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Elizabeth Warren’s presidential campaign is up against a wall. After leading the Democratic field in the polling for a couple of weeks, her support has now softened considerably. She’s not in a terrible position in terms of raw delegates: she overperformed her polling to take third place in in Iowa. But a disappointing fourth-place finish in New Hampshire did little to boost the campaign and her path forward seems uncertain beyond persisting and hoping that other candidates fall flat and their supporters flock to her. How did we get here?

If Warren does end up falling short there will be numerous well-sourced accounts, but the trajectory from the outside is already clear enough. In a primary where voters have been obsessively seeking “electability,” and where other candidates have been willing to spin fables or dramatically change positions to secure votes, Warren’s basic decency and honesty have cost her. And the sexism undergirding much of the conversation around electability hasn’t helped.

Both Warren’s defenders and detractors on the left and right side of the Democratic field rightly point to the healthcare debate as the key turning point. As the primary hit the first series of debates, Warren remained ambiguous about the details of her healthcare plan, dodging questions about taxation and saying only that “costs will go down.” Both Sanders on her left and Buttigieg, Biden and Klobuchar on her right pilloried her for her lack of specificity on this front.

The Buttigieg/Biden/Klobuchar wing was content to diss Medicare for All entirely, hedging toward frankly unworkable “Medicare for All Who Want It” style plans. The challenge for the moderate approach to healthcare will be the same as that of the ACA: half-measures that will be immediately hobbled by the medical provider and insurance industries, and that will not provide the cost savings required for a universal plan to be effective. Politically, this was an attempt to undermine Warren whom they saw as the primary threat, and to solidify their own control of the “moderate” lane. None of them saw Sanders as a serious threat at the time, nor did they factor in the degree to which many of their own voters supposedly in the moderate lane had Sanders as their second choice. They also strongly underestimated the degree to which Democratic voters genuinely like and want Medicare for All.

The Sanders campaign, for their part, took advantage by playing a dangerous game. Sanders openly admitted to planning to raise taxes on more than just the top 1%, but correctly noted that it would be made up for by removing premiums. While this is correct on its own terms and is a smart play in a Democratic primary, it’s an extremely risky move for the general election where Republicans will take those “raise taxes” sound bites, scaring seniors into believing that Sanders will raise their taxes while destroying Medicare and handing their money to supposedly undeserving poor young people. There is a reason that no other candidate in the field was willing to deliver that sort of public sound bite–and it’s not due to dishonesty or corruption. Sanders’ strategy has been to simply win the Democratic primary and worry about the consequences for the general election later. Admittedly, it is working for him so far: he is the definitive frontrunner for the Democratic nomination. And perhaps the downside will not be so grave in the general election should he become the nominee. Current head-to-head polling shows Sanders doing quite well against Trump. That said, the general election attacks on taxes and Medicare for All have yet to begin. The attacks could turn out to have no impact–or they could be as devastating as they were against Democrats across the board in 2010.

Besieged on both sides, Warren was forced to draw up some more specific plans on how she would pay for Medicare for All–and how she would pass it. Curiously, however, no such particular specificity was asked of Sanders, who has persistently refused to explain exactly how much it would cost or how he would pay for it. Of course, the moderate candidates refused to even attempt it. Only Warren, apparently, had to have a plan. To be fair, having a plan is her brand. But on the other hand, it smacked more than a little of sexism that only the woman in the race had to get the details all squared away while Sanders, Biden and Buttigieg remained vague.

On the more serious wonk side, it quickly became apparent that a rapid, 1st-term conversion to Medicare for All would be fiscally difficult and politically impossible for all the stakeholders involved (including and especially much of labor.) So Warren straddled the divide, calling for a phased-in transition in her second term while avoiding any tax increases on any but the top 1% to pay for it. On the practical side, Warren has long advocated for eliminating the filibuster and expanding the courts–fully aware that not even a public option much less a Medicare for All plan would garner 60 Senate votes, and that the stacked conservative Supreme Court would find a way to strike down whatever did get passed. The moderate candidates (Buttigieg excepted) have mostly demurred on these political necessities, while Sanders has advocated requiring a talking filibuster as a solution (does anyone doubt that Republicans would talk as long as it takes to stop Medicare for All?) while violating Senate rules and using the Vice President to cheat the parliamentarian by trying to pass the law through reconciliation–which no serious person believes will actually happen, and which would be struck down in the courts if it did. Warren has consistently been the only one tied to both budget and procedural realities, while also taking care to position herself responsibly for a general election and maintain the commitment to Medicare for All that the majority of Democratic voters expect.

