Medicare for All a Vote Loser in 2018 U.S. House Elections

[brooklynite]

Larry Sabato

— “Medicare for All” has been a major issue in the Democratic primary race. But it also came up a lot in the 2018 cycle.

— A regression analysis comparing the performance of 2018 Democratic House candidates shows that those who supported Medicare for All performed worse than those who did not, even when controlling for other factors.

— Democratic presidential candidates would do well to take heed of these results, particularly as the eventual nominee determines what he or she wishes to emphasize in the general election.

[vsrazdem]

1. Well, since we won a record breaking number of house seats, I'm not worried.

[Demsrule86]

3. Moderates won back the house running on the ACA and /or local issues...so if we run on MFA,you

need to worry. We could lose the house... already we have lost one seat because we forced a great member to resign over sex.

[vsrazdem]

10. Not going to happen.

[Gothmog]

34. Medicare for All is a recipe for a Republican Congress.

Link to tweet

[vsrazdem]

38. Medicare for all in its current form will not be the final product. There will be compromise just

like there was with the original plan for a public option which became the ACA. I would rather start high and go down that start from the bottom.

[Gothmog]

39. And I do not want to lose downballot races due to a plan that was proven to hurt candidates

The study shows that this plan hurt 2018 candidates. Having sanders or Warren on the top of the ticket will kill down ballot candidates. We flipped 12 state house seats and 2 congressional seats in Texas in 2018. We need 9 more state house seats to flip control of the Texas House of Representatives and I am working on two campaigns The DCCC and Texas Democratic Party is targeting 6 congressional districts to flip and MJ Hegar could defeat Cornyn. If these candidates are forced to run an unpopular plan like Medicare for All, we will lose all of these races.

[vsrazdem]

40. Whoever wins the primary will be the one running and that choice is for the American people to

decide, regardless of what their preferred healthcare plan is.

[Gothmog]

43. Coattails and helping downballot candidates are important criterion

Warren or sanders would kill downballot candidates with their unpopular plans

[vsrazdem]

45. Whoever wins, wins. That's how it works, it is about the president of the US, not about

winning local races. State and local races will be selected by state and local issues and what matters to those voters.

[Gothmog]

32. We won those seats with candidates who ran away from Medicare for All

The victories were by candidates like Lizzie Fletcher and Colin Allred who did not campaign on and would not support either Warren's or sanders' plans.

[Gothmog]

59. From Harry Reid

Link to tweet

[evertonfc]

2. It's a loser period

It's one reason why Warren or Sanders will not be President. I actually support a single payer. It's a loser to-do not because of its ability to obviously help people but the way it's articulated. As a voter left of most, it's why I'm supporting Biden.

[Demsrule86]

4. I don't like Medicare...don't get me wrong...glad such a program exist...but there are multiple

flaws in this program. I have been working with my husband's oldest sister who broke her leg in four places. Right now she is languishing in a rehab/nursing home not received PT because her medicare days are up...everyday this goes on makes it more likely she will never come out of this facility. She is otherwise healthy. This opened my eyes. We can do better.

I support universal health care...building on the ACA. We are working to get her on Medicaid but even then the PT will be way less than what is needed to restore her mobility IMHO. I plan to go in and work with her myself as soon as I can get permission but right now all she can do is lay in bed or sit in a wheel chair...she isn't standing much less walking...terrible system.

And she could not afford her meds or wrap if she didn't live with us. Of course,she is family...no rent or anything like that naturally. Many seniors can't afford the premiums, the deductibles or to have a wrap...some own their own homes and can get little help. Some seniors can barely afford to have a place to live and some are homeless...it is a flawed system. We can do better.

[dware]

7. I'm curious,

would universal health care affect my military retirement benefits, ie, my TRICARE?

Thanks.

