Sen. Joe Manchin (D-W.Va.) said Thursday that Democrats "need to stabilize" Medicare before expanding the program, The Hill reports.

Why it matters: Progressives are hoping to expand Medicare through a broad social spending bill, which Democratic senators have urged Manchin to support. Manchin's vote is critical in passing any Democratic bill in the 50-50 Senate.

Democrats are exploring adding a huge array of health policies to upcoming spending legislation, ranging from further enhancing Affordable Care Act subsidies to allowing Medicare to negotiate prescription drug prices.

Why it matters: The next few months may give Democrats the opportunity to walk the walk after campaigning extensively on health care for years, and to plug some of the glaring holes in the system that were exposed by the pandemic.

The universal experience of COVID-19 could change how opponents view Medicare for All, Rep. Ro Khanna (D-Calif.) said at an Axios virtual event on Friday.

What they're saying: "The pandemic has reminded us of our shared humanity with other American citizens. It's no longer possible to think, 'Oh, we're not part of those who get sick.' Now almost everyone knows, unfortunately, someone who has been hospitalized, someone who had a serious bout with COVID," Khanna said.

As part of our What Matters 2020 series on the critical trends that will outlive this moment, Axios co-founders Jim VandeHei and Mike Allen discuss the soaring costs of the American health care system.

Health care has become the framework that defines the broader ideological and stylistic divisions within the Democratic primary — a contest between political revolution and Medicare for All vs. bipartisan compromise and a public option.

Yes, but: It's kind of a false choice. Passing either of those health care plans would require a knock-down, drag-out party-line brawl just as intense as the fight over the Affordable Care Act.

Democrats finally debated health care subjects other than Medicare for All on Tuesday night.

Why it matters: We have a much wider range of health care problems than political debates usually suggest. Discussing rural Americans' lack of access to health care may not be as exciting as debating whether to do away with private insurance, but it's a subject that many voters struggle with every day.

Republican voters have moved on from the Affordable Care Act, shifting their focus and opposition instead toward Medicare for All.

By the numbers: In our latest Kaiser Family Foundation tracking poll, 19% of registered Republicans said opposition to Medicare for All is their top health care issue, compared to just 3% who said the same for opposition to the ACA.

Unions across the country are at odds over Medicare for All, with some saying it would free them up to focus on wages and working conditions, while others argue that the health benefits they've already won are better, Politico reports.

The big picture: The fight reflects the larger battle over Medicare for All, but is particularly acute in union-heavy states like California, New York and Michigan. This has all come to a head in Nevada, after the Culinary Workers Union slammed Medicare for All and didn't endorse any of the candidates, providing a portrait of how divisive the issue is within one of the Democratic party's most loyal institutions.

Go deeper ... Medicare for All: Where the Democratic candidates stand

Health care was voters’ top issue in both Iowa and New Hampshire, and it benefitted Sen. Bernie Sanders as well as his more moderate rivals.

The big picture: Sanders has emerged as a national front-runner thanks in part to a base that’s deeply committed to his Medicare for All plan, even as polling data indicate that more moderate ideas like a public option have a broader base of support.