No good deed goes unpunished in politics. Warren’s critics on the left pounced, declaring that she had betrayed her commitment to Medicare for All, and (ironically) that she had become dishonest or inconsistent on the subject. Her more moderate opponents followed suit as well, still underestimating Sanders and assuming that they would dominate the field with Warren weakened. Warren’s poll numbers began to slip–first from the conservatives in her unity coalition who shifted to Buttigieg, and then from some progressives who shifted to Sanders. In a perverse turn of events, Warren has struggled to regain her footing as the master of policy, despite the fact that she remains arguably the only candidate who has put forward a serious, credible proposal for achieving the healthcare proposals that Democratic voters want.

But electability issues have also plagued the Warren campaign. Consistently for months now, Warren has beaten Trump in head to head polling, but by smaller margins than Biden or Sanders. It would be unwise to put too much stock into this given factors like name recognition that can generate small differences, as well as the fact that the hyperpartisanship of a general election will likely smooth out those differences. But Democratic voters are obsessed above all else with who can beat Trump, and a series of polls showing Warren underperforming her male opponents against Trump certainly haven’t helped.

Again, though, this is hardly Warren’s fault. Democratic voters shellshocked after Trump’s unexpected victory were told that sexism denied Hillary Clinton the White House. While this is true in part, the typical analysis also consistently undersold the mistakes Clinton made in the 2016 campaign that another woman candidate might successfully avoid in a 2020 match. Instead, mainstream newspapers delivered ethnography after ethnography of unshakeable and deplorable Trump voters in midwestern diners. The notion that a woman cannot beat Trump began to take on the air of an self-fulfilling prophecy. Dispatches from canvassers for the Warren campaign on social media have consistently told of voters who like Warren but are afraid that she can’t beat Trump in a general election–essentially a story of Democratic voters vainly attempting to second-guess what archetypical Obama-Trump voters in Wisconsin exurbs might or might not do. Senator Amy Klobuchar, whose politics are well to the right of Warren’s, has suffered similar electability concerns despite her actual track record of electoral success in the midwest. Meanwhile, a male candidate whose biggest claim to fame and electoral victory is the mayorship of a small city in Indiana is reaping the benefits of nervous voters rejecting more accomplished women on “electability” grounds.

Warren’s chief male opponents in Sanders on the left and Biden and Bloomberg on the right, meanwhile, are promoting theories of electability with little intrinsic merit. There is precious little evidence that Sanders will generate a turnout surge to propel him to the White House, nor is there any particularly compelling evidence that Biden or Bloomberg have significantly greater crossover appeal than more progressive candidates–especially when their liabilities are exploited. All are vulnerable to the same dirty tricks that were used against supposedly unassailable moderates Clinton, Kerry and Gore. There is, however, a large amount of evidence that both Warren and Klobuchar are suffering from both real sexism in the general electorate and the internalized sexism of a Democratic electorate disproportionately obsessed with unpredictable notions of electability.

Where does Warren go from here? It’s hard to say. She is famously persistent and refuses to be anything other than who she is. The entry of Mike Bloomberg, a paragon of exactly the sort of Wall Street-friendly billionaire she has made it her political life’s work to oppose, potentially gives her an opportunity to regain her footing and reassert herself as a champion of both policy and the middle class.

There would be many salutary effects of a Sanders nomination in terms of pushing the Democratic Party toward a more progressive vision (so long as Sanders’ most toxic supporters can be sidelined and avoid becoming the face the campaign and the party.) But it would be a terrible shame if one of the lessons of the 2020 election cycle were that honesty, decency and attention to detail–as well as just being a woman in a world where Donald Trump festers in the White House–were seen as lethal drawbacks for a candidate rather than the strengths they rightly ought to be. And it would be a stain on the Democratic Party if a woman attempting to unite the two factions of the party after an ugly rift in 2016 were left high and dry by both sides in their respective attempts to dominate the other.