[Demsrule86]

11. I would like to see universal healthcare modeled on the military program...we have a great program

in Cleveland...shouldn't depend on where you live but it does...my friend receives great care. That being said, don't think soldiers have the same needs as the general population. We have men and women coming home from what I call the oil wars grievously injured. Many would have died in past wars. And some will need care for the rest of their life and we have PTSD...some of these folks have done numerous tours which is risky in terms of mental health...their needs must be met, I believe military care must stay in place. I do think soldiers should have a choice so if you live in an area where there is not great care available (boonies-and such areas should not exist by the way)...you can get the universal care...choice is always a good thing. In the Youngstown area, all non-catholic hospitals have closed. This puts pregnant women at great risk should they miscarry...which is very common and should not be life threatening but it is without timely treatment. The entire system is a mess. People who live in small town or rural areas are at great risk right now with all the hospital closings.

[dware]

12. Thank you for the reply.

I pretty much agree with every thing you posted.

I'm perfectly satisfied with TRICARE, they've been very good to me, hell, my Military Retirement Benefits have been wonderful to me.

[Demsrule86]

15. Don't let anyone take them away...no one in any party...union and military benefits are the best

health care programs available.

[dware]

17. That's exactly why I'm a solid Democrat.

I went to Vietnam a Republican, I came home a dedicated Democrat, and stayed that way throughout my career in the Military, despite the RW bent in the Armed Forces.

[Demsrule86]

18. The GOP have been coming for your benefits for years...But I think MFA is a threat to union

and military benefits too. So that is my two cents. We can have universal without M4A. The military must always have dedicated doctors who understand a soldiers needs...and as for unions, they gave up salary in order to get these benefits. I just don't get why we need to start over and no one has ever explained it in a convincing way. We can make the ACA what we want it to be without starting over.

[dware]

19. +1million.

[thesquanderer]

8. re: "I don't like Medicare...there are multiple flaws in this program."

Remember, MFA does not mean everyone gets what we currently call Medicare... MFA means everyone--including current people on Medicare--get a new, improved Medicare, which also addresses flaws in the current Medicare system, i.e. eliminating most deductibles, copays, "gaps," and currently uncovered but still necessary procedures. So it's not just about covering everyone, it's also about addressing the kinds of flaws you're talking about.

[Demsrule86]

13. Medicare is the model though and it shouldn't be IMHO. I fail to see why it is a good idea to start

from scratch and attempt to put every person on one healthcare plan...a huge undertaking and one fraught with peril, when we can build on the ACA and make it what we want. Lets get coverage to those who need it first and go from there. A public option and beefed up subsidies would get a lot more people insured immediately than a years long attempt at MFA which I believe would fail in the end...I well remember how hard it was to roll out the ACA which was intended to cover those without access to work place insurance, those with pre-existing conditions and kids who are in college or just starting out.

[thesquanderer]

24. Medicare and ACA are BOTH reasonable models to consider.

Building on ACA advantages: Less government involvement (which many people, especially non-Dems, see as an advantage). Lower amount of money the government must bring in to pay for it. Less disruptive to the health care industry. People can kinda keep the private insurance plan they have... though as Obama found out, that's not really a promise anyone can make. Many of us over many years of private insurance have run into times when we have not been able to keep the insurance we had (i.e. because the insurance companies themselves discontinue a plan, or because we change jobs, or because our employer changes the plans available to its employees, or because a premium increase forces us to find another plan)... and ACA does not change any of that... which is why much of the argument about whether people can keep their private plans is kind of bogus, as there is never any assurance that we can really keep our private plans, there never has been. However, there is an advantage with ACA over MFA in that it is *likely* you will be able to keep your current private plan, at least for *some* amount of time, as opposed to definitely phasing it out.

Advantages of MFA: Covers everyone, and covers virtually every healthcare need, neither of which are things that any existing "build on ACA" plan does. Removes the layer of expense which is created by the insurance companies, whose primary goal is not health care, but rather to return profits to their shareholders. Removes the administration expense/complication of medical facilities dealing with tons of different forms/procedures/requirements from different insurance companies, instead they only need to deal with the one (i.e. the government system, as opposed to what they do today which is the government system for medicare plus a ton of others). The idea behind these last couple is that more of the money being put into the system is actually being used to provide health care.

To your other point, MFA is not "starting from scratch," it is still building on an existing Medicare system whose administrative procedures are in place and familiar to providers. But it will cover more things, for more people. Please also see my post #23.

