The Democratic hopefuls, and political watchers and policy experts, too, will say there\u2019s actually quite a bit of daylight between them. That Markey and Moulton are leaning into these pitches ahead of the Sept. 1 primary speaks to the rising costs that are unsettling residents and businesses, and the candidates\u2019 own attempts to assuage voters.<\/p>\n
It also underscores their mission to prove to Democratic primary voters which man truly has the liberal bona fides, as well as their desire to stand out in a race where both candidates often land on the same side of national issues.<\/p>\n
The US health care system is a hybrid of private insurance, employer-sponsored plans, and public programs such as Medicare and Medicaid. While the Affordable Care Act expanded insurance coverage, the United States remains one of the few developed nations without a fully universal health care system.<\/p>\n
Massachusetts has led in this area, reforming health care in 2006 and establishing a marketplace, the Massachusetts Health Connector<\/a>, for those eligible for free and low-cost care.<\/p>\n The term \u201cMedicare for All\u201d is regularly repackaged to fit a politician\u2019s platform, but it often refers to legislation long championed by progressives that would establish a universal, single-payer national health insurance system, similar to those in Canada, the United Kingdom, or Taiwan, and eliminate private insurance. The version pushed by Sanders would, however, go further than any other country, experts say, in also covering dental, vision, and other costs. <\/p>\n During a debate earlier this month<\/a>, Markey affirmed that his support for Medicare for All makes him \u201ca clear choice\u201d as a progressive candidate \u201cwho is going to fight for the future of Massachusetts families.\u201d The term \u201cMedicare for All\u201d was mentioned 12 times during the hour-long event; Markey accounted for 11 of the mentions.<\/p>\n In doing so, he also boasted endorsements from a cadre of progressive leaders, such as Representative Ayanna Pressley, Senator Elizabeth Warren, and Sanders, the Vermont independent who has refiled the Medicare for All Act in the Senate every year since 2017. Warren made the idea a tentpole<\/a> of her 2020 presidential campaign. Sanders, of course, did, too<\/a>.<\/p>\n \u201cIt\u2019s about Medicare for All, which Congressman Moulton does not support,\u201d Markey said during the debate. \u201cMy support for Medicare for All differs from his. He\u2019s going to side with the insurance companies. He\u2019s going to side with the big healthcare companies.\u201d<\/p>\n Moulton\u2019s more vague \u201cuniversal health care\u201d pitch veers closer to former president Barack Obama\u2019s \u201cMedicare for All Who Want It\u201d approach, which Congress never passed. <\/p>\n Universal health care, as Moulton has framed it, would offer public health insurance to those who want it while also keeping private health care plans available.<\/p>\n Moulton, a Marine veteran who receives health care through the Department of Veterans Affairs, said having competition among health plans \u201cbrings down costs,\u201d an argument that has been studied without a definitive conclusion. He also knocked the potential costs of instituting a single-payer system, which could run in the trillions<\/a>.<\/p>\n \u201cMedicare should be available to all. [Markey] thinks it should be imposed on all,\u201d he said. \u201cWe don\u2019t need taxes to go up because of the Senator\u2019s plan.\u201d<\/p>\n At an unrelated event in Boston on Wednesday, Moulton needled Markey, saying he \u201cpromised\u201d Medicare for All when he was last elected in 2020.<\/p>\n \u201cWe need an approach that would actually work,\u201d Moulton said. \u201cIf you have a health care plan that you really like … you shouldn\u2019t be forced off of that program.\u201d <\/p>\n In a recent poll of likely 2026 midterm voters by health care research nonprofit KFF<\/a>, 60 percent of Democratic voters said it is \u201cextremely important\u201d that candidates talk about healthcare costs. Nearly six in 10 said they were worried about affording health insurance or out-of-pocket costs for medical visits and prescription drugs.<\/p>\n Ashley Kirzinger, the director of survey methodology at KFF, said the split between those who support transitioning to single-payer health care, \u00e0 la Medicare for All, and those who want to reform the existing Affordable Care Act falls between \u201cmore progressive and more moderate wings.\u201d <\/p>\n She added, however, that many people don\u2019t fully understand the complex structures of different health insurance systems. \u201cMessaging can have a lot of impact on public opinion,\u201d she said.<\/p>\n Plus, Massachusetts has already expanded health care coverage, and a far higher share of its population under 65 is insured \u2014 nearly 98 percent<\/a> \u2014 than in the rest of the country. Ten percent<\/a> nationwide reported being uninsured in a federal survey. That means voters here may care more about health care costs rather than access, Kirzinger said.<\/p>\n To that end, some voters in well-insured Massachusetts may feel like Medicare for All is a solution to \u201cother states\u2019 problems,\u201d said Leemore Dafny, an economist and public policy professor at Harvard Business School and the John F. Kennedy School of Government.<\/p>\n \u201cThe bigger concern for voters in our state is affordability, and are we going to do something about that?\u201d said Dafny, who oversaw health care at the Federal Trade Commission and advised the Congressional Budget Office for over a decade. \u201cIf people are voting with their local hats in mind, they are more concerned with how expensive it is to have the health care we have in Massachusetts.\u201d <\/p>\n Mark Peterson, a political science professor at UCLA and senior fellow at the university\u2019s Center for Health Policy Research, said in his experience polling voters, \u201cvery few people like the current version\u201d of health care in the United States. <\/p>\n He said the idea of expanding health insurance has come up in campaigns \u201cmore than I have ever seen before.\u201d<\/p>\n \u201cThere is a basis for politicians to come forward and say, \u2018We know this is what the public wants,\u2019\u201d Peterson said. \u201cWhat we don\u2019t agree on is how exactly to do it.\u201d <\/p>\n Samantha J. Gross can be reached at samantha.gross@globe.com<\/a>. Follow her @samanthajgross<\/a>.<\/p>\n![\"US](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/08\/IJ6FCIYMD2N63T4EHOISFHNRRQ.jpg\")
US Representative Seth Moulton spoke to reporters in Boston on Wednesday. Josh Reynolds for The Boston Globe<\/p>\n