Kara Eastman wasn’t expected to win the Democratic primary in Nebraska’s 2nd District. But Eastman managed to edge out her opponent by almost 3 percentage points, entering the midterm election cycle armed with a policy that has turned into a rallying cry for liberal Democrats: Medicare-for-all.
Former Rep. Brad Ashford outspent her and outraised her going into the primary elections in May. He was also the chosen favorite of the Democratic Congressional Campaign Committee. But Eastman’s campaign on a Medicare-for-all platform helped secure her a victory that will see her face off against Rep. Don Bacon in the swing district this fall.
Including Medicare-for-all as part of their platforms has proven to be a successful strategy for some Democrats in the primaries for competitive House races. The idea energizes liberal Democrats to turn out and vote, but could be a risk in general elections if Democrats in a district are moderate, experts say.
Democrats who have touted some form of Medicare-for-all system have won primaries in places like Pennsylvania and Illinois as well, although their ideas vary. Democratic candidate Gina Ortiz Jones, meanwhile, is touting her support for single-payer in her bid for Texas’s 23rd District seat. Medicare-for-all was also a consideration for voters during Tuesday’s primaries in Orange County, California.
Now the question is whether this would carry these progressive Democrats to victory in November.
In Eastman’s case, she wants to see America’s health care system move toward single-payer, an idea that was further left than Ashford’s campaign proposal to allow people to buy into Medicare.
“We’re spending far too much on health care costs and we’re not getting the results that we need, so it’s just not economically sustainable right now, and so moving towards the Medicare-for-all option seems like the most sustainable model we have,” she said.
How her idea is branded matters. Eastman said that voters generally reacted favorably to Medicare-for-all, but are more skeptical when single-payer is mentioned.
“I think we have to be very clear with our messaging and explain to people that this is not something where they’re going to lose out but actually the majority of people will gain through the system,” she said.
Her Republican opponent, Rep. Don Bacon, said the Medicare-for-all proposal is certain to be an issue in the campaign. Bacon, who had voted for the House Obamacare-repeal bill last year, said that when voters have been asked about Medicare-for-all, the split is fairly even between those who support the idea and those who do not.
“If people know that they are going to lose the health care they like, those numbers go way down,” he said.
“Once you define what this means, the support for Medicare-for-all goes significantly down, so I’m going to have to make this a part of my campaign,” he added.
The issue has become a litmus test for liberal Democrats, said Robert Blendon, professor of health policy and political analysis at Harvard University. “Single-payer is associated with a series of beliefs that says, ‘This candidate is a liberal,’” he said.
In districts where the Democratic voters are generally liberal, a call for Medicare-for-all could motivate voters during midterm election cycles, which typically suffer from poor turnout, Blendon said.
“If I’m in a district where the Democrats and independents rarely ever say that they’re liberal, then it is a risk because you’re putting yourself as right away on the left of your political party,” he said.
Medicare-for-all faced its most recent test in California’s 45th District on Tuesday. Of the four Democrats running, three included Medicare-for-all proposals as part of their platforms. But Dave Min had not entirely signed onto single-payer and instead promoted ideas that he considered more immediate steps, like a buy-in option.
Min told National Journal last week he is not against single-payer, but that his ultimate goal is universal health care coverage. Medicare-for-all is just one pathway to reaching that goal, he said.
“The concern I have is if you get tied down to one approach and it’s something that has trouble getting political traction, you’re fighting over that perfect approach while real people, whether in my district or across the country, are suffering from not having health care coverage,” he said.
A political pathway for a Medicare-for-all idea may be nonexistent right now in Washington. “I think for Democrats who maybe are a little bit on the fence over those ideas, they can rest assured that they are not going to get passed in the next Congress, and even if they passed the next Congress this president is not going to sign them into law,” said John Hudak, deputy director of the Center for Effective Public Management at the Brookings Institution.
“It’s easy, I think, to sign onto something that you know is not going to happen, particularly if it wins you some political support in your party,” he added. “Now that’s not to say all of these Democrats don’t truly believe in these ideas but I think it certainly makes it a little bit easier for them if they do have some questions about the policies in their own mind.”