However, whether such a plan can actually pass, and if not, the prospect of it being better to settle for half a loaf than none, are reasonable concerns. My feeling is that a President Warren or President Sanders would indeed settle for the half a loaf if they had to. That is, if the best Congress could bring to their desk was an improved ACA with some nods toward any progress at all toward something like MFA, they would sign it rather than veto it. But even those small nods toward MFA would more likely be absent if our president hadn't campaigned in support of any kind of MFA in the first place.

[brooklynite]

20. If what you get isn't current medicare, then it's not "medicare for all"

Come up with a different name for it.

[Hassin Bin Sober]

22. If you want to expand on the ACA or Obamacare, then don't call it the ACA or Obamacare.

Sounds silly, doesn’t it...

[thesquanderer]

25. LOL, says much more concisely what I was basically saying in post #23! (n/t)

[Gothmog]

33. Build on Obamacare not tear it apart!

I want to build on and expand the ACA. That is the best way to go if you do not want to lose a ton of down ballot races

Link to tweet

[thesquanderer]

23. The proper name would be "single payer"...

...but that scares people, because they don't understand what that means, even though Medicare--which they view positively-- IS a single payer system.

I see it as similar to when people would say things like "We need a G.I. bill for..." something or a something "new deal." It wouldn't literally be the same as the existing versions of those things, but the phrases communicate a concept.

The basic Medicare concept is that everyone's health needs are covered by a government-administered program. And that isn't changing. The details of a new implementation do not need to be identical to the current plan. Heck, the current plan is not identical to the original Medicare implementation, either! Here are changes it has already gone through...

https://www.medicareresources.org/basic-medicare-information/brief-history-of-medicare/

There's no reason they should have had to change its name every time they made those (sometimes quite substantial) changes to the plan.

MFA would be building on the Medicare infrastructure, and improving it. Medicare often pays 80%, where MFA pays 100%. Along with similar improvements in copays and deductibles, MFA negates the need for supplemental or "gap" insurance. And MFA covers things that Medicare does not, like dental. If anything, referring to it as a kind of Medicare program *undersells* it, since MFA does everything Medicare does plus more. But the MFA term is conceptually understandable, as "a government run health insurance system that covers everybody" -- that is its defining feature. People may not know that that feature has its own name, "single payer," but they do understand that that is the fundamental concept of what we call Medicare, regardless of the details, which have changed over time, and will continue to do so, regardless of whether it morphs into MFA or not.

[EmInColorado]

30. Yes, we need Medicare For All not Mediocre For All.

[JudyM]

37. Welcome to DU, Em.

[Gothmog]

60. Warren's latest health plan is causing concerns for some centrist, moderate and rural Democrats

I and other true Democrats have been working hard to turn Texas blue. We hope to pick up six congressional seats in addition to the two seats we flipped in 2018. We have a chance to defeat Cornyn in the Senate. The Democrats picked up 12 seats in the Texas House and need 9 more to take control of the Texas House prior to the next redistricting session. If Biden is the nominee, Texas will be a battleground state. If Warren or sanders is the nominee. Texas will not be a battle ground state and we can forget about keeping the two seats that we flipped in 2018

Speaker Pelosi is worried about losing control of the House with a weak top of the ballot ticket with a program that will kill down ballot candidates
.

Link to tweet

The most-vulnerable Democrat in Colorado’s state House, Bri Buentello, is dreading door-knocking in her rural district now that Elizabeth Warren dropped her massive “Medicare for All” plan into the presidential arena.
“This is going to cause down-ballot damage in swing districts and states if she’s the nominee,” Buentello says, describing how her Pueblo-area constituents — who voted overwhelmingly for Donald Trump in 2016 — were already echoing criticisms about a giant, one-size-fits-all big government run plan that cancels private health insurance and raises taxes.
Story Continued Below

The fear of blowback is indicative of the broad and largely negative response to Warren’s proposal from centrist, moderate and rural Democrats — many of whom, like Buentello, back Joe Biden in the primary. And it exposes the fault line between those who fret about winning voters in the center and the activist progressive base propelling Warren to the front of the Democratic pack.

The long-awaited plan to raise the $20.5 trillion she says is needed to pay for single-payer health care in America is Warren’s attempt to answer critics after weeks of questions from rival candidates about the cost of her proposal and the prospect of higher taxes. Warren promised, as she has in the past, that "not one penny in middle-class tax increases” is necessary to finance the effort.

