Gloria Neal Showers, a 72-year-old resident of Sumter, South Carolina, loves former Vice President Joe Biden because he’s a “seasoned” politician.

“I want someone to look at things in a realistic manner,” said Showers, a retired federal government employee who’s volunteering for the Biden campaign. “[Sanders] makes me uncomfortable with all the promises he makes. It would take a long time to make all of those things to happen.”

But 500 miles away in Chillicothe, Ohio, Portia Boulger, 66, doesn’t buy what Biden is selling. “[Joe Biden] is a damn liar,” she said.

This past winter Boulger was sick for several months, and she couldn’t believe how much she had to pay for her medicine with basic Medicare. Boulger, who helped start Silvers For Sanders, heard Biden misleadingly tell a group of older voters at the AARP presidential forum recently in Des Moines, Iowa that Medicare-for-all would mean “hiatuses” in health care for older adults. “He is exploiting the elderly,” she concluded.

In the last presidential election, 71 percent of Americans over 65 voted, according to US Census Bureau data — more than any other age group. Older adults are also much more likely to participate in primary elections than their younger counterparts.

For now, that’s good news for Biden. A Washington Post poll from late June to early July showed Biden earning the support of 47 percent of Democratic-leaning respondents over 65. Meanwhile, that same survey showed Sen. Bernie Sanders with just 3 percent backing him. Sen. Elizabeth Warren (D-MA) polled at 10 percent, and Sen. Kamala Harris (D-CA) at 13 percent.

Like any demographic group, voters 65 and older are no monolith. But there are certain characteristics that have come to define older Americans: that they’re generally more conservative, they really care about issues like Medicare, Social Security, and drug prices, and they vote. But advocates for seniors see an electorate actually more fluid than these tropes suggest. They’re also interested in what world they’ll leave for their grandchildren, from climate change to education access and income inequality. And broadly they’re shifting ideologically to the left.

“We have seen a shift since 2010 of older voters moving more Democratic than any other age group,” Richard Fiesta, the director of the Alliance for Retired Americans, said. The question is, just how far left are they willing to go?

What do older adults want?

Republicans have relied on older Americans’ support since the 2000 presidential election. In 2016, 53 percent of adults 65 and older voted for President Donald Trump, who campaigned on protecting Medicare and Social Security and lowering drug prices. But those dynamics could be changing.

Republicans spent the first year of full government control under Trump attempting to repeal and replace the Affordable Care Act with a policy that would have weakened protections for preexisting conditions, and could have been more costly for older and sicker patients. And Republicans are backing a lawsuit to overturn Obamacare’s protections for preexisting conditions. Trump’s 2020 budget proposal included $25 billion in cuts to Social Security over the next 10 years.

“Ideas like privatizing Social Security and Medicare, for the most part — Republicans have been burned by that,” Fiesta said of some older adults’ growing skepticism around conservative ideas. “In general, older voters are just looking at policy and how it affects their day-to-day life and their pocketbooks in terms of retirement security.”

In the months leading to the 2018 election, a Morning Consult poll showed that among the voters that prioritized issues most important to seniors — like Social Security and Medicare, 52 percent preferred a Democrat. Only a third said they would vote for the Republican candidate. And there’s more openness to more progressive ideas.

It’s no longer a matter of protecting Social Security, said Jon Bauman, the president of Social Security Works PAC, but a push to expand it. He cited a 2018 survey from Public Policy Polling, which found 72 percent percent of voters over the age of 65 said they were more likely to support a candidate that supported expanding Social Security. Sixty-eight percent of older voters said the same of Medicare.

But it’s not just Social Security and Medicare.

“I have never met a grandmother who hasn’t lived eyes through the eyes of the grandchildren,” Boulger said, emphasizing income inequality, infrastructure, and environmental policy as issues that drew her to Sanders and the progressive policies he supports. “I really want my grandchildren to have a good life. I want them to be able to travel and float in the ocean. I’m fortunate to live on a farm [by a river]. I wouldn’t put my feet in that river because it’s so filthy.”

