With a slew of headline-making negative reactions to Sen. Kamala Harris’ (D-Calif.) support for eliminating private health insurance – including an effort by Sen. Elizabeth Warren (D-Mass.) to dodge the issue and what Vox called a “confusing” answer by Sen. Cory Booker (D-N.J.) as he sought to square his support for the Sanders single-payer bill while calling for the preservation of private health insurance – it’s important to step back and consider the different path Presidential candidates are taking from the one that delivered Democrats the House majority last year.

What can 2018’s midterm elections teach us about the 2020 health care debate? Speaking to The New York Times this past weekend, one Democratic strategist sums it up this way:

“Most of the freshmen who helped take back the House got elected on: ‘We’re going to protect your health insurance even if you have a pre-existing condition,’ not ‘We’re going to take this whole system and throw it out the window,’” said Kenneth Baer, a Democratic strategist.

Providing additional background for those seeking to understand the political risks and realities of a Medicare for All approach, a new report issued by Third Way takes a look at November’s midterm results in early 2020 presidential primary states:

In 2018, Democrats won all six competitive House races in the four early primary states … Not a single one of these winning candidates was a far-left populist … They ran not on a Democratic Socialist agenda but on mainstream and moderate solutions to the problems that most vex their constituents: [such as] healthcare affordability and access … Healthcare dominated, and every single one of these successful Democrats focused on voters’ core interests like access and reducing cost, as well as preserving seniors’ earned benefits of Social Security and Medicare. None of the six supported single-payer healthcare.

Meanwhile, The Atlantic’s Ronald Brownstein takes note of the high percentage of Americans in key Congressional districts who benefit from employer-provided health coverage:

More than four-fifths of the population receives employer-provided coverage in a wide range of districts that Democrats flipped from the GOP in 2018, including suburban seats in Northern Virginia and New Jersey, and seats in Chicago, Minneapolis, and Detroit, according to census results. And roughly three-fourths receive health insurance through their employers in districts that Democrats won elsewhere: in northeast Iowa; Irvine, California; Salt Lake City; Virginia Beach, Virginia; and the suburbs of Richmond, Virginia; Atlanta; Des Moines; Kansas City, Kansas; and San Diego … Very few of the winners in these suburban seats endorsed the single-payer idea, as the journalist Libby Watson has tabulated.

When looking at this debate, it’s crucial to remember that millions of Americans count on employer-based and other private health coverage, and polls show most Americans are happy with the coverage they have. They have made it clear that they want their elected leaders to protect and build on what’s working in our health care system, and come together to fix what isn’t.