[George II]

5. He's correct, and it won't be a winner next year either.

[backtoblue]

6. If it matters to anyone, it was based on 2016 presidential info

Notes: District Partisanship based on 2016 presidential vote margin. A handful of districts were not included because there either was no Democratic nominee or the Democratic nominee had not yet been determined at time of survey release.

Source: Survey of Democratic House candidates by National Nurses United and data compiled by author.

[thesquanderer]

9. It matters... losing issues can become winning issues 4 years later.

Look at how many more people already support some of what people were saying was radical in Sanders' platform 4 years ago. Look at how fast gay marriage turned from being a third rail idea to becoming generally accepted.

[Demsrule86]

14. It is not a winning issue and there is no question...those running on the ACA are doing better...we

have the house back for that reason.

[Demsrule86]

16. The article specifically talks about the 2018 midterms.

And I do think those running in 16 did better running on the ACA too.

[Gothmog]

29. Read the actual study

One factor used in the analysis on partisan bias came from 2016 but the rest of the data is from the 2018. This is a well done study
http://crystalball.centerforpolitics.org/crystalball/articles/medicare-for-all-a-vote-loser-in-2018-u-s-house-elections/

But 2020 is not the first election in which Medicare for All was an important campaign issue. It was also debated extensively during the 2018 midterm elections. By examining the impact of Medicare for All on the results of the 2018 U.S. House elections, we may gain some insights into how this issue could affect the 2020 presidential election.

Fortunately, we have very good information about the positions taken by Democratic House candidates on Medicare for All based on their responses to a survey conducted by a group advocating for this policy, National Nurses United. According to the results of this survey, 51% (219 of 429 districts included in the survey) of Democratic House candidates endorsed a version of Medicare for All supported by NNU — one that is fairly close to that proposed by Sanders and Warren.....

In order to further explore the impact of Medicare for All on the results of these competitive House contests, we need to conduct a multivariate analysis controlling for other factors influencing the outcomes. Table 3 presents the results of a multiple regression analysis of the House results in these 60 districts. The dependent variable here is the Democratic margin in the House election. The independent variables are the Democratic presidential margin in the district in 2016, a dummy variable for districts with a Republican incumbent (vs. open seat contests), the natural logarithm of Democratic campaign spending, the natural logarithm of Republican campaign spending[2] and, finally, whether the Democratic candidate supported Medicare for All.

The results in Table 3 indicate that after controlling for all of the other variables affecting the outcomes of these contests, Democratic candidates who endorsed Medicare for All did significantly worse than those who did not. The estimated coefficient of -4.6 indicates that support for Medicare for All cost Democratic candidates in these competitive districts almost five points of vote margin — a substantial effect in a close election.

[Laura PourMeADrink]

21. I still don't get why a candidate can't concentrate on

Illuminating the public on what trump and GOP have done to ACA and pledge to reverse and move toward controlling costs and insuring all. Why do we have to go zero to sixty? Think it scares voters and arguing about details of a hypothetical seems pointless.

[brooklynite]

28. Because that would make them a corporatist DINO sellout. Try to keep up.....

[Laura PourMeADrink]

31. Try to keep up! There's a monster in the White House and half of America find ridding

Ourselves of him paramount. Making ourselves happy with policy will go absolutely nowhere if we lose. And by the way, we have a divided public as well so any $20+ trillion dollar plan has one in a zillion chance of becoming reality even if we win back the WH and the senate.

[Gothmog]

35. Joe is focusing on this

Link to tweet

[Laura PourMeADrink]

36. Yes...he lived through the gruel of even coercing

a few of our own into ACA. Wish someone would plan out a long term, incremental approach to universal care with fully thought out transition plans and costs spread.

