Vermont Sen. Bernie Sanders and his vision of single-payer healthcare won the night in New Hampshire for Democrats. Donald Trump, who has shared less about his healthcare views but also once favored a more centralized insurance system, came in first for the Republican field.
Both were declared winners of the New Hampshire primary by wide margins as soon as the polls closed. By contrast, Sanders was nearly tied with Hillary Clinton in the Iowa caucuses last week, while Trump came in second to Texas Sen. Ted Cruz.
Exit polls showed issues such as income inequality and the economy as top concerns for Democratic voters in New Hampshire, while terrorism and the economy were top of mind for Republican voters. The exit polls also showed that the majority of the Medicare-eligible age group, those age 65 and older, voted for Clinton.
The expected New Hampshire results are nevertheless a blow to the Clinton campaign. She has pushed back recently on Sanders' Medicare-for-all plan, saying there is no chance it would pass in Congress, and that the nation should instead focus on building on the successes of the Affordable Care Act.
Sanders countered that he would not scrap the current system while working toward his single-payer plan, and that he is a supporter of the ACA who wants to further healthcare access.
In his victory speech Tuesday night, Sanders did not back down from his proposal.
"In a time when every major country on Earth guarantees healthcare to all of their people, we should be doing the same in our great country," Sanders told supporters, according to a transcript. "In my view on President Obama's leadership, the Affordable Care Act has been an important step forward, no question about it, but we can and must do better. Twenty-nine million Americans should not remain uninsured, and an even greater number should not be under-insured with large deductibles and copayments."
Sanders also said his single-payer approach would lead to lower per-capita health spending, and went after prescription drug companies, calling it "an obscenity" that the top three U.S. manufacturers "made $45 billion in profit last year."
"When we make it to the White House, the pharmaceutical industry will not continue to rip off the American people," Sanders said.
Republicans may take Sanders' victory in New Hampshire as cause to begin directly attacking his health policy ideas, which are to the left of most Democrats, and very far from the Republican plan to repeal the ACA entirely. In a debate last week, Cruz railed against "socialized medicine" and said it would create healthcare rationing.
Trump has said he would repeal the health reform law, but has also indicated he would be interested in some more liberal ideas for healthcare. He has expressed support for allowing Medicare to negotiate drug prices with pharmaceutical companies, which both Sanders and Clinton also support. During an early Fox News-hosted debate in Cleveland, Trump said a single-payer system works “well in Canada, it works incredibly well in Scotland."
In a recent interview, Trump said he would “take care of everybody” to ensure health coverage, and that the government would pay for it. He has not elaborated or offered any detailed plans.
The next votes will come in the South Carolina primaries and the Nevada caucuses toward the end of the month. That will be followed by more than a dozen primaries on Super Tuesday, March 1.