Democratic socialists give new life to Medicare for All

Democratic socialist and progressives' success in this year's primaries is evidence of new enthusiasm for Medicare for All plans that many centrists have long dismissed as costly pipe dreams.

Why it matters: The health affordability crisis and widespread frustration with the medical system are fueling a new appetite for big-government solutions to address drug prices, insurance premiums and long-term care costs.

• "This does feel like a moment where the Democratic base is looking for bigger ideas that go beyond incremental policies," said Larry Levitt, executive vice president of policy at KFF.

State of play: In Colorado last week, Melat Kiros, a 29-year-old attorney backed by the Democratic Socialists of America, defeated 15-term Rep. Diana DeGette for a Denver-based House seat.

• Kiros called for a single-payer health system and accused DeGette — herself a backer of Medicare for All — of being in the pocket of pharmaceutical companies and big health insurers.
• Kiros' win came just one week after progressive candidates Brad Lander, Claire Valdez and Darializa Avila Chevalier each beat incumbents or establishment favorites in New York's Democratic primaries.
• Lander touted his progressive credentials as New York City comptroller and his opposition to an effort to shift retired municipal workers to a Medicare Advantage plan.
• Before that, Illinois Lt. Gov. Juliana Stratton and Maine's Graham Platner played up their support for a single-payer system in winning Senate primaries over more moderate opponents.

The intrigue: Incumbents like DeGette and New York Reps. Dan Goldman and Adriano Espaillat were ideologically aligned with the challengers on health care, but they didn't emphasize single-payer health care as much during their campaigns.

• Political analysts said they were vulnerable to charges they haven't done enough to bring down health costs, expand insurance coverage and keep people from being swamped by medical debt.
• "Even candidates that may have supported Medicare for All in the past are getting ousted because they are considered part of the establishment," Levitt said.

Reality check: The Medicare for All cause is mostly a vessel to showcase public frustration with the health system, since Republicans and President Trump would block any single-payer legislation.

• "The candidates who can both convey a true understanding of the frustrations people are experiencing with a compelling commitment and credible policy to address them are those who will win out," said veteran Democratic strategist Chris Jennings.
• "Yes, Medicare for All is back, but what is unclear is whether those advocating it have a credible plan to achieve it."
• The real test could come in 2029, if Democrats can win control of Congress and the White House, Levitt said.

What they're saying: "Our role in Congress is to push the conversation while building power with movements on the outside to get it done," Valdez, the progressive who won a primary to represent parts of Brooklyn and Queens, told Axios in an email.

• "It's clear that Americans overwhelmingly support Medicare for All, but we need to organize together if we're going to pass it."

Health insurers remain steadfastly opposed to Medicare for All, arguing that a government-run single-payer system would increase federal spending in an unsustainable way and limit patients' choices.

• "Americans consistently report strong satisfaction with their health coverage.… Policy solutions are needed to rein in the ever-higher prices charged by hospitals and drugmakers and make care more affordable for everyone," Chris Bond, a spokesperson for the trade group AHIP, told Axios.

What we're watching: Some Democratic insurgents are going beyond Medicare for All and floating other sweeping health care changes to tap into voter frustrations.

• Former Wayne County, Mich., health director Abdul El-Sayed, who's running in August's Michigan primary for an open Senate seat, has said he wants to get rid of pharmacy benefit managers entirely.