Democrats are increasingly committing to support single-payer healthcare, amid Republican attacks on ObamaCare and pressure from their party’s left-wing base.

What was once considered only a progressive talking point has gained traction as more Democratic candidates have been willing to embrace government-funded healthcare on the campaign trail and more House members have been signing onto the idea.

Single-payer isn’t just being discussed in liberal enclaves of the country like California, where a single-payer measure recently fell short in the state Assembly. It’s a hot topic in Speaker Paul Ryan Paul Davis RyanKenosha will be a good bellwether in 2020 At indoor rally, Pence says election runs through Wisconsin Juan Williams: Breaking down the debates MORE’s (R-Wis.) Republican-leaning district, where all the Democratic candidates running in the primary have supported it.

ADVERTISEMENT

The idea hasn’t won universal appeal in the party, but the spotlight has been shone on the concept of a government-run healthcare system as concerns mount over the Senate GOP’s plan to repeal and replace ObamaCare, which would lead to 22 million more Americans without insurance.

Sen. Bernie Sanders Bernie SandersNYT editorial board remembers Ginsburg: She 'will forever have two legacies' Two GOP governors urge Republicans to hold off on Supreme Court nominee Sanders knocks McConnell: He's going against Ginsburg's 'dying wishes' MORE (I-Vt.) championed the idea of universal healthcare during his insurgent presidential campaign, and he’ll introduce his single-payer plan once the debate over ObamaCare ends.

Other senators — such as Elizabeth Warren Elizabeth WarrenBiden's fiscal program: What is the likely market impact? Warren, Schumer introduce plan for next president to cancel ,000 in student debt The Hill's 12:30 Report - Presented by Facebook - Don't expect a government check anytime soon MORE (D-Mass.) and Kirsten Gillibrand Kirsten GillibrandSunday shows preview: Justice Ginsburg dies, sparking partisan battle over vacancy before election Suburban moms are going to decide the 2020 election Jon Stewart urges Congress to help veterans exposed to burn pits MORE (D-N.Y.), two potential 2020 contenders — are getting on board with a Medicare for All proposal. Sen. Tammy Baldwin Tammy Suzanne BaldwinKeep teachers in the classroom Cher raised million for Biden campaign at LGBTQ-themed fundraiser Democrats seek balance in backing protests, condemning violence MORE (D-Wis.), who faces a tough reelection in a state won by President Trump, said she’s a “maybe” on Sanders’s plan but “anticipates” supporting it, according to The Capital Times.

In the House, Rep. John Conyers Jr.’s (D-Mich.) Medicare for All bill has already netted 113 co-sponsors — nearly double the number of co-sponsors the legislation garnered last congressional session.

Key names are noticeably absent from the list, including House Minority Leader Nancy Pelosi (D-Calif.) and Minority Whip Steny Hoyer (D-Md.). But other members of leadership, including Democratic Caucus Chairman Joseph Crowley (D-N.Y.) and Assistant Democratic Leader James Clyburn (D-S.C.), are co-sponsors of the bill.

“It’s nice to see many senators … and a variety of people in the House publicly stating for the first time on record that a single-payer system is the way of the future that we need to be working toward,” Shannon Jackson, the executive director of the Sanders-aligned group Our Revolution, told The Hill.

Warren has publicly encouraged Democratic candidates to campaign on the idea in 2018 and 2020. But even though the Democrats in Ryan’s likely safe GOP district are supporting it, other Democratic candidates in red states and districts have been more cautious about endorsing single-payer. Rob Quist, the Montana Democrat endorsed by Sanders, was the only candidate in this year’s House special elections to run on that platform.

“I think that the politicians who choose to run on a campaign that states and embodies that pillar of our platform will be successful and they will be able to connect with the people,” Jackson said.

A Kaiser Family Foundation poll shows a modest increase in Americans’ support for the concept, with 53 percent of the public supporting all Americans getting their coverage through a single government plan.

That’s up from 2008 and 2009, when about 46 percent of the public held this position. A majority of the uptick in support has come from independents, Kaiser noted.

But in practice, Democrats haven’t been able to muster enough votes to pass a single-payer plan. In California’s state Assembly, moderate and progressive Democrats couldn’t agree on the proposal. While it passed the state Senate, California Assembly Speaker Anthony Rendon (D) ultimately tabled the proposal in his chamber.

“It’ll tend to be an issue that more left-leaning Democrats are willing to embrace,” said Dan Mendelson, president of consulting firm Avalere Health.

“In order to embrace that concept, you’ll have to be willing to defend the efficiency and effectiveness of a fully run government system, and there are many Democrats who are not going to do that and there are some who are.”

For Democrats, the increased talk about single-payer offers an alternative message to oppose the Senate GOP’s bill to repeal and replace ObamaCare, he said.

Under a single-payer system, all Americans would have health coverage, whereas the nonpartisan Congressional Budget Office estimates 22 million people would become uninsured under the Senate GOP’s healthcare plan.

“I think what you see is the Democrats on the Hill are searching for a single unifying message to unite in opposition to what is happening presently in the Congress,” Mendelson said. “And that’s really what they're looking for.”

Republicans have taken note, seizing on Warren’s request for Democrats to campaign on single-payer in an attempt to play offense in the healthcare debate as Republicans struggle with their unpopular plan.

But Republicans are seeing an advantage in Democrats’ embrace of single-payer, too. The National Republican Senatorial Committee (NRSC) is running auto-play Facebook ads that seek to tie the 10 Democratic senators up for reelection in states Trump won to Warren and government-run healthcare.

The Senate GOP’s campaign arm and the Republican National Committee have pointed to studies that say Medicare for All could cost as much as $32 trillion over a decade.

“I think that the idea that this is becoming our central focus is mistaken and one that our opponents are trying to put forward so they don’t have to talk about their age tax,” said a Democratic strategist with ties to Senate races. “What unites Senate Democrats is opposition to this disaster of a Republican bill.”

Some Republicans don’t see single-payer becoming a toxic issue for Democrats, arguing that those kinds of attacks are more of a “deflection tool” from the GOP’s own healthcare bill.

“It almost seems like it’s too wonky and not enough red meat to really make something catch fire,” a Republican operative in Washington told The Hill. “It’s hard to attack Democrats over single-payer healthcare when we can’t get our act together on repealing ObamaCare.”

Despite increasing talk of single-payer, Democrats haven’t agreed yet on a healthcare message for the 2018 midterms, in part because that will depend on whether Republicans manage to repeal ObamaCare.

"The [GOP] Senate bill is almost designed to make healthcare top-tier issue in the next elections,” said Larry Levitt, a Kaiser Family Foundation senior vice president.

“If the repeal and the replace bill is enacted and signed into law, Democrats will face a challenge as to what their healthcare message will be in 2018 and 2020,” Levitt said, adding that “it’s very likely that many Democrats would turn to single-payer as the next step.”