When House Speaker Nancy Pelosi introduced legislation this week to strengthen the Affordable Care Act, Democrats across the ideological spectrum were quick to express their support: moderates, liberals, even Representative Alexandria Ocasio-Cortez, the often uncompromising progressive freshman.
But not Bernie Sanders.
When asked on Tuesday night whether he, too, supported the House bill, Mr. Sanders was defiant.
“No,” he said tersely.
“No,” he said again, when pressed. “The incremental reform that I support is phasing in ‘Medicare for all.’”
Mr. Sanders, the independent senator from Vermont, is not one to compromise on his long-held policy positions, especially his signature stance on health care, though he has, in fact, supported non-“Medicare for all” legislation in the past, including backing a 2017 bill to allow people to buy into state Medicaid plans.
Yet more than a month into his second presidential bid, his response underscored, once again, his willingness to stand apart from a party he has not joined but hopes to helm.
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His reply on Ms. Pelosi’s bill also afforded him momentary distance from ideologically similar rivals, including Senator Elizabeth Warren of Massachusetts, who on Wednesday tweeted out her own support for the Affordable Care Act.
Mr. Sanders’s unflinching position is a reminder to voters that he is unabashedly left-wing and unlikely to worry about working within the confines of the existing system anytime soon. It also reflects a schism within the Democratic Party over the best way to recapture power in Washington: Should Democrats project big, bold policy ideas that could fundamentally alter the political structure but face long odds in a hyperpartisan Congress? Or should they present incremental measures that are more likely to appeal to the center and could succeed sooner?
Some candidates, including Ms. Warren, are hoping they can bridge the gap and do both. Others are betting that there is a following for within-the-system politics. Candidates like Senator Amy Klobuchar of Minnesota and Beto O’Rourke, the former congressman from Texas, have spent the early days of their campaigns highlighting their common-ground legislation with Republican colleagues, and former Vice President Joseph R. Biden Jr., expected to enter the race next month, wears his bipartisanship like a badge of honor.
It is a debate that has raged within the party since before the midterm elections last year, with some strategists suggesting that bold, disruptive ideas like the ones championed by Mr. Sanders electrify voters and spur them to the polls.
“Whoever is president next just can’t make incremental change,” said Karine Jean-Pierre, a senior adviser to the progressive political organizing group MoveOn.org, who worked on President Barack Obama’s 2008 and 2012 campaigns. “We just have to be bold, and we have to take chances — people are hurting. We need to move forward in a big way.”
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Others, however, argue that candidates should offer a vision of political compromise and deliberate change, a line of thinking that seemed to have taken hold anew this week. The day after Ms. Pelosi put forth — and Mr. Sanders rejected — her health care proposal, she introduced a plan to combat climate change inspired by, but far more modest than, the sprawling resolution known as the Green New Deal.
(The Green New Deal proposal, which aims to fight climate change as well as address societal problems including income and racial inequality, has garnered qualified support among some Democrats, including Mr. Sanders and other 2020 candidates. But Democratsvoted “present” on a motion in the Senate this week to consider the plan, calling the vote a political ploy by Republicans. It failed, 0 to 57.)
Mr. Sanders’s campaign said he was not available to comment for this article.
Even as Mr. Sanders remained firmly rooted on the left, two presidential candidates rolled out policy proposals this week that seemed more palatable than revolutionary.
Ms. Klobuchar, who has been more circumspect in her policy positions than some of her opponents, introduced a plan on Thursday that called for a trillion dollars in federal funds to upgrade the country’s infrastructure, an issue that her aides say has broad bipartisan appeal. Senator Kamala Harris of California announced a plan to invest federal money into teacher pay. Under the proposal, her campaign said, the average teacher in America would receive a $13,500 pay increase.
Other candidates have also balked at promoting attention-getting proposals that would fundamentally remake existing policies, even when they broadly support them. During a town hall-style forum on Wednesday night, Senator Cory Booker of New Jersey called the current health care system “broken” and said he believed the country should have “Medicare for all.” But he also said, “We have to show a pathway to get there through practical things” that included lowering drug prices, a policy that even some Republicans have embraced.
A recent NBC News/Wall Street Journal poll showed that 55 percent of Democratic primary voters preferred a candidate who “proposes larger-scale policies that cost more and might be harder to pass into law, but could bring major change on these issues”; 42 percent said they preferred someone who “proposes smaller-scale policies” that would “bring less change.”
Mr. Sanders is not the only candidate with bold, agenda-setting policy plans. Ms. Warren, for example, has proposed levying an annual tax on the superwealthy and breaking up technology giants like Amazon and Facebook.
But among moderates in the party, the notion that candidates have to be daring to capture the nomination is anathema.
“The path to the White House and to majorities has to be in a pragmatic, progressive area,” said Jim Kessler, executive vice president for policy at Third Way, a center-left think tank. “If you go too far left, Donald Trump gets re-elected and Republicans control both houses of Congress.”
“Our heads are in the clouds, but our feet are also on the ground at the same time,” he added. He cited his group’s universal health care plan, which he said was “just as ambitious” as Mr. Sanders’s proposed “Medicare for all.”
There was, however, a key difference.
“It just doesn’t blow up the system,” Mr. Kessler said. “It builds on the existing system.”