[Cha]

26. KR! Yes it was.

[Gothmog]

27. Medicare for All a Vote Loser in 2018 U.S. House Elections

I really like Larry Sabato and agree with this study http://crystalball.centerforpolitics.org/crystalball/articles/medicare-for-all-a-vote-loser-in-2018-u-s-house-elections/

“Medicare for All” has emerged as a key issue in the 2020 Democratic presidential nomination campaign. Two of the leading candidates, Sens. Bernie Sanders (I-VT) and Elizabeth Warren (D-MA), have made Medicare for All a central issue in their campaigns. Warren’s and Sanders’ proposals would abolish private health insurance in the U.S. within a few years and move all Americans into a government health plan based on the current Medicare program but with no copayments or deductibles.

Several Democratic candidates, including former Vice President Joe Biden, who has led in most national polls, have been highly critical of this idea. These candidates, along with a number of health policy experts and pundits, have attacked Sanders’ and Warren’s Medicare for All proposal as prohibitively expensive and politically unrealistic. They have also argued that embracing Medicare for All would alienate many independents and moderate Democrats and risk costing Democrats the electoral votes of several key swing states.....

Conclusions
An analysis of the impact of Medicare for All on the 2018 House elections indicates that Democratic challengers and open seat candidates in competitive districts who endorsed a version of Medicare for All similar to that proposed by Bernie Sanders and Elizabeth Warren did significantly worse than those who did not. This negative effect, close to five points of margin after controlling for a variety of other factors, was clearly large enough to affect the outcomes of some House contests.

It is possible that the estimated effect of Medicare for All was a byproduct of other differences between supporters and non-supporters. For example, supporters might have taken more liberal positions on a variety of other issues as well as Medicare for All. Even if that is the case, however, these findings are not encouraging to supporters of Medicare for All. They indicate that candidates in competitive races who take positions to the left of the median voter could get punished at the polls. Democratic presidential candidates would do well to take heed of these results, particularly as the eventual nominee determines what he or she wishes to emphasize in the general election.

[myohmy2]

41. right-wing...

...propaganda caused people to be suspicious and dislike Obamacare...

...but now that they've had a taste, they like it...

...just think how much better MFA will taste...

...they'll love it...

[Gothmog]

42. LARRY Sabato is not a right winger

[Tarheel_Dem]

44. You do remember we lost the House, and ultimately the Senate primarily due to suspicions over ACA?

I, for one, am not willing to back anyone who wants to reinvent the wheel when we have a perfectly good program to build on. As long as Republicans control the Senate, it will be difficult to get a public option, but there is no way in hell they're gonna pass something as sweeping as M4A.

[myohmy2]

46. I think...

...we have a better sales team this time around and the mood in the country is right...

...we now have a very large crop of voters out there that believe Socialism isn't a bad word and are willing to see it as a viable solution to our problems...

...I'll admit, I'm part of the 'ok boomer' crowd that believes MFA will work...Medicare For Me works quite well...Medicare For You and Me should work even better...

...it's 2020, not 2018 or 2016 or 2012 or 1948...you're free to vote how you choose, but I see it as taking an out-of-date square healthcare wheel and making it round...trump being president has proved to me anything is possible...

...and remember, you do have to break a few eggs to make an omelet...

...think delicious; MFA would make a very tasty omelet...

[PhoenixDem]

48. ...

[Gothmog]

56. The midterm elections were, to an important extent, a referendum on the Affordable Care Act

Link to tweet

[Tarheel_Dem]

57. +1. I can't imagine Congress Critters having to go back home and defend something that...

many or most of them don't believe in. We've seen that movie, and we know how it ends.

[PhoenixDem]

47. MFA is political suicide n/t

[Joe941]

49. Mfa done right will be a winning issue.

Americans need cheap health care.

[Gothmog]

50. Medicare for All at the top of the ticket in 2020 will lose us the House.

Link to tweet

[Joe941]

51. A scare tactic. We need to be bold!

[Gothmog]

52. I trust Speaker Pelosi

I stand with the leader of our Party, Speaker Pelosi

Link to tweet

“What works in San Francisco does not necessarily work in Michigan,” Pelosi said in an interview with Bloomberg News published Saturday. “What works in Michigan works in San Francisco — talking about workers’ rights and sharing prosperity.”
“Remember November,” she added. “You must win the Electoral College.”

While the California Democrat declined to endorse any candidate in the primary race, she unloaded on progressive policies, saying they fail to make inroads with swing voters who backed President Trump in 2016.

