Photo Illustration: Sarah Grillo. Photos: David McNew/Getty Images, Drew Angerer/Getty Images, Ethan Miller/Getty Images, and Zach Gibson/Getty Images

The way the Democratic candidates talk about "Medicare for All" has shifted and sharpened over the course of the campaign — and Medicare for All has gotten less popular in the process.

The state of play: When Sen. Bernie Sanders introduced his "Medicare for All" bill in 2017, all of his likely 2020 rivals in the Senate signed on as cosponsors, and many Democrats treated Medicare for All as a catch-all or a loosely defined goal.

What they're saying:

  • Sanders hasn't changed at all. He has tweaked the details of what his plan covers, but still makes the same forceful case for a national plan with no copays, deductibles, premiums or coverage limitations — paid for by tax increases.
  • Sen. Elizabeth Warren still backs Sanders' version of the national health plan, but has said she would pursue a public option first, then a full-scale single-payer program later.
  • Pete Buttigieg has long supported a public option, not Medicare for All, though his criticism of single-payer has gotten more aggressive as he (and Warren) have climbed in the polls.
  • Joe Biden also has a clear position on Medicare for All: He's against it. He, too, prefers a public option. "The party's not there. The party's not there at all," he told "Axios on HBO."

Why it matters: This is the defining debate of the Democratic primary — and it's a fight that Sanders and Biden, at least, are eager to have.

Yes, but: The powerful health care industry, particularly hospitals, opposes a public option almost as fiercely as it opposes single-payer, and would fight it just as hard in Congress, with just as much help from Republicans.

  • Democrats are divided over what to fight for, but it would be a fight no matter what.

Go deeper:

Go deeper

Updated Sep 18, 2020 - Axios Events

Watch: What's at stake in the 2020 election

On Friday September 18, Axios' Margaret Talev hosted a conversation on the 2020 election, exploring the Trump and Biden administrations' positions on everything from health care to economics to the coronavirus response, featuring Rep. Ro Khanna and Rep. Susan Brooks.

Rep. Khanna discussed how the government response to coronavirus has affected Americans' attitudes towards health care, and the possible ramifications on the 2020 election.

  • How COVID-19 has shifted Americans' perspectives on the health care system: "Even middle class, upper middle class professionals who have lost their jobs or are without health insurance are now seeing how costly and how cruel the private insurance system can be."
  • On the long-term policy impact of the coronavirus response: "Because there is a greater shared understanding about the vulnerability of people who lose their jobs, the vulnerability of people who don't have health care — I think that's created the groundswell for support for Medicare for All."

Rep. Brooks discussed how coronavirus exposed the limitations of the national stockpile and need for reinvestment in the Paycheck Protection Program.

  • On the strategic national stockpile: "What we've learned with the strategic national stockpile is that we're really not adequately supplied for a very long incident or episode of a pandemic...Besides the fact that Congress had been beefing up the appropriations for preparedness, it certainly was not enough."
  • On strengthening the economy: "We need to replenish the Paycheck Protection Program to keep people employed. We had the lowest unemployment before this pandemic hit — 3.6% I believe — and then we soared into unprecedented numbers...We've got to do what we can to get people back into that workforce."

Axios co-founder and CEO Jim VandeHei hosted a View from the Top segment with filmmaker of FRONTLINE's The Choice 2020: Trump vs. Biden Michael Kirk, who discussed making a documentary during the pandemic and the impact of pivotal life experiences on both presidential candidates.

  • On the structure of the documentary: "[It's] eight different crisis moments in the lives of these two guys, and we try to reveal something surprising about what they gathered along the way...What is the man carrying with him, as part of his life methodology, as a result of these moments?"

Thank you PBS and FRONTLINE for sponsoring this event. The Choice 2020: Trump vs. Biden airs Tuesday, September 22 on PBS.

Biden campaign plans travel around competitive Senate races

Joe Biden elbow-bumping a worker during a campaign stop in Wisconsin. Photo: JIM WATSON/AFP via Getty Images

Joe Biden's campaign is storming states with competitive Senate races this week to help boost Democratic candidates in the run-up to the election.

Why it matters: Supreme Court Justice Ruth Bader Ginsburg's death is galvanizing Democrats to fight harder for control of the Senate with less than two months before Election Day.

Caitlin Owens, author of Vitals
Sep 22, 2020 - Health

Before Ruth Bader Ginsburg died, 2020 wasn't much of a health care election

Data: NPR/PBS NewsHour/Marist poll; Note: ±3.8% margin of error; Chart: Axios Visuals

Health care wasn't the top issue heading into the 2020 election — and then Ruth Bader Ginsburg died.

Between the lines: This poll was conducted in the days before her death, which has significantly increased the threat to the Affordable Care Act and thus the threat to the law's pre-existing conditions protections.

Get Axios AM in your inbox

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Subscription failed
Thank you for subscribing!