Medical debt is turning Medicare for All into a kitchen-table issue in Michigan
LANSING, Mich. — Christina Starks-Clay brought a cashier’s check to a Senate town hall because she was paying down her son’s dental bills on the spot. She still owed $389 after handing over $1,000, even though she has dental insurance. A cleaning for herself had cost $600 only weeks earlier.
Her frustration captured the mood outside Abdul El-Sayed’s September event in Lansing, where voters lined up through the heat and talked less about ideology than about bills, deductibles, and the price of staying healthy. Starks-Clay works as an early childhood special education paraprofessional and runs a small business. She likes the idea of Medicare for All even if she cannot describe every moving part of it.
“It sounds like something that works for everyone,” she said. “All of us.”
Her reaction helps explain why the proposal has gained fresh traction. A new KFF poll found that support for expanding the government health program is now at its highest point in at least a decade, with two-thirds of Americans backing it. The polling also captures a basic problem at the center of the debate: many people do not have a clear definition of Medicare for All, and support shifts when the policy is described in different ways.
The idea remains emotionally powerful because the underlying grievance is simple. Too many Americans cannot afford care, and many who carry insurance still face crushing out-of-pocket costs. In that setting, Medicare for All functions as both a policy demand and a symbol of dissatisfaction with the current system.
Rising costs are giving the proposal new political oxygen
The appeal is strongest in places where the current system feels especially brittle. Jonathan Oberlander, a University of North Carolina-Chapel Hill professor who studies healthcare politics, said the proposal resonates because people are increasingly frightened by what illness can cost.
“We are now, in the past two years, in an era where the Trump administration and congressional Republicans have reversed that progress,” he said, referring to the gains that followed the Affordable Care Act.
Those gains were real. The ACA cut the uninsured rate nearly in half during its first decade and barred insurers from denying coverage based on preexisting conditions. Since then, 40 states plus Washington, D.C., have expanded Medicaid to cover more low-income adults and people with disabilities. But the ground has shifted again. Michigan saw among the steepest enrollment drops in ACA marketplace plans after Congress allowed enhanced subsidies to expire at the end of last year. Insurers in the state raised individual market premiums by an average of 20%. Urban Institute estimates suggest as many as 355,000 Michiganders could lose Medicaid coverage in 2028 because of cuts in Trump’s signature law, the One Big Beautiful Bill Act.
Those figures are not abstract in a state like Michigan, where the cost of getting care now shapes daily decisions. At El-Sayed’s town hall, Darleana Ash said patients at the medical diagnostics lab where she works are skipping tests because they cannot afford them. Some travel hours from rural areas after local labs close or fall out of network. Others have to decide whether medication or groceries comes first.
“If you got somebody that’s 75, 80 years old, guess what? They’re going to go without the medication, because they got to eat,” she said.
El-Sayed has made universal coverage central to his identity
Few candidates have tied themselves to the idea as tightly as El-Sayed. A physician by training and former Detroit public health director, he has campaigned on Medicare for All since his 2018 bid for governor. In Michigan, the proposal has become nearly inseparable from his political brand.
That identity matters because voters often read healthcare plans as a test of whether a candidate is willing to confront the system itself. For Starks-Clay, the appeal is not ideological purity. It is whether a candidate will keep pushing until the cost problem changes in a meaningful way.
“I need to hear, how are you going to make this better for everyone?” she said after showing the payment she had made toward her son’s care.
Healthcare workers and retirees in the crowd described the same pressure from different angles. Some talked about patients choosing between medication and food. Others described their own financial collapse after a serious illness. Cindy Lou Coolich, a retired worker who once helped uninsured people enroll in coverage, said a near-fatal bout of sepsis left her disabled and pushed her onto Medicaid and Social Security. She lost a 15-acre horse farm and then everything else except her car, she said. The irony of the system struck her sharply: her financial life improved only after her ex-husband died, because she became eligible for his Social Security benefits after a marriage that lasted more than 10 years.
“That hardly seemed like the mark of a functioning healthcare system,” she said.
Republicans are warning that universal coverage would force tradeoffs
Michigan Republican Mike Rogers, El-Sayed’s Senate opponent, has answered the issue with a brief healthcare plan and a direct attack on Medicare for All. He argues that a federal single-payer model would eliminate private coverage for millions and require major tax increases.
“If the government’s going to give you something, they have to take it away from someone else,” he said.
Rogers also cited an estimated annual cost of roughly $4 trillion for a Medicare for All system. Yale researchers, in a recent preprint, estimated the policy would cost $4.2 trillion per year but save about $1 trillion in healthcare spending. Those numbers capture the central political fault line: a universal system could reduce total spending while still shifting who pays, when they pay, and through what mechanism.
Opponents know the terrain well. Oberlander said concerns about taxes, disruption, and access to services can make Medicare for All a liability in a close race. Fear of the unknown can be more potent than a spreadsheet of projected savings.
“Politically, what matters is if they can scare people,” he said.
The policy remains far from enactment even if the message resonates
The larger structural problem is that one Senate race cannot remake the U.S. health system. Even if El-Sayed wins, Medicare for All would still face stiff resistance from Republicans, many moderate Democrats, and the healthcare industry’s lobbying power. The proposal may be increasingly popular as a slogan and a response to financial pain, but translating that popularity into law would require a coalition that does not yet exist.
Thomas “Jermaine” Carey, an activist at a Detroit town hall, said he had grown disillusioned with what he sees as party politics that do not deliver enough for ordinary people. Medicare for All sounded good to him, but belief was another matter.
“It’s still America,” he said. “You still have super PACs, the lobbyists that control everything.”
For now, the strongest force behind Medicare for All is not legislative momentum. It is the steady accumulation of medical bills, deductibles, denials, and delayed care that has pushed more voters to see universal coverage as a practical answer to a system they no longer trust.