This Bernie Sanders-backed idea is connecting Democrats winning midterm primaries, CNN, April 12, 2026, by Ronald Brownstein
Replacing private health insurance with a universal coverage system funded and run solely by the federal government has long been a priority for the Democratic Party’s left wing. But the push for a single-payer plan, also known as Medicare for All, appeared to be on life support among Democrats after its leading advocates, Sens. Bernie Sanders and Elizabeth Warren, struggled to defend the idea during the party’s 2020 presidential primaries. Under President Joe Biden, a single-payer skeptic, Democrats focused instead on substantially expanding health coverage through the Affordable Care Act.
Now, though, a new generation of Democratic House, Senate and even gubernatorial candidates are resuscitating the single-payer idea. “I do think that there is a resurgence in interest in single payer,” says Joseph Geevarghese, executive director of Our Revolution, the organizing group founded by Sanders. “We’re in a moment where people are starting to feel the affordability crisis when it comes to health care in a very real way.”
Like Geevarghese, most Democratic operatives believe the idea’s revival reflects growing frustration over rising health care costs at a moment when voters are especially stressed about their overall cost of living. The paradox for single-payer advocates is that while higher health care costs make the idea more attractive in theory, they also make it more daunting in practice.
One principal reason the idea lost momentum in the 2020 Democratic presidential race was that its supporters could not convincingly explain how they would fund a complete government takeover of the health care system. Because of the nation’s rising health care spending, the 10-year bill for a federal single-payer plan would be nearly twice as high now as it was in 2020, according to a broad projection of possible costs shared exclusively with CNN by John Holahan, a fellow at the Urban Institute, a center-left think tank.
Single payer is receiving renewed attention among Democrats because “costs have risen and there are no obvious solutions on the horizon to deal with that,” said Larry Levitt, executive vice president for health policy at KFF, a think tank that focuses on health issues. “But the political liabilities of Medicare for All, like having the government exercise more control over health care and needing a big tax increase to pay for it, are all still there.”
Single payer sees a new surge among Democrats
Proposals to replace the existing health care system with a single-payer government-run system have sprouted in Democratic primaries this year. In Illinois, Lt. Gov. Juliana Stratton, who decisively won the Democratic Senate primary last month, forcefully touted the idea and attacked her opponents for taking contributions from health industry interests. In Maine, progressive first-time candidate Graham Platner has stressed his support for a single-payer system while opening a consistent lead in polls for the Democratic Senate nomination over Gov. Janet Mills. …
Similarly, in a closely contested New York City primary, Rep. Dan Goldman and both of his challengers have endorsed the idea. So has Bob Brooks, the former firefighter and president of the state firefighter union who is running against Republican Rep. Ryan Mackenzie for a northeast Pennsylvania seat. …
But the revival of single payer hasn’t been confined solely to deep blue places. Former Rep. Jasmine Crockett pushed it in the Texas Senate primary ultimately won by State Rep. James Talarico in March. The issue is also a major point of division in the Democratic primary to oppose Republican Rep. David Valadao, whose Central Valley district remains a toss-up even after California Democrats redrew the state’s Congressional maps. Randy Villegas, who is running as a populist insurgent, is a full-throated single-payer supporter, while state Assembly member Jasmeet Bains, a physician whom Democratic leaders prefer, talks instead about strengthening existing programs. …
The revival of interest in single payer from so many Democratic candidates this year virtually guarantees the party will face another version of that 2020 debate in its 2028 presidential primaries. “Just based on what we are seeing in the midterms,” says Geevarghese of Our Revolution, “there’s no doubt in my mind there will be a fight over single payer in ‘28.” …
What “further” means, though, remains a matter of intense dispute. Last week, the Center for American Progress, a leading liberal think tank, released a “Patients’ Bill of Rights” to try to immediately reduce health care costs through new regulatory restraints on insurers and hospitals. “The public is hungry for polices that will lower their costs now and the debate about health care system change — whether it’s single payer or a public option – are going to take a decade or so to happen,” said Neera Tanden, the CAP president and CEO and former chief domestic policy adviser for Biden.
Many Democratic candidates, though, want deeper changes in the system. Geoff Garin, a Democratic pollster who has extensively studied health care attitudes, said rising health care costs have made single payer more politically viable than in 2020. “There is a lot of anger about what many voters see as a badly broken health insurance system, more than when Medicare for All was last litigated in 2019 and 2020,” Garin said. “And for that reason, voters are more open to the idea of moving to a single-payer system, including some blue-collar Trump voters.”
But, Garin added, “the cost and tax implications” remain a big hurdle for single-payer proposals, “especially for voters who are used to having an employer pay for most of their insurance costs.” …
Comment:
By Jim Kahn, M.D., M.P.H.
The message on health insurance in recent primaries is clear: Democratic voters support candidates who endorse single payer / Medicare for All, in varied geographic settings.
Yet, if CNN is correct, single payer will stumble in general elections on concerns about its “high cost”. Which, to be precise, refers to the large increase in government budgets as premiums and cost-sharing are shifted from families to the public coverage system.
But budget size is the wrong issue. The proper framing is: How will families do, on net? How will increased taxes compare with avoided premiums and cost-sharing (including deductibles)?
We have an answer, and it’s favorable for single payer. The Medicare for All Household Savings Calculator makes this precise comparison. Based on the first 1,500 users, 89% result in saving money with single payer, with median annual savings of $5,900. Nine out of ten families would do better financially. Poorer and sicker individuals and families would benefit even more.
Is that a “high cost”? Nope. It’s a “cost reduction”. It arises from ridding the system of profit-taking and administrative bloat to contain overall costs, and then using progressive taxes to fairly distribute the burden.
The net gains to most Americans means that single payer is not only the right thing to do – assuring universal health care – it is eminently affordable.
Not everyone is on board. The neoliberal Center for American Progress recently offered a “Patient Bill of Rights” to tweak our current insurance approach. Provisions include limiting premium increases; lowering deductibles; and banning prior authorization. These steps seem quite appealing, on the surface. However: no guarantee they can be implemented. And, as with all tweaks to current insurance, they fail to eliminate insurer profits and administrative waste (>20% of all spending) inflicted by our insanely fragmented insurance.
After decades of rising financial burdens on families, it’s time to do what works around the world: identical insurance for everyone, with no profit-taking.
It’s time for single payer, Medicare for All. Voters are ready.
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