“As a left-wing San Francisco liberal I can say to these people: What are you thinking?” Pelosi said. “You can ask the left — they’re unhappy with me for not being a socialist.”

The speaker specifically singled out Medicare for All as an example of a policy that may be beyond the pale for moderate voters the party will need to win back next year.

“Protect the Affordable Care Act — I think that’s the path to health care for all Americans. Medicare For All has its complications,” Pelosi said, adding that “the Affordable Care Act is a better benefit than Medicare.”

[wellst0nev0ter]

53. "Obamacare Is A Vote Loser! Run Away!"

Do you people listen to yourselves?

And ACA WAS a vote loser, until it wasn't.

Stand up for what you believe in, and the rest will come.

[Gothmog]

55. The ACA was a winning issue for Democrats in 2018

Link to tweet

[wellst0nev0ter]

58. Yes it only took 8 years

If it was 2010, centrists would reject Obamacare as an election loser.

[treestar]

63. Not so. Democrats have been for the ACA since

they campaigned for Obama. In fact, they wanted a public option, but could not get it due to Ted Kennedy's death and Joe Lieberman, who comes from the State of Insurance Companies.

Yet we saw many posts on DU in 2008 wanting to "kill the bill" because Obama promised a public option. They wanted nothing rather than the ACA.

[Gothmog]

54. Michigan Democrats show less enthusiasm for progressive policies

Link to tweet

Democratic enthusiasm to vote against President Donald Trump in the 2020 election could be matched by Republicans motivated to oppose a more progressive nominee.

At least that’s the historic argument for why a moderate Democrat could have the advantage in swing states, said Matt Grossman, director of Michigan State University’s Institute for Public Policy and Social Research. While Democrats consider which of their candidates is best positioned to beat Trump, recent polling suggests Democrats in Michigan and other general election battlegrounds are motivated to vote but less enthusiastic about progressive policy ideas.,,,,

A majority of Democratic voters in Michigan put Medicare for All at the bottom of their health care priorities, the KFF survey found. Union members have also expressed issues with losing health benefits they fought for over decades of negotiations with employers.
Candidates in the moderate lane like Biden and South Bend, Ind., Mayor Pete Buttigieg favor expanding coverage under the Obama-era Affordable Care Act. Biden and Buttigieg support giving people the option of buying-in to Medicare but don’t want to expand it to everyone.

Biden’s campaign has come out swinging against Warren’s Medicare for All plan, saying it’s too costly and would hike taxes on the middle-class.

Trump and other Republicans call Medicare for All a “socialist" policy, portraying the plan as reckless and expensive. The “danger” of socialism is poised to get a lot of mileage in Republican campaign messaging during the next year, Grossman said.

[Gothmog]

61. MFA is not popular

Link to tweet

[Gothmog]

62. Medicare for All's JOBS problem

Link to tweet

Initial research from University of Massachusetts economists who have consulted with multiple 2020 campaigns has estimated that 1.8 million health care jobs nationwide would no longer be needed if Medicare for All became law, upending health insurance companies and thousands of middle class workers whose jobs largely deal with them, including insurance brokers, medical billing workers and other administrative employees. One widely cited study published in the New England Journal of Medicine estimated that administration accounted for nearly a third of the U.S.’ health care expenses.

Even if a bigger government expansion into health care left doctors, nurses, and other medical professionals’ jobs intact, it would still cause a restructuring of a sprawling system that employs millions of middle-class Americans.

University of Massachusetts researchers who analyzed the 2017 version of Sanders’ Medicare for All bill estimated that nationwide more than 800,000 people who work for private health insurance companies and a further 1 million who handle administrative work for health care providers would see their jobs evaporate.

The workers generally earn middle-class wages, according to the November 2018 study forecasting the economic ramifications of Sanders’ plan. The median annual income of a worker employed in the health insurance industry is nearly $55,000; for office and administrative jobs at health care service sites, it’s about $35,000, researchers said.

“The savings don’t come out of the sky,” said Pollin. “The main way we save money is through administrative simplicity. That means layoffs. There’s just no way around it.”

[Gothmog]

64. Nancy Pelosi is "not for doing away with Obamacare" and prefers to give people choices.

Link to tweet