El-Sayed rallies rural Michigan on Medicare for All

Medicaid cuts are expected to close hospitals in Escanaba

On Oct. 26, 2026, Democratic U.S. Senate candidate Abdul El-Sayed began a one-day, 131-mile campaign tour through Michigan’s rural Upper Peninsula. The route started at the Escanaba county fairgrounds and later stopped at the local ski lodge in Iron Mountain and the gymnasium at Northern Michigan University. The Guardian described Escanaba’s surrounding area as the place where nearby Wisconsin dairy country spills into dense forests and the sandy shores of Green Bay. It described the Upper Peninsula as a rural stretch north of Michigan’s mitt and electorally crimson, noting that Donald Trump won some districts near Escanaba by more than 41%.

At the fairgrounds, past sheds labeled “Beef” and “Swine,” hundreds of locals on the political left gathered in the hangar-size 4H Club meeting hall to hear El-Sayed speak. He led the opening call-and-response: “Money out of Politics,” “Money in your Pocket” and “Medicare for All.”

The Oct. 26 tour followed a series of campaign events documented by The Guardian. El-Sayed was photographed near his campaign bus after a Flint rally on Oct. 18. A Latinos for Abdul rally took place at Western International high school in Detroit on Oct. 16, and Ocasio-Cortez spoke to El-Sayed supporters in Rochester on Oct. 16. On Oct. 8, El-Sayed supporters squared off against supporters of Republican Senate candidate Mike Rogers in Grand Rapids. El-Sayed also appeared at a Port Huron rally on Oct. 6.

Days before the midterms, El-Sayed appeared to have caught a rising tide of interest in Medicare for All. The Guardian reported that Americans were preparing for historic cuts enacted in the Republican-led “One Big Beautiful Bill Act,” which was expected to push 17 million people from their health insurance plans.

Ocasio-Cortez served as El-Sayed’s supporting act during the tour. The Guardian described the influential Democratic congresswoman as a longtime Medicare for All proponent and the subject of whispers about a 2028 presidential run. According to an October poll by the Kaiser Family Foundation, two-thirds of Americans support Medicare for All.

Medicare for All is an insurance reform, The Guardian explained. Proposals currently before Congress would replace private insurance, as Medicare for All advocates call for, and make the federal government the nation’s health insurer through a “single-payer” system more closely aligned with health systems in peer-developed democracies such as Canada.

The policy has entered other Democratic campaigns. Troy Jackson, the Democratic U.S. Senate candidate from Maine who is in a dead heat with Republican Susan Collins, called Medicare for All “great coverage.” Angie Nixon, Florida’s Democratic U.S. Senate candidate, made it part of her “working families guarantee.” Chris Van Hollen, the current U.S. senator for Maryland, added Medicare for All to his platform last December after “listening to his constituents.”

The Guardian reported that U.S. healthcare prices were the highest in the world and climbing, that one in every five dollars went to healthcare and that even insured people could find themselves in medical debt. It described the existing insurance patchwork as fueling the profits of “world-leading, resource-unlimited corporations and powerful local monopolies.” The Guardian also reported that some of the most popular health policies of recent years, including measures reining in medical-debt collections, sprang directly from the policy work of Medicare for All advocates. Almost half of all healthcare is already paid for by federal, state or local government, according to the federal Centers for Medicare and Medicaid Services.

El-Sayed’s campaign came as the Trump administration was enacting what The Guardian described as the largest federal healthcare cut in the nation’s history, extracting $1tn from the system primarily through severe Medicaid cuts. Medicaid is the federal-state health insurance program for low-income and disabled people. The Guardian reported that the Medicaid cuts are expected to close hospitals, particularly rural outposts such as Escanaba and the urban core.

