Almost 15 percent of workers in Nevada belong to labor unions, making the organizations prominent in state politics. The Nevada Culinary Workers Union, one of the most powerful forces, has 60,000 members — over half of them Latino — and represents most hospitality workers on the Las Vegas Strip.
Health care is the union's greatest concern going into the presidential election and the.
Nevada has one of the worst health care systems in the country, according to a recent report by the Commonwealth Fund. The state was ranked last in the nation for prevention and treatment, and second to last for access and affordability.
The Culinary Workers Union, however, has its own health care system that many members worry could be threatened by. The union has distributed flyers warning that Medicare for All plans would threaten members' current coverage.
"Every human being needs and deserve to have better health care. … But at the same time we believe in choices," said Geoconda Arguello-Kline, who has been in the Culinary Workers Union for 36 years and is secretary-treasurer. "We feel very important to keep our own health care because we have the best health care in Nevada."
Employers pay into the culinary union's health fund, which supports its own private health center for members and their 70,000 dependents.
Union member Lino Paredes, who works at Caesar's Palace, is voting for the first time.
"I just had a baby. My wife just had a c-section and you guys know how expensive that is, right? I didn't have to worry much because I knew I was covered by my insurance," he said.
The concern, however, has created conflicting views on health care among the state's union members.
Yarleny Roa-Dugan, a 31-year-old mother, immigrant and nurse, said she supports Bernie Sanders and Elizabeth Warren. She told CBS News contributor Maria Elena Salinas that, as a voter, one of her main concerns is health care, and that she supports Medicare for All.
"I think most of us can agree that even if you have health insurance, the costs make it very difficult," Roa-Dugan said.
"As a labor and delivery nurse, I see women that come in without any prenatal care … we can see issues with the babies that we otherwise would have been able to fix or prevent … It's very hard."
Roa-Dugan's union, which represents health care and public service employees, will also play a role in Nevada's caucuses.
About 137 million Americans faced financial hardship last year because of medical costs, according to the Journal of General Internal Medicine. High health care bills are the No. 1 reason people take money out of their retirement accounts or file for bankruptcy.
All the Democratic presidential candidates have visited Nevada's culinary union to share their platforms.
Some have seized on the Culinary Workers Union's concern, and promised that the union's health care would not be put in jeopardy under their presidency. Others, like Bernie Sanders, have argued that switching to government health care could help them fight for higher wages.
"Employers save money under our legislation, workers get the difference," Sanders said.
When asked by CBS about the union's fears, Senator Elizabeth Warren said she wants the whole country to have health care as good as the union's system.
"I want to see health care centers like that available not just for the culinary union, I want to see them available all across Nevada and across this country," she said.
Regardless of the outcome this weekend, Roa-Dugan said she's proud to be participating.
"I think every vote counts. So my vote is very important and I am encouraging all my friends and family to vote too," she said.
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