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How ‘Medicare for All’ became a rallying cry in California’s most conservative districts

Democrats hope that backing single-payer health care will help them ride a blue wave into office this November.

Democratic candidates in California are running on Medicare for all and hope to flip conservative districts. CREDIT: Getty Images / EDIT by Diana Ofosu
Democratic candidates in California are running on Medicare for all and hope to flip conservative districts. CREDIT: Getty Images / EDIT by Diana Ofosu

ORANGE COUNTY, CALIFORNIA — “We have to make America mentshlekhkeyt again,” Rabbi Arnold Rachlisl declared with a grin at Sabbath service at University Synagogue in Irvine, California.

The rabbi was clearly proud of his joke. Mentshlekhkeyt means “humanity” or “human decency” in Yiddish, he explained to the crowd gathered at the synagogue.

Many in the congregation Friday evening had not been aware that the campaign event for Katie Porter would begin with a Shabbat service, leaving dozens of goys awkwardly swaying, arms clasped around their neighbors, before the congressional candidate spoke.

After a service that lasted 45 minutes or so, Porter, a law professor and consumer advocate, talked about the ways she would, as the rabbi put it, make America mentshlekhkeyt again.

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Porter vowed to crack down on big banks and protect working people, a message consistent with one embraced by her mentor, Sen. Elizabeth Warren (D-MA). She offered another idea in a Q&A following her remarks, when asked about what kind of health care legislation she would support.

Republicans in Washington, Porter said, are “taking us down a road that we can literally ill afford.” If like her, you have employer-sponsored health insurance, you can expect to receive a 2019 benefits update in the mail soon.

Porter said she knows what to expect in her envelope: Higher co-pays, higher premiums, and fewer options.“We have to change the health care system to deliver on its promise,” she declared.

In an interview with ThinkProgress after the event, Porter said it was her background in consumer advocacy that drove her to support Medicare for All.

“I’ve seen how difficult it is for people to navigate as consumers in the health care system. They have long complicated contracts about what is and what isn’t covered, they get changing terms, the pricing is completely hidden for most kinds of procedures — people can’t shop,” she said.

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“It’s not a real marketplace for people, and so I think the best system is the one that will provide the most care to the most folks at the best price, and for me that’s a Medicare for All type system.” Businesses are struggling to shoulder employer coverage, too, Porter added, and people are staying in jobs their unhappy in just for the health care coverage.

Porter is one of seven of Democrats running in California districts currently held by Republicans, but that Hillary Clinton won in 2016. Over the weekend, former President Barack Obama traveled to Orange County to stump for Porter and the others, including Gil Cisneros, who is running in the 39th district; Harley Rouda in the 48th; Mike Levin in the 49th; Josh Harder in the 10th; TJ Cox in the 21st; and Katie Hill in the 25th.

Obama’s event Saturday was his first of the 2018 campaign, and Democrats consider all seven of the districts vital to any electoral success in November. It’s clear that the path to taking back the House runs through these districts, and the Democratic nominee in every single one of them has endorsed Medicare for All. 

That widespread buy-in, especially among these establishment darlings, is somewhat unexpected, in an election year that has often been marked by Democratic infighting. It’s proof that the party, and the state, are shifting.

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“There’s a lot of support [for Medicare for All] from people young and old,” Porter said of her experience talking to voters while campaigning. “Those who are on Medicare know that the system works, and young people… know the path we’ve been on the last few years is not one we can stay on.”

A changing landscape

Levin, who’s running in Rep. Darrell Issa (R-CA)’s former district, first endorsed a single-payer system over a year and a half ago. He told ThinkProgress that he first learned about how valuable Medicare for All could be while working in a nursing home as a high school student.

“Too many people don’t have long-term care insurance, too many people don’t have retirement security at all to pay for private health insurance,” Levin said over the weekend. “Medicare is, I would offer, one of the most successful if not the most successful government programs in our nation’s history.”

Levin said he has grappled with the questions that surround a move to a Medicare for All system. What would the costs be? What would the benefits be? How, he asked, would people’s lives be changed?

“For me, it would be one of the great moral issues of our time if we did not provide quality and affordable health care for everyone possible,” he said. “That’s why the Affordable Care Act was a breakthrough… But we must continue always to try to go further and provide health care for everyone.”

The consensus about Medicare for All among these Democrats is somewhat unexpected, considering the national party’s refusal to embrace the policy and the Democratic Congressional Campaign Committee’s (DCCC) history of intervening in California primaries, having handpicked Cisneros and Rouda.

All seven districts of these districts are now part of the DCCC’s Red to Blue program, which the party describes as “a highly competitive and battle-tested program at the DCCC that arms top-tier candidates with organizational and fundraising support to help them continue to run strong campaigns.”

