在许多民意调查中，医疗保健和处方药的高成本一直是选民最关心的问题，但全国各地的民主党选民基本上拒绝了推动全民医疗保健或全民医疗保险的候选人。

前民主党总统候选人、佛蒙特州参议员伯尼·桑德斯周三暂停了竞选活动，他的标志性政策提案虽然吸引了许多人，但似乎没有在选民中引起足够强烈的共鸣，无法解决当前医疗保健现状中的问题。相反，更多的选民支持提供适度调整的候选人，即扩大平价医疗法案，通常被称为奥巴马医改，并增加一个公共选项，让更多的美国人获得医疗保险。

印第安纳州南本德市前市长、前民主党候选人皮特·巴蒂吉称他的温和医疗改革为“所有想要的人的医疗保险”与此同时，民主党总统候选人、前副总统乔·拜登提出了一个类似的计划。最终，这些对医疗保健系统的不太引人注目的调整似乎赢得了胜利。

虽然多名民主党候选人都支持全民医保，只是略有不同，但将全民医保作为其竞选核心的桑德斯和马萨诸塞州参议员伊丽莎白·沃伦是唯一两个在投票真正开始之前留在竞选中的竞争者。沃伦，甚至在2月3日爱荷华州党团会议之前，就目睹了自己的竞选失败，因为她努力解决专家和竞争对手对她计划如何为这项雄心勃勃的政策买单的担忧。尽管她去年似乎是进步的领先者，但这些持续存在的问题和担忧与她在2019年底的投票数下降有关。

3月11日，在佛蒙特州伯灵顿的佛蒙特酒店，参议员伯尼·桑德斯(佛蒙特州)在发表了竞选最新消息后离开了讲台

11月，加利福尼亚州的民主党众议员南希·佩洛西、众议院议长和华盛顿的民主党高层表达了她对桑德斯和沃伦的医疗保健计划的担忧。

“我不是全民医保的狂热粉丝，”佩洛西在接受彭博社采访时表示。“我是说，我欢迎这场辩论。我认为我们应该为所有人提供医疗保健。”

“这是昂贵的，”众议院领袖提到全民医保。“有些人对他们现有的私人保险有一个舒适的水平，如果要逐步取消，让我们来讨论一下，但我们不要只通过一个法案就能做到这一点，”她争辩道。

佩洛西的谨慎似乎引起了民主党选民的共鸣。

即使将桑德斯、沃伦和夏威夷众议员图尔西·加巴德(他支持全民医疗保险，但也有一些私人保险)在总统竞选中赢得的代表和选票结合起来，那些提倡更温和的医疗改革的人还是赢得了胜利。事实上，综合起来看，支持全民医保的候选人在爱荷华州初选、新罕布什尔州初选、南卡罗来纳州初选、内华达州初选和超级星期二的支持率明显较低。温和派赢得了超过770万张选票，而进步派在所有早期竞选中总共只获得了大约710万张选票。

在《超级星期二2》中，这一趋势继续下去，竞选范围缩小到只有拜登和桑德斯。这位前副总统获得了200多万张选票，而这位来自佛蒙特州的参议员只赢得了不到150万张选票。

然而，根据美国有线电视新闻网的投票后调查，绝大多数选民说他们支持政府为所有人运行的计划，而不是私人保险。事实上，大多数民主党选民表示，他们更喜欢在爱荷华州、新罕布什尔州、内华达州、阿拉巴马州、阿肯色州、加利福尼亚州、科罗拉多州、缅因州、明尼苏达州、北卡罗来纳州、俄克拉荷马州、田纳西州、得克萨斯州、犹他州、佛蒙特州、弗吉尼亚州、华盛顿、密歇根州、密苏里州和密西西比州建立全民医保体系的想法。在马萨诸塞州，50%的选民支持政府经营的私人保险计划，在南卡罗来纳州，49%的多数人支持全民医保的想法。

但是，尽管这些民调显示选民更支持全民医保计划，就像桑德斯支持的那些计划一样，这位佛蒙特州参议员只在其中六个州取得了胜利。美国有线电视新闻网没有北达科他州的出口民调数据，桑德斯也赢得了该数据。

