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Long thought of as an idealistic but unrealistic proposition promoted by far-left activists, single-payer health care has become a major discussion point across the political landscape. Bernie Sanders made it a central focus of his insurgent 2016 run for the Democratic presidential nomination against Hillary Clinton. House Democrats' messaging on health care in the 2018 midterm elections, and the burgeoning campaign for the 2020 Democratic presidential nomination, have elevated single-payer even further, bringing the issue to the center of American politics.