In early 2020, all roads in American politics led to Medicare for All. The policy demand, shorthand for a universal, tax-funded, single-payer health insurance plan, began its ascent four years prior when it was elevated by Bernie Sanders’s first presidential campaign. Over the intervening years, its popularity soared, and debate became intense. By the 2020 Democratic presidential primary, everyone had an opinion, and where you stood seemed to say everything about your core values and fundamental worldview.

For the rising economic populist left, Medicare for All was the flagship demand — the purest expression of the Sanders movement’s ethos, promising to mobilize ordinary working-class people en masse, across lines of political and demographic difference, in a necessary challenge to capitalist domination and exploitation. The Medicare for All army came equipped with political arguments, economic projections, policy papers, physicians’ opinions, patient testimonies, and regiments of self-taught true believers ready to talk through the details with anyone who would listen. As the pressure mounted, centrists squirmed in their seats, conservatives clutched their pearls, and corporations benefiting from the private health insurance status quo commenced a lobbyist hiring spree, affirming with their dollars how seriously they took the threat.

Then, in mid-2020, poof. The demand for Medicare for All evaporated. Sanders’s primary loss and Joe Biden’s presidential victory squashed the momentum. By 2021, with the policy’s main champion defeated and an avowed opponent in the White House, the proposal migrated almost overnight from the center of the primary debate to the margins of respectable Democratic Party discourse. Even a public option, which Biden had promised to champion as a compromise, disappeared from discussion without a trace. When the Republicans, under newly reelected Donald Trump, set out inevitably to destroy Biden’s health care legacy, they were reduced to ripping up enhanced Affordable Care Act (ACA) subsidies — a distant fourth cousin to the ambitious and once-mighty Medicare for All.

Still, it’s important to decouple the demand’s short-term political prospects from its actual popularity among the electorate. And on this point, a new poll from Data for Progress offers some clarity. In a survey of 1,207 likely voters conducted November 14–17, 2025, Data for Progress found that 65 percent of voters support a Medicare for All system — described as a “national health insurance program . . . that would cover all Americans and replace most private health insurance plans.” That number includes 78 percent of Democrats, 71 percent of independents, and 49 percent of Republicans.

Data for Progress also tested what happens when respondents are given more information about what Medicare for All entails. After being told the policy would “eliminate most private insurance plans and replace premiums with higher taxes, while guaranteeing health coverage for everyone and eliminating most out-of-pocket costs like copays and deductibles,” 63 percent of voters still expressed support, including 64 percent of independents and a slight plurality of Republicans.

To further gauge the durability of Medicare for All’s political appeal, the pollsters presented respondents with arguments from both sides: supporters emphasizing that the policy would ensure everyone can receive the care they need and save families money, opponents countering that it would raise taxes and give the government too much control over health care. Even after hearing these competing messages, 58 percent of voters said they still support Medicare for All. That’s a seven-point drop from the initial question — a real drop but a modest one, suggesting that the support is resilient under rhetorical fire.

In her 2017 book, fresh off her presidential contests against first Sanders and then Trump, Hillary Clinton accused Sanders of campaigning against her on the promise to give every American a pony. Like many opponents of Medicare for All, she viewed it as a superficial policy with shallow support predicated on a lack of detailed understanding. But if these Data for Progress poll numbers are any indication, the demand retains majority support when both policy specifics and counterarguments are presented.

In response to Clinton’s pony remark, Sanders’s economic adviser Stephanie Kelton explained that it would be perfectly feasible to give every American a pony if the nation pooled its resources to breed enough ponies. Whether Americans would be interested in pursuing an agenda of equine abundance is unknown. But the majority do seem to like the idea of eliminating private health insurance and associated costs — and, for the most part, are not deterred by the prospect of higher taxes to achieve it. This shouldn’t be too surprising, as the concept of spending money to save money is hardly foreign to working-class Americans, no more difficult to comprehend than the workings of a Costco membership.

By 2023, even the health insurance industry’s trade publications were commenting on the near-total disappearance of Medicare for All from political discourse. While Medicare for All legislation was resubmitted that year with over one hundred congressional signatories, it seemed to lack momentum or the ability to generate conflict. The trade press predicted, correctly, that Medicare for All would not be a major issue in the 2024 election, having been replaced by the major health care issue of reproductive rights. But they also predicted that it would come roaring back in 2028.

Given current trends, that seems like a safe bet. The political fortunes of Medicare for All have been volatile, but the underlying problem has only intensified.

The cost of living is a dominant and pressing concern for American voters, and health care sits near the center of that anxiety. Health care costs keep climbing, vastly outpacing wage growth. Uninsurance and underinsurance are still rampant. Tens of millions of US adults carry medical debt, often considered the most common factor in personal bankruptcy. Millions of Americans continue to delay or forgo care because they cannot afford it. With enhanced ACA subsidies set to expire at the end of this year, enrollees are already facing sticker shock — some looking at premium increases of 50 percent or more for 2026. The dysfunction is chronic and worsening, and no amount of technocratic tinkering will make it go away.

Health care costs remain a major source of hardship in American life and will therefore no doubt remain a source of tension in American politics. If Zohran Mamdani’s victory in New York City’s mayoral election is any indication, the Sanders-inspired economic left has plenty of runway, which means the fight over Medicare for All within the Democratic Party is likely to reignite at some point. Given that the party has been hemorrhaging working-class voters as it struggles to articulate a positive political vision that ordinary people can connect to, the Democratic establishment would do well not to undermine it so mercilessly next time.