To: Centrist Democrats and the Insurance Lobby

From: Sean McElwee, Co-Founder of Data for Progress, Avery Wendell, Senior Advisor, Data for Progress, Jason Ganz, Senior Advisor, Data for Progress, Ethan Winter, Senior Advisor, Data for Progress

Subject: Medicare for All and Democratic Primaries

Key findings:

  • Fifty-seven percent of likely Democratic primary voters said they would disapprove of their incumbent member of Congress opposing Medicare for All, with 25 percent saying they would approve and 17 percent not expressing an opinion.

  • Among likely Democratic primary voters, disapproval of opposition to Medicare for All was the majority position in all but one district, where it was the plurality position


After the 2016 election President Trump and the Republican Party sought to ‘repeal and replace’ the Affordable Care Act (Obamacare). Not only did they fail to do this, but their attacks reshaped the public’s view of the role that the state should play in healthcare more generally.  A growing number of Democrats, including nearly every presidential contender, support the idea of Medicare For All, which Vermont Senator Bernie Sanders first helped popularize. New polling from Civis Analytics and Data For Progress suggests that Medicare for All has quickly become a central issue for Democratic primary voters––particularly those who are less wealthy and have more precarious employment.

Civis Analytics surveyed 2,426 likely Democratic primary voters voters online in the districts of Brian Higgins (NY-26), Dutch Ruppersberger (MD-2), Eliot Engel (NY-16), Filemon Vela (TX-34), Gregory Meeks (NY-5), Henry Cuellar (TX-28), Jim Cooper (TN-5), Kathleen Rice (NY-4), Kathy Castor (FL-14), Seth Moulton (MA-6), Stephen Lynch (MA-8), and Tom Suozzi (NY-3). The districts ranged from the 14th most conservative district controlled by Democrats (+1D) to the 185th (+37D). Respondents were asked “If your current representative [Representative Name Here] opposes "Medicare for All", would you approve or disapprove of [Representative Name Here] decision to oppose "Medicare for All"?”


Among likely Democratic voters in the selected districts, the choice was clear: 57 percent of those surveyed said they would disapprove of their representatives opposition to Medicare to All, compared to only 25 percent who would support their representatives opposition to Medicare for All, yielding a net disapproval of opposition to Medicare for All at 32 percent, with 17 percent of those surveyed saying they were not sure. In all but one of the districts an outright majority said they would oppose any representative who came out against Medicare for All; in the one district where it did not obtain a majority -- Henry Cuellar’s TX-28 -- the number who said they would disapprove was 49.7 percent.


Ideology is the most powerful factor in determining whether a likely voter will approve or disapprove of a representative’s decision to oppose Medicare for All. The most liberal voters would disapprove by a 16 to 70 margin––for a net approval of negative 53 percent––while somewhat conservative voters would approve by a net approval of 9 percent. Beyond ideology, the most significant factors were related to economic security––employment type and income. We find significantly higher support for Medicare for All in groups of people who would be most likely to lack good health insurance, namely those employed in part time jobs and those making less than $75,000 a year.


The strong support among the Democratic base means there are serious implications for legislators who refuse to support Medicare for All. A Medicare for All bill was introduced in the house in January of 2017 by Representative John Conyers (D-MI). H.R. 676 the “Expanded and Improved Medicare For All Act.” This legislation would make Medicare universal and significantly expand it: eliminating copays and deductibles while providing dental and vision care. While it did not come to a vote, it attracted numerous cosponsors. By looking at whether the representatives whose districts were polled cosponsored H.R. 676, we can see who would be vulnerable to a primary for opposing Medicare for All.  


Representatives Higgins, Engel, Vela, Meeks, Cooper, and Castorare all cosponsors. Representatives Ruppersberg, Cuellar, Rice, Moulton, Lynch, and Suozzi, meanwhile, are not confirmed cosponsors. Given that a plurality of likely voters in their districts would disapprove of them opposing Medicare for All, the door to progressive primary challengers may be opened going forward.