When Democrats campaigned on health care in the 2018 midterms, it helped win them back the House. And now that more than 20 of them are running for president, they're starting to stake out their positions on how to overhaul the system.
According to, health care is a dominant issue among Democrats in early voting state, particularly when it comes to out-of-pocket costs. However, Democratic candidates disagree on the best approach to address the issue.
One of the most talked about Democratic proposals would establish a new single-payer government-run insurance program as outlined in. Sanders' bill would make private insurance supplemental for those who choose to get it, while aiming to provide a basic level of care for all Americans paid for by taxes. A similar bill by the same name has also been introduced in the House.
However, other candidates have used the phrase Medicare for All while embracing something different than what Sanders is proposing. And other pieces of legislation and proposals touted by some candidates would stop short of creating a national single-payer health care system.
The Choose Medicare Act, for example, establishes public health plans in the individual, small group and large group markets. The Medicare at 50 Act would allow people to buy into the program at age 50 instead of 65, the current age of enrollment. The State Public Option Act would allow residents not already eligible be able to buy into a state Medicaid plan. And Medicare for America would provide a public program for the uninsured, people who purchased insurance on the open market, people on Medicare, Medicaid and CHIP, all while maintaining employer-sponsored insurance.
Here's what the candidates have been saying about health care.
Colorado Sen. Michael Bennet
- In April, Bennet introduced his Medicare-X plan, which would create a public health care plan in areas where options are limited before being expanded.
- "I think the American people have waited long enough for universal health care," said Bennet in May after announcing his bid for president.
- Bennet argues his proposal "creates a true public option" administered by Medicare.
- "Medicare-X starts in rural areas because the market there is failing too many Americans, and by using the existing Medicare framework, it provides a new, affordable option without adding bureaucracy," Bennet said in a statement.
Former Vice President Joe Biden
- Since announcing his run for president, Biden has stated at campaign events that he believes health care should be a right, not a privilege.
- In July, to build on the Affordable Care Act including the addition of a public option to "ensure every American has access to quality coverage."
- During a recent South Carolina campaign stop, Biden said one of the proudest moments of his career was passing the Affordable Care Act with President Barack Obama.
- Biden also argues corporations should not be let off the hook for providing insurance to employees.
New Jersey Sen. Cory Booker
- On April 1st, Booker tweeted "I support Medicare for all."
- He is a co-sponsor of Sanders' Medicare for All Act, the Medicare at 50 Act, the State Public Option Act and the Choose Medicare Act.
- Booker has argued on the trail that the best way to improve coverage would be to have Medicare for All but suggests there needs to be a practical pathway to get to universal health care.
- During the AARP/Des Moines Register Forum in July, Booker said the steps he would take toward his goal would be having a "robust public option."
Montana Gov. Steve Bullock
- Bullock is vowing to make Medicaid expansion a "cornerstone" of his campaign.
- On the same day he launched his bid, Bullock tweeted, "If we can get real progressive achievements like Medicaid expansion done in Montana, we can do it anywhere."
- In May, Bullock signed a package bills in Montana including reauthorizing Medicaid expansion and a program to lower insurance premiums.
- At a July campaign stop in Iowa, Bullock said he would "not be a Medicare for All person."
South Bend Mayor Pete Buttigieg
- "You might call it Medicare for all who want it," said Buttigieg in April about his health care plan.
- His idea is to create a version of Medicare that anybody could buy into.
- Buttigieg has argued the public option would be preferred and could "very naturally becomes a kind of glide-path toward a Medicare for All environment."
- He has said on the campaign trail he would not eliminate private insurance but suggested it would be crowded out by a public option.
Former HUD Secretary Julian Castro
- Castro said in April that he believes people who want to have their own private health insurance plan should be able to buy it.
- In July, Castro said the U.S. should base its system off strengthening Medicare and then expanding it to anyone who wants it.
- Castro argues the move to Medicare for All won't be easy to accomplish but no person should be without health care when they need it.
New York City Mayor Bill de Blasio
- De Blasio said in his campaign launch video he believes health care is a human right that has to be available for all and affordable.
- In July, de Blasio told CBS News there has to be the creation of an entirely different health care system.
- At the first Democratic presidential debate, de Blasio was one of two candidates on night one to raise their hands in support of eliminating private insurance.
Former Maryland Rep. John Delaney
- Delaney proposed creating a new public health care plan for all Americans under age 65 that would also encompass Medicaid.
- Medicare would stay in its current form, and people would also be allowed to buy private insurance.
- Delaney opposes the Medicare for All approach, saying it may sound good but is "bad policy."
Hawaii Rep. Tulsi Gabbard
- "I support Medicare for All," said Gabbard when asked about the issue in March. "It is unacceptable in our country we pay far more for health care than many countries and yet have worse outcomes."
- Gabbard is one of 108 co-sponsors of the Medicare for All Act introduced in the House.
- In July, she clarified veterans would continue getting their primary care through the VA system under Medicare for All but argued if it is not working, they should be able to get care through a local clinic or provider.
New York Sen. Kirsten Gillibrand
- Gillibrand is a co-sponsor of the Medicare for All Act but suggests getting to universal coverage could take time.
