favorable view of the ACA compared to nearly half of independents (47 percent), and about one-sixth of Republicans (16 percent).”

The takeaway from this is that Medicare-for-all support will run into the false premise that people would get to keep their plans. (About two-thirds of Democrats have this misconception.) Furthermore, Democrats would be wise to talk less about covering everyone and more about reducing costs for coverage and for prescription drugs specifically. (Sen. Amy Klobuchar, for example, talks regularly about the latter.) Candidates who want to gain broad support within the Democratic Party, avoid a backlash from independents and Republicans and dodge the “socialist” slam would be wise to steer clear of Medicare-for-all. Politically speaking, there is little upside and a whole lot of downside.

Read more:

John Delaney: Medicare-for-all is political suicide for Democrats

The Post’s View: No matter what Sanders says, there’s no Medicare-for-all without tradeoffs

Megan McArdle: Sorry, Bernie, but most Americans like their health insurance the way it is

Paul Waldman: The campaign to destroy Medicare-for-all has already begun

The Post’s View: The cosmically huge ‘if’ of Medicare for all