But in the wake of widespread public rejection of GOP health care proposals last year, Democrats see an opportunity to seize the initiative and advance the party's long-held dream of universal health coverage.
"We're on offense on health care," said Brad Woodhouse, campaign director for Protect Our Care, an advocacy group formed last year to fight the GOP effort to roll back the 2010 health law. "We need to make health care the No. 1 issue."
Speaking to a recent conference organized by Families USA, a leading national patients' rights group, Woodhouse cautioned, however, that Democrats must offer voters more than just a defense of the current law.
In recent months, Democratic lawmakers on Capitol Hill have filed a growing number of bills that would expand eligibility for Medicare or Medicaid, which currently limit coverage to qualifying elderly, disabled or poor Americans. The two mammoth government programs are much cheaper than commercial insurance, in large part because they pay hospitals and other medical providers less.
At the same time, Democratic leaders in several states, including California, New York and New Mexico, are exploring state-based initiatives to expand government health plans.
And last week, the Center for American Progress, a leading liberal think tank, released a plan to open up Medicare to all Americans, while still giving workers the option to stick with coverage offered through an employer.
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"Democrats have mostly been trying to keep Republicans from repealing the current law," said Sen. Tim Kaine, D-Va. "Now we need to come up with the next set of ideas about how to improve coverage and affordability."
Kaine and Sen. Michael Bennet, D-Colo., are co-sponsoring yet another proposal -- which they call Medicare X -- for a new government program based on Medicare, particularly for consumers in parts of the country with limited commercial options.
The renewed interest among Democrats in government health insurance has buoyed the hopes of those who support a more ambitious push to create a single public health plan for everyone.
"What has been happening in the last few years is that millions of working people and young people are getting involved in the party ... and the grassroots movement is overwhelmingly clear about what it wants from health care," Sanders said in an interview.