Medicare for All is going to be the litmus test of progressivism in 2020. Legislation will soon be introduced in both chambers of Congress by Senator Bernie Sanders and Rep. Pramila Jayapal that would guarantee health care to every person in America. The bills come after a midterm election in which Democrats took back the House with dozens of candidates running on universal single-payer health care, some of them in deep red states.

A majority of House Democrats supported single payer in 2016, as did all of the 2020 hopefuls in the Senate. At the opening of this 116 Congress, House Speaker Nancy Pelosi announced her support for hearings on Medicare for All following the launch of the House Medicare for All Caucus last summer. (Though, out of the other side of her mouth that day, Pelosi oversaw the passage of “Paygo” legislation, an austerity measure that requires all new spending to be offset with deficit reduction.)

Recent polls tally support for Medicare for All at 70 percent, with 85 percent of Democrats and more than half (52 percent) of all Republicans. Single payer’s growing popularity, in and outside the Beltway, is a function of US lawmakers’ refusal to legislate an egalitarian health care system and a failure of neoliberalism more generally. Health care is a barometer of how a society values human life and how wealth and political power are distributed in it.