An Emporia State political science professor sees the different candidates for President trying to make themselves clear through health care policy choices.

“Essentially, plan A is, do we build on the Affordable Care Act, undo some of the changes that Donald Trump made and continue to expand that as a sort of fallback for people that don’t have private insurance, who don’t have very good or very affordable private health insurance, or do we do what the supporters are calling Medicare for All, essentially national health insurance along the lines of Canada or Western Europe.”

Smith sees this as the wedge issue thus far among the Democrats.

“They’re using this as a proxy for are you more in the center, that would be the Affordable Care Act supporters, are you more on the Progressive Left, that’s the Medicare for All,” said Smith. “It’s important to keep in mind that’s a decision that needs to be made by Congress. Really, what these candidates are doing is taking symbolic positions to send signals to voters.”

Health care policy changes would likely not happen if Republicans continue to control the Senate, even if the Democrats win the White House.

“Trump changed the Affordable Care Act in some ways through Executive Orders, changing some of the thresholds for what counts as a valid policy under the ACA and so forth,” said Smith. “Giving the insurance companies more flexibility to exclude people with high needs and high costs. Those could probably be undone by executive order, but major, large-scale, sweeping changes would absolutely have to get through the Senate.”

Even if Democrats get a Senate majority, as long as Republicans have enough votes to filibuster, changes would be difficult to make.