Outside of California, the DCCC has most often endorsed Democrats with more conservative health care policies. In February, The Intercept obtained an internal memo sent by the Democratic Congressional Campaign Committee (DCCC), which instructed candidates about the position party leaders wanted them to take on health care.

The memo included poll results from a survey of 52 “battleground” districts, which asked asked respondents, “If you could change one thing about your healthcare or health insurance, what would it be?”

Of those surveyed, 44 percent said, “Make it cheaper, more affordable, lower premiums, deductibles, [and] drug prices.” The two results that followed — tied at 12 percent — were “nothing, no complaints” and “make it single-payer, universal, socialized.”

That, the DCCC concluded, was enough to caution candidates against pushing for “repealing or replacing” the Affordable Care Act (ACA) “with something radically different.”

“The American people overwhelmingly want Congress to improve the Affordable Care Act,” the memo said. “We need to offer reasonable solutions to improve the law instead of a massive overhaul.”

And while the DCCC and others in the establishment and on the right have painted Medicare for All as a radical idea, none of the candidates Obama stumped for over the weekend are all that radical. None has called, for example, for the abolition of Immigration and Customs Reform (ICE), something a number of leftist candidates and members of Congress have pushed for, and all of them advocated getting to a single-payer system incrementally.

“For right now, for me being practical, it’s about protecting what we have. Protecting the Affordable Care Act… Not allowing them to take away [protections for] pre-existing conditions,” Cisneros told me recently at a canvassing event in Diamond Bar.

“I think as soon as we get there, we protect the Affordable Care Act, you know, put the individual mandate back in, don’t allow them to take away [protections for] pre-existing conditions, and then we can keep progressing and working towards making sure everybody has Medicare for All.”’

Cisneros said he’d support adding a public option to the Affordable Care Act. “It’s a progression,” he said.

Cox, who’s running in the 21st district, laid out a similarly incremental approach. “We know we can have it, provide quality, affordable health care for all at a much less price than we’re paying today. I do support Medicare for All, but that might be a long stretch to get to,” he said in an interview following Obama’s rally on Saturday.

First, Cox said he would support other steps, including adding a public option to the ACA that would allow anyone to buy into Medicaid. “Medicaid for all, that could be done right now. You could buy in,” he said.

But these campaigns make one thing very clear: The landscape has dramatically shifted. Medicare for all, as its advocates have been arguing for decades, isn’t actually a radical idea at all.

Voter buy-in

Just one day before Obama came to Orange County, he called Medicare for All “a good idea.” Outside Saturday’s rally, voters waiting to see the ex-president told ThinkProgress they favor the proposed single-payer system.

“Absolutely, health care is right not a privilege,” said one woman, Callae Wallcott, who lives in the 25th district, when asked if she supported a single-payer system. “What I hate to see is what’s happening now,” she said.

“The people who need health care the most, the poor, people with serious problems, health care is being taken away from them, and that’s just not a society I want to be a part of.”

Single-payer is undeniably popular in California. A poll last year found that 70 percent of Californians support a single-payer health care system. But Orange County in particular — known for its conservative voters in the otherwise deeply blue state — is one of the last places one would expect to find support for it. 

Yet, voter after voter at events in and around Orange County told ThinkProgress — some more hesitantly than others — said they support a single-payer system.

Sherry Cole, a retired Orange County resident who didn’t vote in 2016, said at Porter’s event at the synagogue Friday that she has voted for Republicans in the past. If she wasn’t familiar with the candidates in a particular race, she would skip voting.

This year, she said, will be the first time she votes for Democrats up and down the ticket. And, she added, she strongly supports Medicare for All. “I’m very much in favor of that. We are the only industrialized, progressive nation in the world that doesn’t have universal health care,” she said.

Cole lamented that during the 1950s “the country made a choice to go to employer-funded health care versus government-funded health care because it was easier and more people worked for large corporations… It was a big mistake.”

Now, Cole says we need to follow the rest of the world, and that doing so would help her family and be good for the economy.

“I believe that having employer-based coverage prevents people and makes them afraid to be innovative and switch jobs,” she said. “I have a son that was born with a heart condition… I’m always afraid. What if he doesn’t have health insurance for a period of time?”

Barbara Tanaka, 60, also attended Porter’s event. Both she and her husband still work, and she said she’s grown increasingly concerned about how they will handle health care costs when they retire.

With Medicare coverage “it would be a lot less scary,” she said. “I do have pre-existing conditions personally. Stuff’s gonna happen continuously, and I don’t want to be knocked out of the system.”

Another voter, Roger Kirk, who canvassed for Cisneros over the weekend, said one of the reasons he’s supporting Cisneros is because he supports Medicare for All.

“When you look around the world… even in countries that are not as economically advanced as us that have figured out a way to ensure health care for everybody in their country, and we can’t, something’s not right,” Kirk said, drifting off. “So, yeah.”