哈佛大学之前进行的一项调查显示，纽约时报联邦基金可能会为这种看似脱节的现象提供更多线索。11月初公布的这项民意调查显示，尽管大多数选民最初表示支持全民医保方案，但许多人在后续问题中表现出更温和的偏好。

受访者有三个选择:全民医保，这是一个类似于拜登的提议，也是共和党人提出的另一个更保守的计划，在政策上也有分歧。大约30%的人支持每个想法，分别是32%、28%和29%。

2020年民主党提名竞争是否将是全民医疗保险的最后一次全民公决仍有待观察。包括桑德斯在内的进步人士认为，当前的冠状病毒危机更清楚地揭示了政府对医疗保健系统进行大刀阔斧改革的必要性。然而，拜登在最近的民主党辩论中反驳了这一观点，指出意大利的全民医保体系并没有阻止病毒的传播。相反，他认为在大流行的情况下需要立即采取紧急行动，而不是一个全新的医疗保健系统。

3月15日，民主党总统候选人、前副总统乔·拜登在华盛顿特区的美国有线电视新闻网华盛顿分社演播室参加第11届民主党2020总统候选人辩论

但是全民医疗保健的支持者也认为潮流正在改变，越来越多的美国人支持全民医疗保险制度。

“全民医保是不可避免的。这是时间问题，而不是是否。这是因为目前的体系正在崩溃，私人健康保险公司是照顾数百万美国人的守门人，”前私人健康保险主管温德尔·波特告诉记者，他现在提倡重大的医疗改革新闻周刊。“选民将医疗保健列为他们的头等大事并支持全民医保的原因是，他们感到越来越多的财务困难。”

尽管桑德斯和“全民医保”候选人落选，但对这位佛蒙特州参议员签名政策提案的支持日益增加，这与2008年前民主党总统巴拉克·奥巴马(Barack Obama)赢得大选时围绕医疗保健的辩论相比，是一个显著的变化。那时候，即使是温和的民主党人也努力反对他推动平价医疗法案的努力。现在被认为是温和建议的拟议公共选择，不得不完全放弃，以便立法向前推进。

波特认为这种转变对私营保险部门来说是一个不好的信号，不管全民医保在这个选举周期中是否是一个获胜的问题。“当候选人和政策制定者赶上公众舆论时，我们将很快到达一个临界点，”他预测道。

BERNIE SANDERS DROPPED OUT OF THE PRESIDENTIAL RACE—SO IS MEDICARE FOR ALL DEAD?

Health care and the high cost of prescription drugs have consistently appeared as top concerns of voters in numerous polls, but Democratic voters across the country have largely rejected the candidates pushing for universal health care, or Medicare for All.

The signature policy proposal of former Democratic presidential candidate Senator Bernie Sanders of Vermont, who suspended his campaign on Wednesday, while appealing to many, does not appear to have resonated strongly enough with voters as the solution to address the perceived problems with the current health care status quo. Instead, many more voters backed candidates offering modest tweaks, namely expanding the Affordable Care Act, known commonly as Obamacare, and adding a public option for more Americans to gain access to Medicare.

Former Democratic contender Pete Buttigieg, the former mayor of South Bend, Indiana, dubbed his version of moderate health care reform, "Medicare for All who want it." Meanwhile, former Vice President Joe Biden, the presumptive presidential nominee for the Democratic party, put forward a comparable plan. In the end, these less dramatic adjustments to the health care system seem to have won the day.

While multiple Democratic candidates had backed Medicare for All, with slight variations, Sanders and Senator Elizabeth Warren of Massachusetts, who made universal health care a centerpiece of their campaigns, were the only two contenders to stay in the race until voting actually got underway. Warren, even before the Iowa caucuses on February 3, saw her campaign stumble as she struggled to address concerns from pundits and rivals about how she planned to pay for the ambitious policy. Although she appeared to be the progressive frontrunner last year, these persistent questions and concerns correlated with her declining polling numbers by the end of 2019.

Senator Bernie Sanders (i-Vermont) walks away from the podium after delivering a campaign update at the Hotel Vermont on March 11 in Burlington, Vermont

In November, Democratic Representative Nancy Pelosi of California, the Speaker of the House and the top Democrat in Washington voiced her misgivings about Sanders' and Warren's health care plan.

