How does a progressive Democrat try to unseat a Republican? Step one: Don't talk about single-payer healthcare

Congressional candidate Katie Hill was sitting around a kitchen table with a local activist group last spring when one of the attendees asked her a question: Will she have to “soft pedal” her stance on any issues to unseat Republican Rep. Steve Knight in the 25th District?

The progressive Democrat started to answer, then paused to ask a person livestreaming the meeting on Facebook: “This isn’t going to be something that I’m going to be blasted all over Facebook for, right?”

After getting assurances that the video would only be available to a private group, Hill said one of the issues she can’t discuss directly is single-payer healthcare.

“I shouldn’t go into the district and talk about single-payer, right? Like, that word by itself is going to be something that just immediately turns off a lot of people,” Hill said. “But, if I talk about how we need to make sure that everybody has access to healthcare and that it’s affordable for everybody and how having a government option [is needed] at the very least, that is something people can really get behind. It’s more about the way we talk about things than being very far apart on issues.”

The video, which was posted online to the storage site Dropbox and shared with the Los Angeles Times this week, shows the delicate line some Democratic candidates are walking as the national party goes after the more than 30 seats it needs to win back control of the House. The idea of a single-payer healthcare system, in which the government pays for a base level of healthcare for all citizens, has been growing in popularity in party circles since it became a major policy plank in Sen. Bernie Sanders’ campaign for the Democratic presidential nomination. But it remains a nonstarter for many conservatives and is unlikely to catch on in a Republican-controlled Congress and White House.

The path to a House Democratic majority goes through the seven California Republican-held districts that backed Hillary Clinton in 2016. That includes places such as the 25th District, where voters have sent Republicans to Congress for decades, but Democrats have a 3-percentage-point voter registration lead and voters there chose Clinton by nearly 7 percentage points in 2016.

Hill said in an interview that she believes the country will eventually have single-payer healthcare, but using the term puts off people in a district with a large number of conservative voters. Hill said she asked whether the video — shot during a May 2 gathering for the liberal activist group Indivisible — would be widely shared, because talking to a liberal group is different from talking to the general public.

“Look, is it the best idea to be talking about the strategy for how we frame conversations? Probably I wouldn’t be advised that’s what I should say,” Hill said.

Hill has spoken publicly about her wish for every person to have healthcare and about paying out of pocket for her teenage brother’s drug addiction treatment. But she said achieving a single-payer healthcare system shouldn’t be prioritized over working for healthcare solutions in the interim, including practical fixes to the system that both sides can embrace.

“It comes down to having nuanced discussions,” Hill said. “As purple districts, we have the opportunity to say, ‘No, we can’t have these binary conversations.’”

Healthcare is expected to be a key issue in the 2018 contests.

Democrats are already lambasting GOP lawmakers, including Knight, for backing their party's House healthcare bill in May. Knight has said it was a tough vote, but he thinks it was the right bill to address changes needed to the Affordable Care Act, and he isn’t worried about Democrats using it against him.

At the same time, some have threatened to make support for single-payer healthcare a litmus test for Democrats. Our Revolution, a political group inspired by Sanders, threatened primary challenges this week against Democrats who aren’t vocal about it.

Former Ohio state Sen. Nina Turner, president of Our Revolution, told Politico, "We're not going to accept no more hemming and hawing. No more game playing. Make your stand."

Backers of single-payer healthcare in California are also trying to recall Democratic Assembly Speaker Anthony Rendon because he shelved a bill to create a state system earlier this year.

But the National Republican Congressional Committee is trying to use single-payer healthcare against Democrats. Just last week, it went after another Democrat in the race against Knight, Bryan Caforio, over whether he supports a single-payer system. He has said for months that he does, although Caforio, like Hill, doesn’t use the phrase. He’s more likely to refer to “Medicare for all.”

“This is a universal human rights issue, and I’m going to talk about that in the district,” Caforio said.

Caforio lost to Knight in 2016 by 6 percentage points. Three other Democrats have announced challenges, but Caforio and Hill have an early fundraising lead.

sarah.wire@latimes.com

Follow @sarahdwire on Twitter

Read more about the 55 members of California's delegation at latimes.com/politics

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