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Why 2020 Democrats are backing off Medicare-for-all, in four charts

Sen. Kamala D. Harris (D-Calif.) has changed her health care position no fewer than three times since becoming a 2020 Democratic presidential candidate. (Video: JM Rieger/The Washington Post, Photo: Salwan Georges/The Washington Post)
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A notable number of the 2020 presidential candidates (save Sen. Bernie Sanders) who endorsed Medicare-for-all are starting to say it’s a long-term ambition rather than a practical policy proposal they would enact when in the White House.

“I finally was like, ‘I can’t make this circle fit into a square,’ ” said Sen. Kamala D. Harris (D-Calif.), who is one of the five senators running for president who endorsed Sanders’s Medicare-for-all bill in the Senate. (Sanders is one of the five.) The Washington Post’s Chelsea Janes and Michael Scherer reported more on how she and others are now backing away from the idea.

Polls show why they’re doing this. On the surface, the idea sounds as if it would appeal to voters: Significantly cheaper health-care costs. No battling with insurance companies over coverage. No more high deductibles.

Here’s how all Americans and Democrats, respectively, felt about the idea when asked in a Post-ABC News poll in July whether they prefer a universal health-care system to the current one. A majority would opt for Medicare-for-all:

But notice how support declines when people are told that such a program would require getting rid of private insurance. A majority of Democrats still said they support Medicare-for-all if it would mean no private option available, but not a majority of Americans.

That question didn’t even dig into the potentially politically troublesome detail of how such a plan would be implemented. Providing health care for all Americans would cost billions of dollars, so taxes on the middle class would go up.

A January Kaiser Health News poll shows a majority of Americans, 60 percent, flat-out opposed Medicare-for-all if that were the case.

At the past two presidential debates, Sanders (I-Vt.) was the only candidate to clearly and explicitly acknowledge that the plan would require raising taxes. He argued that Americans’ costs overall would go down because they wouldn’t be paying high deductibles or much in out-of-pocket costs. (A detailed New York Times analysis found that some people would end up paying less overall but that others might end up paying more.)

The other candidates seem to find it politically untenable to simply say, yes, voters’ taxes would go up, and then explain why.

Democrats' intense Medicare-for-all debate, paraphrased

Then there’s the socialism aspect of this. Most Americans would rather vote for an atheist or Muslim than a socialist. Sanders is the only presidential candidate running who embraces the s-word — he calls himself a democratic socialist. But his Medicare-for-all plan is Exhibit A of how he would try to create a socialist-style political revolution that he says would even the playing field for all Americans, and a number of his 2020 competitors had supported it.

The legislative fights shaping the 2020 election

Other polls show that Democratic voters are hesitant about the idea of creating such a big government program. A July CBS News-YouGov poll in Iowa found that, of Democrats in the first-nominating state, they would prefer a mixed option rather than creating an entirely new health-care system run by the government.

Nationally, the feeling is the same. A July NPR-PBS NewsHour-Marist poll found that, by a broad margin, Americans support having the option to choose government health care rather than having a government program for everyone’s health insurance.

The candidates are also probably very aware that the consistent leader in the polls, former vice president Joe Biden, doesn’t support a Medicare-for-all plan.

“I understand the appeal of Medicare-for-all, but folks supporting it should be clear that it means getting rid of Obamacare, and I’m not for that,” Biden said in a video.

These numbers show that even among Democrats’ base, Medicare-for-all supporters have some selling to do. And rather than climb that hill, a number of Democratic presidential candidates have just decided not to.

Scott Clement contributed to this report.