The Guardian reported that Democrats worry that replacing private insurance would provide fodder for Republicans and characterized the party as making the stoking of popular resentment against government part of an electoral strategy. The Guardian said those barriers had repeatedly relegated Medicare for All to the political hinterlands. Centrist Democrats worry, it reported, that Medicare for All is nothing more than a decades-old, tried-and-failed idea in a country where “me-but-not-thee” politics has long prevailed.

The Guardian described the broad-daylight assassination of an insurance executive as eliciting “catharsis and not mourning” and called the public yearning for change “personal and visceral.”

El-Sayed, who ran both the Detroit and Wayne County health departments and received a medical degree from Columbia University, said, “Not enough doctors, not enough healthcare.” A member of the crowd shouted, “Not enough psychiatrists!” El-Sayed answered, “Not enough mental healthcare,” and added the campaign slogan, “It shouldn’t be this hard.” Later, someone in the same corner called out, “What about our teeth!”

Competing positions were visible outside El-Sayed’s Escanaba rally, where pro-Trump protesters gathered. Bonnie, a 70-year-old Republican in Delta County who declined to give her last name, said, “We should almost go back to square one and start analyzing what caused this.” She added, “When the socialistic ideas started coming in, like Obamacare, that’s what threw everything in a tailspin.”

Lisa Pieczyski, a woman in her 60s from near Escanaba, carried a homemade anti-green-energy sign. She said, “I want everything privatized,” and argued, “We’ve mandated too many things under insurance that have made the premiums outrageous.” Pieczyski also said she could not trust the government because “Obamacare did all this.”

Michael Glass, 77, the Delta County Republican spokesperson, receives insurance through Medicare Advantage, a privatized version of Medicare. Glass described himself as always middle class and said he had given up something else, such as a Cadillac, to pay for medical insurance. He said, “It is the individual who should take responsibility for his own healthcare, period.”

The Guardian traced employer-based coverage back a century and described its birth as “entrepreneurial innovation and historical accident.” In 1929, Baylor University hospital offered insurance to cover hospital bills for $6 per year to 1,500 schoolteachers in Dallas. The idea spread across the country and gave rise to Blue Cross.

Health insurance became institutionalized during the Second World War. Amid government price controls, employer benefits were one of the few ways businesses could compete for workers. The federal government made the benefit tax-exempt, as it remains today, according to author Paul Starr’s history of the subject. Democrats subsequently pushed for reform and expansion, with their failures to achieve universal coverage shaping the contours of the present patchwork system.

In 1965, Democrat Lyndon Johnson passed Medicare for people older than 65 and its sister program Medicaid, which together provide insurance for more than one-third of Americans today. The Guardian described the reform as a momentous triumph over segregationist opposition and noted that Medicare desegregated hospitals, but said it fell short of its architects’ vision of universal national health insurance.

Robert Ball, a top official in the Kennedy and Johnson administrations, said in an article in Health Affairs, “We expected Medicare to be a first step toward universal national health insurance.” Johnson signed the Medicare bill on July 30, 1965, with Vice President Hubert Humphrey and former President Harry S. Truman present.

Medicare also changed the hospital industry, according to Dr. Luke Messac, an emergency-room doctor at Mass General Brigham and author of Your Money or Your Life, a history of medical debt. Messac said Medicare pushed hospitals to commercialize in the 1980s. Hospitals, the majority of which are nonprofit in the United States, argued that they could drop the explicit charitable missions for which many were founded because Medicare paid patients’ bills. The industry then pushed the IRS to loosen its definition of community benefit while retaining nonprofit status and scaling up billing.

Messac said the result yielded “a lot of middlemen in our system that do not provide a benefit to the public.” He said, “One of the things Medicare for All is intended to do is take the power back from those actors.” He added that strong opposition was predictable and did not establish that the proposal was a bad idea: “It doesn’t mean it’s a bad idea – it may mean it’s a good idea.”