"I'm not a big fan of Medicare for All," Pelosi told Bloomberg News in an interview. "I mean, I welcome the debate. I think that we should have health care for all."

"It is expensive," the leader of the House noted of Medicare for All. "There is a comfort level that some people have with their current private insurance that they have, and if that is to be phased out, let's talk about it, but let's not just have one bill that would do that," she argued.

Pelosi's caution appears to have resonated with Democratic voters.

Even when combining the delegates and votes won by Sanders, Warren and Representative Tulsi Gabbard of Hawaii (who backed Medicare for All with caveats that allowed for some private insurance) in the presidential race, those promoting more moderate health care reform won the day. In fact, combined together, the popular vote for candidates that backed Medicare for All was significantly lower in the Iowa caucus, the New Hampshire primary, the South Carolina primary, the Nevada caucus and on Super Tuesday. While moderates won more than 7.7 million votes, the progressives combined garnered just about 7.1 million in all the early contests.

On Super Tuesday II, this trend continued with the race narrowed to just Biden and Sanders. The former vice president garnered over 2 million votes, while the senator from Vermont won less than 1.5 million.

However, voters have—according to exit polls by CNN—overwhelmingly said they supported a government-run plan for all as opposed to private insurance. In fact, the majority of Democratic voters said they preferred the idea of a universal health care system in Iowa, New Hampshire, Nevada, Alabama, Arkansas, California, Colorado, Maine, Minnesota, North Carolina, Oklahoma, Tennessee Texas, Utah, Vermont, Virginia, Washington, Michigan, Missouri and Mississippi. In Massachusetts, 50 percent of voters backed a government-run plan over private insurance, and in South Carolina, a plurality of 49 percent supported the idea of universal health care.

But while those polls suggest that voters are more supportive of a Medicare for All plan, like the ones backed by Sanders, the Vermont senator only pulled off victories in six of those states. CNN did not have exit polling data for North Dakota, which Sanders also won.

A previous survey conducted by Harvard, The New York Times and the Commonwealth Fund may provide additional clues to this seeming disconnect. That polling, which was published at the beginning of November, showed that while most voters initially say they support a universal health care approach, many reveal more moderate preferences in follow-up questions.

Respondents were offered three options: Medicare for All, a proposal similar to that of Biden and another much more conservative plan proposed by Republicans, and split among the policies. About 30 percent backed each idea, or 32 percent, 28 percent and 29 percent respectively.

Whether the 2020 Democratic nomination contests will be the final referendum on Medicare for All remains to be seen. Progressives, including Sanders, have argued that the current coronavirus crisis reveals more clearly the need for drastic government reform of the health care system. However, Biden countered this argument in the most recent Democratic debate, noting that Italy's universal health care system had not prevented the virus' spread. He argued instead that immediate emergency action was required in a pandemic situation, not an entirely new health care system.

Democratic presidential candidate former Vice President Joe Biden participates in the 11th Democratic Party 2020 presidential debate in a CNN Washington Bureau studio in Washington, D.C. on March 15

But proponents of universal health care also believe the tide is changing, with more and more Americans backing a Medicare for All-style system.

"Medicare for All is inevitable. It is a matter of when, not if. That's because the current system, with private health insurers being the gatekeepers to care for millions of Americans, is collapsing," Wendell Potter, a former private health insurance executive who now advocates for major health care reform, told Newsweek. "The reason voters rank health care as their top issue and support Medicare for All is because they are feeling more and more financial distress."

Even though Sanders and Medicare for All candidates lost, the growing support for the Vermont senator's signature policy proposal is a marked change from the debate around health care when former Democratic President Barack Obama won in 2008. Back then, even moderate Democrats worked to counter his efforts to push through the Affordable Care Act. A proposed public option, which is now considered to be the moderate proposal, had to be dropped entirely in order for the legislation to move forward.

Potter sees the shift as a bad sign for the private insurance sector whether or not Medicare for All was a winning issue in this election cycle. "We will reach a tipping point soon when candidates and policymakers catch up with public opinion," he predicted.