Three weeks away from the Democratic National Convention (DNC) a group of delegates are poised to withhold support for Biden as the presidential nominee unless the party changes the platform to include Medicare for All at the DNC.

On July 27 Democratic leaders took a big step in finalizing the Party’s 2020 platform, meeting remotely to approve what would be included and excluded. The official platform hasn’t been published yet but a draft platform gives a good idea of what will and won’t make it in.

Crafting this year’s platform presents some challenges; it of course has to reflect the values of core Democratic voters, but the party is also trying to pull in new progressives, more liberal voters who backed Bernie Sanders, and moderate Republicans who may be swayed against Trump. Different groups may prove essential for Biden to win different swing states so the Party can’t afford to alienate anyone if they want to take the Presidency in 2020. Balancing the competing priorities of the various voters is hard in a good election year, and this year Medicare for All is becoming sticking point for a Democratic Party trying to have historically broad appeal.

Universal health care has been a Democratic standard for years and is already firmly cemented in the platform, but the debate centers around how to achieve that. There are a couple of different potential ways to implement Medicare for All but it is basically the idea of a single payer health care system, or essentially for everyone in the country to have one insurance company. Many other countries with universal health coverage use a single payer model including Canada, Australia, Taiwan, and several European countries. The other option for achieving universal health coverage in the U.S. would be to expand on the Affordable Care Act (ACA) and keep private insurers but improve access and affordability.

The plan outlined in the the current draft of the Democratic platform would expand the ACA rather than move towards Medicare for All. The chapter outlining the plan is titled “Securing Universal Health Care Through a Public Option” and it’s described as giving “all Americans the choice to select a high-quality, affordable public option through the Affordable Care Act marketplace.” The draft platform mentions Medicare for All in passing, saying the Party welcomes supporters of that plan. It seems unlikely that the platform is going to undergo the major change necessary for it to include support for Medicare for All at the DNC.

Bernie Backers Ready to Bail on Biden

As the Vice President when the ACA was signed into law it makes sense that Biden continued to support the program and has advocated for it over a Medicare for All plan. His campaign website gives details about his plan to “protect and build on” the ACA if he’s elected. He has His plan does include “Giving Americans a new choice, a public health insurance option like Medicare.” This seems like a possible attempt to appease some Medicare for All advocates, but if it is it hasn’t worked.

Former presidential candidate Bernie Sanders has been one of the biggest proponents of the Medicare for All plan. His commitment to single payer universal health coverage seemed to a big draw for his campaign and set him apart from the more moderate democratic establishment. Sanders and the Social Democratic ideals that he espouses still enjoy a lot of support among certain Democrats, and others who don’t identify as Democrats. 360 delegates, most of whom support Sanders have pledged to not vote for Biden as the party’s presidential nominee at the DNC unless the official Democratic Party Platform includes Medicare for All.

The 2020 convention will have 3979 delegates and Biden needs 1991 to get the nomination. He’s won a large majority of Democratic primaries and he is going to be voted to be the Democratic Presidential Candidate for 2020, even if the 360 delegates follow through with their plan to rebel over Medicare for All at the DNC. However, having close to ten percent of the delegates dissenting over this issue does send a message that the Democratic party is not quite as unified on some important issues as they might like voters to believe, and may spell trouble for Biden.