Since Johnson’s Medicare bill, the Affordable Care Act of 2010 has been the only law to rival Medicare in scope. Better known as Obamacare, a market-based version was first proposed by scholars at the conservative Heritage Foundation. Democrats then sought bipartisan support by developing a bill to subsidize insurance for individuals, but that effort did not succeed, and the law passed on a party-line vote. The Guardian called the vote “one of the first signposts of the new era of polarization.”

Republicans targeted the Affordable Care Act for more than a decade. The Guardian said the law is now etched into the minds of conservative voters as the source of healthcare problems. A photograph from the US Capitol showed Democratic House members at an Oct. 28, 2009 event unveiling the Affordable Health Care for America Act.

Stephanie Woolhandler, a professor of public health at the City University of New York and a decades-long Medicare for All advocate, said the single-payer movement has experienced dips and peaks but returns. She said support “always comes back” and explained: “And the reason it always comes back is because the healthcare system has not been fixed – and it may not be fixable at all without single-payer.”

At Iron Mountain, El-Sayed greeted an overflow crowd at the local ski lodge, one of the few public meeting places in the rural town. Supporters repeated ideas they believed ran parallel to Medicare for All: kindness, respect and shared responsibility. One lifelong Democrat said there had not been that much excitement since Bernie Sanders visited the area a few years earlier.

After his speech, El-Sayed condemned U.S. support for Israel’s war in Gaza, called for cheaper gas, groceries and healthcare and criticized Islamophobia. A registered nurse who had worked for 40 years asked El-Sayed how advocates could bring people around to Medicare for All and requested, “Can you make a video or some kind of something explaining – some easy way for people to understand how great and easy it’s going to be?” El-Sayed answered, but Ocasio-Cortez captured the room.

Ocasio-Cortez asked the audience to “Raise your hand if you have waited or delayed getting a treatment or seeing a doctor because you felt you couldn’t afford it.” Every single person raised a hand. She said, “Right now, we are waiting weeks, months, years – to wait until we can afford to see a doctor one day. Healthcare has become a luxury.” She added, “Medicare exists – we provide a healthcare system for every American above the age of 65.”

Ocasio-Cortez then addressed the objection that people should not pay for “someone else’s thing.” She said: “There is this idea that I don’t want to pay for someone else’s thing. First of all, does that mean you don’t want someone else to pay for your care? Does that mean we shouldn’t have Medicare today? Because I’m a young person and I gladly pay, because I want to live in a society where seniors” — before audience cheers interrupted her. The crowd responded with cheers from people excited to share the cost.

At the end of the one-day, 131-mile trail, El-Sayed was in the Northern Michigan University gymnasium, where enormous pictures of athletes looked out at the audience. Physician assistant Anna Aho Rink, a Democratic candidate for Michigan’s 109th U.S. House district, opened the final rally with public health at the center. She said, “All it took was the closure of my little Planned Parenthood clinic about 18 months ago,” and “me being completely fed up with the system that is not working well for any of us to get me up here today and running for office.”

Students were a minority among the Northern Michigan University audience, which also included elderly residents and middle-aged parents with children on a school night. Ocasio-Cortez told the audience, “You don’t need a medical degree to recognize the symptoms of a broken economy,” and, “Michigan, corruption is making this country sick.”

El-Sayed cited his public-health record, including providing 16,000 children with free reading glasses, distributing Narcan, the overdose-reversal medication, through vending machines, and testing water at daycares and preschools for lead before remediating dozens of sites. He concluded, “You deserve to have a long, healthy life in the United States of America.”

The Guardian wrote that, for many, the politics was in perfect relief to the worldview of the Trump administration — one where there is not enough to go around, where someone needs to lose, the government must be gutted and loyalty ranks much higher than fact. The tour’s three-part chant closed the day: “Money out of Politics,” “Money in your Pocket” and “Medicare for All.” The appearances did not resolve the partisan divide over private insurance and government responsibility, but El-Sayed appeared to gain attention for Medicare for All in the Michigan Senate contest.