And of course, Trump’s conduct in office has added an important cultural layer in this election cycle.

“Later in your life there is a very visceral desire to see the country be stable, to see it be decent,” Bauman said. “If I were Joe Biden, I would be running on return to decency because the Obama administration for many years represented that — a certain kind of decency that is clearly gone.”

That was certainly on Showers’s mind.

“After listening to all the racist rhetoric and his supporters condone the things that [Trump’s] saying, it’s really unraveling to me,” Showers said. “I am black ... I have two boys — they’re men now — I want them to be safe.”

Democrats talk to older voters a lot about health care — with some key differences

In the last week, almost every single candidate running in the 2020 Democratic presidential primary made a point to be at the AARP presidential forum in Des Moines, Iowa, making their pitch to America’s older voters.

Candidates’ talking points hit on similar themes: They talked about lowering drug prices, and ensuring Medicare and Social Security benefits.

Warren touched on her housing plan that would allocate money specifically for older Americans, and touted a bipartisan bill with Iowa Sen. Joni Ernst (R-IA) that would give a tax credit to family home caregivers. Harris said she would advocate for linking drug prices to prices in foreign countries, and that any pharmaceutical company profits made from selling above that set price would be taxed at a rate of 100 percent.

Biden also unveiled his “Plan for Older Americans.” It included policies to control drug prices, like enacting price caps on drugs manufactured by a single company, overturning the federal restriction on negotiating drug prices with drug companies, and making it easier to bring in drugs from other countries, which candidates across the ideological spectrum support. Sanders also advocated for Medicare negotiating drug prices with companies, putting a cap on prescription medication at $200 and making it legal for pharmacies to buy FDA-approved drugs from overseas.

Notably, the biggest divide between Democratic candidates comes down to Medicare, and the health care debate over a government-run system or keeping private insurance. Biden’s plan made clear that he does not support single-payer Medicare-for-all system, instead advocating for reforms to the Affordable Care Act.

“Medicare goes away as you know it. All the Medicare you have is gone. It’s a new Medicare system,” Biden said, adopting a misleading conservative talking about Medicare-for-all at the AARP event.

Warren and Sanders pushed back.

“I am a strong defender of Medicare,” Sanders said, explaining that his proposal expands Medicare coverage to include vision, dental, hearing, and long-term care. “My only criticism of Joe on this one is he basically provided misinformation about what Medicare-for-all would do.”

As Vox has explained, there is no Democratic proposal cutting Medicare, and Medicare-for-all would offer coverage that expands what is currently covered by Medicare. Sanders’s single-payer proposal, which is co-sponsored by Warren, Harris, Booker, and Gillibrand, would phase in the program over four years with no loss of coverage.

Can Sanders and Warren win over older voters?

There’s no question in the polls: Biden is currently winning with older voters. But senior issues advocates like Fiesta and Bauman aren’t sure whether that’s because of familiarity or because of an ideological difference.

“Joe Biden represents a known person who represents a certain kind of decency and would bring that back but he is by no means the only person in this field that represents that,” Bauman said.

The same goes with the effectiveness of Biden’s line of attack on Medicare-for-all. Certainly, Republicans used the line in the 2018 election against Democrats trying to flip conservative-leaning seats — but it’s not clear it worked across the board.

“No one has explained [Medicare-for-all] in a manner that is clear and how it would be different,” Showers said. “I think if it’s developed in the right way it would be a good way for all the people [to get health care].”

The way the Sanders camp sees it, they’re in a better position in the long term. Biden is is on defense, hoping that older adults stick with him. But Sanders, already with a solid base of youth support — that they don’t see going to candidates like Biden — is looking to convince seniors to join the progressive movement, a campaign aide said.

Then again, it may not be the policies at all. Showers’s second choice was Warren, a longtime progressive stalwart who has campaigned on many of same policies Sanders has put forward. Why she supported Warren and not Sanders? Showers paused.

“She’s real,” she said. “He agitates me a little.”