Medicare for All Gains Traction as Democrats Prepare for Midterm Battles

Last week, 1,500 unionized nurses convened at the Marriott Marquis in San Francisco to rally behind their long‑standing push for Medicare for All.

Once viewed as a radical notion, sweeping healthcare reform has gained momentum after a string of progressive primary wins ahead of the November midterms. Senate hopeful Abdul El‑Sayed of Michigan emerged as a leading voice, taking the stage before the nursing crowd.

El‑Sayed posed the question, “Medicare for whom?” and the attendees answered in unison, “ALL!”

He explained that his book on Medicare for All seeks to clarify the straightforward belief that, in the world’s wealthiest nation, no one should endure hardship to obtain healthcare.

As progressive candidates like El‑Sayed secure primary victories and the Democratic party emphasizes unity against the Republican midterm challenge, Medicare for All remains a pressure point—cherished by the left but viewed as a liability by centrists.

“There are too many preventable illnesses and avoidable costs,” said Michelle Gutierrez Vo, president of the California Nurses Association, the National Nurses Organizing Committee, and vice‑president of National Nurses United—all unions representing the nurses at the San Francisco gathering. “What are we doing?”

These unions have championed Medicare for All for years, watching its popularity rise as candidates like El‑Sayed gain traction. In contrast, centrist Democratic organizations such as Third Way label the proposal an unattainable burden.

“Medicare for All carries considerable political and substantive challenges,” noted Gabe Horwitz, senior vice‑president for economic policy at Third Way. He added that Democrats universally oppose the $1 trillion in healthcare cuts embedded in Donald Trump’s “One Big Beautiful Bill Act,” which they dub the “big, ugly bill,” projecting it could leave an additional 16 million Americans uninsured by 2034.

“Our goal is universal coverage, lower costs, and simpler access,” Horwitz said, acknowledging the party’s consensus that reforms are needed for those struggling with employer‑sponsored insurance. “I doubt any Democrat would disagree with that.”

“There is agreement on the ends—universal care—but not necessarily on the means to achieve it,” he continued.

This split surfaced recently in an 84‑page memo sent to House Minority Leader Hakeem Jeffries from the Cost of Living Healthcare Working Group.

The memo observed, “Members of the Democratic Caucus hold diverse views on achieving universal coverage, ranging from Medicare for All to a variety of more incremental approaches.”

Centrist Democrats have attempted to address soaring healthcare costs and disfavored insurer practices by proposing incremental reforms that build on the Affordable Care Act enacted under Obama.

Their ideas include a patients’ bill of rights, increased government subsidies to private insurers to offset consumer expenses, and some form of a “public option”—a government‑run health plan individuals could purchase.

For years, the party’s left has advocated a single‑payer, government‑funded health system—a concept that seems radical by U.S. standards but is commonplace in many industrialized democracies.

Elaine Kamarck, a senior fellow at the Brookings Institute, pointed out, “Every Democratic platform since Harry Truman has endorsed universal healthcare; that’s not the debate. The question is how to implement it.”

She added that the issue will likely persist beyond the primaries. While Republicans occupy the White House, federal health reform stalls, but a Democratic “trifecta” in 2028 could bring the matter to the forefront.

Currently, the U.S. health system is a mosaic of insurers, or “payers,” all subsidized by taxpayers. Four major programs dominate: employer‑sponsored coverage covers roughly 48 % of the population, Medicare serves those 65 and older (14.8 %), Medicaid assists low‑income and disabled individuals (20.4 %), and the ACA marketplace lets individuals buy private insurance (6.6 %), according to the Kaiser Family Foundation.

Approximately 27 million people (8.2 %) remain uninsured, and about one in four Americans are underinsured, facing high health expenses relative to income.

Through 2034, the federal government projects spending $33.6 trillion on health programs—including subsidies for job‑based private insurance, which grants employers a tax break—equivalent to 7.4 % of GDP. For comparison, the United Kingdom allocates about 11.9 % of GDP to cover its entire populace (Commonwealth Fund), while total U.S. health expenditures consume roughly 18 % of GDP, far above peer nations.

Although the slogan “Medicare for All” is somewhat vague, a recurring congressional bill envisions a Medicare‑style single‑payer system guaranteeing universal coverage, barring private insurers from duplicating services. Given that healthcare accounts for 18 % of U.S. GDP, such a transition would inevitably disrupt thousands of jobs, prompting the bill to include temporary worker compensation measures.

For proponents like Gutierrez Vo, any alternative is merely a stopgap—“a patch‑up, not a fix.”

She elaborated, “Just as nurses attend to the whole patient, focusing only on one part while the rest suffers makes no sense.”

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