Illustration: Sarah Grillo/Axios

The early boom for 2020 Democrats' left turn is yielding to moderate muscle as Elizabeth Warren falls, Joe Biden persists and Pete Buttigieg rises.

  • What's happening: Poll after poll shows voters like the idea of Medicare for All. But the second you tell them about costs and tradeoffs, they turn on it.
  • Why it matters: A harsh spotlight on Warren's specifics collided with Mike Bloomberg's massive spending on a moderate message, as well as rising angst among donors and investors about risks of Warren-Sanders socialism.

Warren collapsed in the latest national Quinnipiac University poll just as she's been diving into the details of how she'd pass Medicare for All — and fending off a barrage of attacks from her more moderate rivals.

  • She's not the only Democrat who's run into trouble. Kamala Harris realized she could be checkmating herself by dismissing private health insurance — which is why she changed her Medicare for All plan to allow private insurers to offer Medicare plans.
  • And in an interview for "Axios on HBO," she told Axios' Margaret Talev she knew there could be a political price to pay for changing her plan — but says she told her team that "we need to do a better plan. This is not good enough."

There's a reason Medicare for All has dominated every health care discussion at every debate, as Axios' David Nather points out: it's a real problem for the liberal candidates. Not just because of the cost, but because not all Americans actually want to dump private health insurance.

  • Even Warren's phase-in plan isn't quieting the critics. As Axios' Caitlin Owens has pointed out, progressives are criticizing her for not being a Medicare for All purist — and experts are skeptical that she could really pass two major reforms within a few years of each other.
  • Now Biden and Buttigieg are firing away at her over whether Americans would really have a choice if they wanted to keep their private health insurance — while Bernie Sanders subtly competes with her by staying a purist.

Sanders, who introduced the Medicare for All Act, has always been candid about his intent to wipe out private health insurance as part of his plan.

  • He hasn't faced as many attacks or struggled with the issue as much as Warren.
  • As a result, he isn't plummeting in the polls. But he hasn't enjoyed Warren's earlier gains, either; Sanders' support has held in the high teens throughout 2019, according to RealClearPolitics, which tracks polling averages.

By the numbers: Medicare for All is a favorite among Democrats who are fed up with private insurance — but it's not a winner with swing voters.

  • Per the Kaiser Family Foundation's Drew Altman, recent polling by Kaiser and the Cook Political Report found that 62% of Democrats in four battleground states — Pennsylvania, Minnesota, Michigan, and Wisconsin — said a Medicare for All plan that eliminates private insurance is a good idea.
  • But 62% of swing voters in those states said it’s a bad idea.

Between the lines: Caitlin notes that since Warren has been on defense on this, the potential appeal of Medicare for All hasn't been discussed as much as its cost and the merits of taking away a private insurance option.

  • So we spend more time debating that rather than what life would be like for Americans if they didn't have any health care costs.
  • In other words, Warren has had to spend a lot of time defending the downsides of Medicare for All (its cost) instead of its upsides (free health care for everyone).

Our thought bubble: 2020 Dems could also be miscalculating the broad appeal of other liberal stands, including free college and decriminalizing border crossings.

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