- "I believe, as I think most Americans do, that health care should be a right, not a privilege, and that means you have to fight for universal coverage that's affordable and quality for everybody," said Gillibrand during a town hall in March.
- Gillibrand has suggested that having a not-for-profit public option competing for businesses would eventually lead to single-payer coverage because most Americans would choose the public option.
- In July, Gillibrand argued Medicare does need some "fixes" including dental and vision coverage.
- She is also a co-sponsor of the Choose Medicare Act.
California Sen. Kamala Harris
- "Nobody should have to worry about paying a medical bill to stay alive. Health care should be a right. It's why I support Medicare-for-All," Harris tweeted in May. She is a co-sponsor of Sanders' Medicare for All Act.
- In January, Harris said she wanted to eliminate private insurance. She later clarified that she wanted to get rid of the "waste" and "bureaucracy" in private insurance, but about her position on health insurance in interviews.
- In May, Harris stated she would be against any policy that would deny a person health care because of their citizenship status.
- Harris has also co-sponsored the Choose Medicare Act, the Medicare at 50 Act and the State Public Option Act.
Former Colorado Gov. John Hickenlooper
- Hickenlooper is advocating for a plan where people can keep their private insurance if they want, but they can also opt for a public option similar to Medicare.
- Hickenlooper wrote a Wall Street Journal op-ed in May in which he argued against shifting to a government-run health care system, claiming a majority of people are "satisfied with the coverage they have."
- On the campaign trail, Hickenlooper argues expanding a public option would help create competition in rural areas.
Washington Gov. Jay Inslee
- Inslee announced on CBS This Morning that he was in favor of "Medicare for those who want it."
- Inslee has touted health care options being developed in his state and argues he can replicate them on a national scale.
- A Washington law signed by Inslee in May directed state officials to work on expanding subsidies for private insurance and required private insurers to start offering standardized plans on the state exchange.
Minnesota Sen. Amy Klobuchar
- Klobuchar says she supports universal health care coverage but stopped short of backing Medicare for All.
- On the campaign trail, Klobuchar has argued for building on the Affordable Care Act including the addition of a public option.
- Klobuchar has also argued for expanding Medicare and Medicaid. In a December interview with Face the Nation, she suggested lowering the eligibility age for Medicare to 55.
- She co-sponsored Medicare at 50 and the State Public Option Act.
Massachusetts Rep. Seth Moulton
- In May, Moulton told CBSN he was concerned with plans that would force everybody onto Medicare when some people want to keep their private insurance.
- The military veteran is advocating for new competition to bring down costs.
- He is suggesting a public option like Medicare along with the private options people already have.
Former Texas Rep. Beto O'Rourke
- "For health care, I like Medicare for America, where you can buy into Medicare," O'Rourke said during an Iowa town hall in April.
- O'Rourke has said on several occasions that a person who likes their coverage should be able to keep it.
- While he's not backing the Medicare for All bills, he is campaigning on a promise to implement high-quality, universal coverage.
Ohio Rep. Tim Ryan
- Ryan is a co-sponsor of the House Medicare for All Act, which as written, would not allow private insurance to compete with the public option, but during the first presidential debate, Ryan did not raise his hand in support of abolishing private insurance.
- He is also a co-sponsor of the Medicare for America Act.
- Ryan has argued the next step is to bring the Medicare eligibility age down to 50 or 55.
- He has also said companies that have 50 employees or less should be able to buy into the Medicare system.
Vermont Sen. Bernie Sanders
- Sanders reintroduced his Medicare for All Act in April.
- His single-payer proposal would establish a new government-run national health insurance program.
- Private insurance companies would only provide supplemental coverage for cosmetic procedures.
Former Pennsylvania Rep. Joe Sestak
- Sestak advocates for a public option on the campaign trail and has even suggested there should be several public options so people can choose which one they want.
- In a July meeting with the Des Moines Register editorial board, Sestak suggested the public option could serve as a pathway to single-payer insurance.
- He also argues the VA could serve as a model for a single-payer system.
- Sestak says he is not against Medicare for All but opposes the two to four year transition periods as outlined in the current bills.
- "Every American has a right to health care," Steyer said in July on the campaign trail in South Carolina.
- On his campaign website, the Democratic billionaire states the government needs to act to protect the "foundations of our health."
- On the campaign trail, Steyer has suggested he is open to examining multiple systems to improve health care in the United States.
Massachusetts Sen. Elizabeth Warren
- Warren is a co-sponsor of the Medicare for All Act, but when asked about health care at a town hall in March, she stressed there were multiple ways to lower costs and expand coverage.
- She has also pointed out that she is a co-sponsor of other bills including the State Public Option Act.
- During the first Democratic presidential debate, Warren raised her hand in support of eliminating private insurance.
Author and activist Marianne Williamson
- Williamson says she supports Medicare for All as a public option, but that people should be able to keep private insurance.
- Williamson also argues that the current system is more of a "sickness care" system than a health care system.
- At a town hall in April, the presidential hopeful said any approach needs to be part of a larger conversation about how to create "greater health from the beginning."
Businessman Andrew Yang
- Yang argues the Affordable Care Act is a good first step.
- Yang's website suggests the path to universal coverage could be though expanding Medicare to everyone or by creating a new health care system.
- He has also advocated for more "holistic approaches" to medical care.