Democratic contenders for the 2020 presidential election need to ensure that their health care proposals need to take into account union-negotiated insurance plans, AFL-CIO President Richard Trumka said on Thursday.

The expansion of America's health care system has been one of the major issues differentiating candidates on the campaign trail. While some of the Democratic candidates have called for a single-payer system such as Medicare for All, which would enroll all Americans on a government plan, others have pushed for more modest measures to expand health care coverage without eliminating private insurance plans.

The head of the nation's largest labor federation told reporters at a breakfast held by the Christian Science Monitor that "there is no question that ultimately we need to establish a single-payer system, but there has to be a role for those hard, hard-fought-for, high-quality plans that we've negotiated."

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Trumka said if the United States were to eventually adopt a plan like Medicare for All, it would generate huge savings for employers — the question is what then happens to those savings. "What we're saying is our plans, we've negotiated hard and given up wages to get there; there has to be a way for us to recoup that."

The labor federation president indicated it is still too early for his organization to endorse any candidate, but that when they do, the candidate would have to have a large groundswell of support. "Any endorsement of a candidate will come from the bottom up from our members to our Executive Council," Trumka said. The AFL-CIO Executive Council requires a 70 percent vote for the organization to endorse any candidate.

Although he would not speak to any particular candidate, Trumka was encouraged that the 2020 Democratic contenders are all talking about workers' rights and unions — and meeting with union members across the country. "That's a big plus," Trumka said.

"I think the lesson that Democrats and these candidates particularly have come to understand is unless you talk about the economic issues that effect working people, you are not going to get elected," Trumka said. The candidates have made kitchen-table economics the centerpiece of their campaigns, as opposed to during the 2016 election when Democratic nominee Hillary Clinton placed defeating Donald Trump above addressing economic issues. Trumka hopes this reprioritization of the economy will drive workers to the voting booth in the next election.

Trumka noted that a key factor in President Trump's election victories in the crucial rust belt states Michigan, Wisconsin and Pennsylvania was his campaign promise to renegotiate the North America Free Trade Agreement (NAFTA). While he credited Mr. Trump for his willingness to take on "the worst agreement that ever happened," Trumka said "the proposed replacement still falls short of what we need."

In order to help facilitate a "pro-worker" new NAFTA, Trumka announced he will be leading a delegation of labor leaders to Mexico next week to meet with Mexican President Andrés Manuel López Obrador. The delegation, which leaves on Wednesday, will voice to Lopez Obrador the labor movement's concerns over President Trump's revised NAFTA, the U.S.-Mexico-Canada Agreement (USMCA).

While Trumka feels López Obrador has been a "friend of the labor movement," Mexico "has yet to demonstrate that it has the resources and the infrastructure to follow through on its promised reforms." Mexico needs to show how it will ensure workers' rights to negotiate fair wages, Trumka told reporters.

Other enforcement issues Trumka feels Mexico needs to address include dispute settlement mechanisms and stemming the continued flow of trade despite agreement violations. "We want to get to 'Yes,'" Trumka said, but if Mexico can't follow through on enforcing labor law reforms, then the new trade agreement is a non-starter.

"At this point I believe it's been pretty clear that without the support of the labor movement in the United States, in Mexico, and in Canada, the new NAFTA will meet the same fate as TPP," Trumka said, referencing the defunct Trans-Pacific Partnership free trade agreement.

The White House hopes to send legislation to ratify the USMCA to Congress in September following the summer recess. Although the AFL-CIO leader said he has a good working relationship with U.S. trade representative Richard Lighthizer, the official in charge of trade negotiations, Trumka is not in favor of the trade agreement in its current form without enforcement guarantees. "If the administration insists on an up or down vote right now, we would oppose it, and I think we would be successful in opposing it," Trumka said.