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Max Nisen

Medicare for All Will Always Be a Tough Sell for Unions

It could offer improvements, but the trade-offs raise uncertainty.

Picking a health-care side isn’t straightforward.

Picking a health-care side isn’t straightforward.

Photographer: Ethan Miller/Getty Images

The Democratic primary debate on Wednesday night had an element of health care deja vu. For the ninth time, the candidates mostly rehashed the same talking points about the relative benefits of a public option and Medicare for All, as proposed by Senator Bernie Sanders.

One of the few exchanges that stood out and might have an impact on Saturday’s caucuses in Nevada focused on the effect of various plans on unions. On Feb. 13, the state’s powerful Culinary Workers Union declined to endorse a candidate. The union has nevertheless been vocal in its opposition to Sanders’s proposal. Several candidates assailed Sanders on that issue at the debate, accusing him of threatening hard-won coverage. The Vermont senator and current front-runner responded by contending that he would never sign a bill that would cut into current benefits.