Few issues have divided Joe Biden and Bernie Sanders, the two top-polling 2020 Democratic presidential candidates, more than health insurance.
Sanders is pushing a "Medicare for All" bill, which would create a government-run program and end private insurance. Biden opposes eliminating the private insurance industry and would rather expand Obamacare by adding a government-run public option.
Other candidates have staked out a middle ground by calling for Medicare for All while also looking to preserve private insurance. Three candidates calling for this mixed approach also co-sponsored Sanders' bill: Sens. Cory Booker, Kamala Harris and Kirsten Gillibrand. (Sen. Elizabeth Warren also co-sponsored the bill, but she supports Sanders' desire to end private insurance.)
Other hopefuls — including former Housing and Urban Development Secretary Julian Castro, entrepreneur Andrew Yang and Rep. Tim Ryan — have said they support a Medicare for All system that preserves private insurance, but Booker, Harris and Gillibrand stand out in light of their sponsorship of Sanders' bill.
Doug Sosnik, a Democratic political strategist and former advisor to President Bill Clinton, said attempts to stake out a middle ground reflect a desire to cater to two audiences simultaneously.
Democratic primary voters are more likely to support Sanders' plan, Sosnik said, but the plan is less popular in the electorate at large. "Trump thinks that's a good issue for him to run on in the general election," Sosnik said. "He thinks he could probably use this issue as a way to reinforce his broader narrative that his opponent is a socialist."
Polling has found that Americans favor maintaining private health insurance, and more support a public option-type program than Medicare for All.
A poll by the Kaiser Family Foundation, a nonprofit focusing on heath care issues, found that 73% of people support establishing a government-run health plan option.
Support for Medicare for All or a similar single government plan has been over 50% for about a year, according to KFF researcher Liz Hamel. An April poll found that 56% of people support such a plan and 38% oppose it. But support for Medicare for All dropped to 37% in favor with 58% opposed, when Kaiser asked respondents if they would support Medicare for All if it eliminated private health insurance companies.
"We find that most people actually think they'd be able to keep their own coverage if a national health plan were implemented," Hamel said. "And that share of people who think they'd be able to keep their own coverage is even higher among supporters of such a plan."
Harris has seemed to change positions on eliminating private insurance. During the first Democratic debate, she raised her hand when candidates were asked if she would get rid of private insurance. The next day, though, she said she misinterpreted the question and that she actually supports "supplemental insurance" in addition to universal health care.
Additionally, during a January town hall on CNN she said, "Let's eliminate all of that. Let's move on," seemingly in reference to the private health insurance industry, but an advisor said the following day that she was open to other options that do not eliminate private health insurance, according to CNN.
A spokeswoman for Harris' campaign did not respond to requests for comment.
Booker has called for a public health care option and has said he does not want to get rid of private insurance immediately, but maintains he also supports Medicare for All.
He told CNN a Sanders-styled government-sponsored health care was his long-term goal and a public option is more practical in the short term.
A Booker campaign spokeswoman did not provide additional comment.
Gillibrand told an AARP forum Tuesday she supports allowing Americans to buy into Medicare and eventually making it an earned benefit like Social Security.
She would not shut down private insurance, but speculated the industry would be unable to compete with a public option.
A Gillibrand campaign spokeswoman did not respond to requests for further comment.