Sydney Ember

As nearly two dozen other presidential candidates and their supporters were heading to an Iowa Democratic Party dinner, the first major event of the 2020 election cycle, Sanders was on his way to march with striking fast-food workers. While such populist gestures have defined Sanders’ life in politics, he was taking a risk in favoring grassroots organizing over the party politicking usually essential to winning the Iowa caucuses, as he acknowledged in a car ride to the protest.

“This is going to be hard,” he said, according to an aide who was present. “But,” he said, using a profanity for emphasis, “this is the only way we’re going to do it.”

Every top Democratic candidate has been making calculations to try to win Iowa’s first-in-the-nation caucus, and, lately, many have been staking their candidacies to a big result on Feb. 3. But Sanders stands out in several ways: He nearly won Iowa in 2016 against Hillary Clinton and, some allies said, he cannot afford to be anything less than a close runner-up again.

He is returning to the state this week after suffering a heart attack that stirred questions about his campaign’s viability. He has the most money in the race but also faces tough competition for liberal voters from a leading Iowa candidate, Sen. Elizabeth Warren.

And, as his solidarity with fast-food workers showed, he is trying to strengthen his base of voters by dedicating time and resources to wooing workers, young people, Latinos and others in Iowa, rather than focusing on winning over more party leaders. It is something of a shift from 2016, when Sanders and his allies were a greater presence at Democratic Party dinners and events to try to compete with Clinton.

Increasingly, Sanders and his allies are making it clear that he is determined to win Iowa, even as he faces an uphill battle with about 100 days to go before the caucuses.

“I’m here this evening to ask for your help,” he said at a town hall-style event in Marshalltown on Thursday. “I don’t have to tell anybody in this room that Iowa plays a very disproportionately large role in the political process.”

Sanders continues to lag behind Warren and former Vice President Joe Biden in polls. As candidates like Pete Buttigieg, the mayor of South Bend, Indiana, nip at his heels, his campaign has zeroed in on Iowa, viewing it as critical to his chances of winning the Democratic nomination, according to several people familiar with his strategy. Some advisers said a strong showing in Iowa — especially if he finishes ahead of Warren — would be enough to catapult him through New Hampshire and into Nevada and Super Tuesday.

“Iowa has to be a top priority for the campaign — we need to do very well in the state,” said Rep. Ro Khanna, one of Sanders’s national campaign co-chairs.

“I hope he can go there every week,” Khanna said. “He needs to be in Iowa as much as possible.”

To that end, his campaign has recently reallocated resources to the state, including spending $1.3 million to air its first television ad this month. It has built out its Iowa team, naming a key communications aide as its deputy state director. The campaign has also expanded its ground operation, with 13 field offices and more than 110 paid staffers.

Sanders returned Thursday for a two-day, five-event swing and plans to be back next week to lead a “march to end corporate greed.” According to aides, his campaign is also discussing a trip to the state with Rep. Alexandria Ocasio-Cortez, who recently endorsed him.

Sanders, however, has competition: Nearly all of the top-tier candidates have also signaled that Iowa is a top priority.

Biden’s campaign has publicly sought to lower expectations, but he has been to the state three times this month and is planning another four-day swing there next week. Warren, whose campaign was among the first to establish a presence in the state, has 19 field offices. Buttigieg recently completed an Iowa bus tour. Sen. Amy Klobuchar, D-Minn., has made 21 trips to the state, including her own post-debate bus tour, and has visited 55 of the state’s 99 counties. Sen. Kamala Harris vowed to visit the state every week in October.

The sudden flurry of attention represents a change from earlier this year, when White House hopefuls appeared to be embracing a more national campaign strategy that took them beyond Iowa and other early nominating states. The growth of social media, the changes to the electoral calendar and the increasing diversity of the Democratic electorate combined to make it seem like Iowa, a predominantly white state, might lose its sway in the primary process.

“Usually there’s a ramp-up period in past presidential cycles,” said Sean Bagniewski, the Democratic chair in Polk County, about the focus on Iowa. “This year, it was like a thunderclap.”

The stakes in Iowa for Sanders have personal and psychological dimensions. After his surprising performance in the caucuses in 2016, some aides said the state has taken on an almost mystical quality. A weak result could also indicate that he does not have the same influence with progressive voters as he used to.

Despite a series of disappointing polls in the state — a Suffolk University/USA Today poll released this week showed him in fourth place — allies are confident he is still in a position to do well.

Like it did in 2016, the Sanders campaign is betting on an extensive ground game that relies heavily on a vast network of volunteers that they hope will motivate other supporters to turn out on caucus night — including people who do not typically participate in the political process.

His aides believe that the technique, known as distributed organizing, will help motivate unlikely or first-time caucusgoers, especially those who were too young to participate in the last presidential caucuses; Latino voters, whose turnout rate in the caucuses is typically low; and working-class voters. The campaign sees high potential for victory particularly in and around college towns, like Ames and Iowa City, and in rural areas.

To solidify his base of support, he has spent hours rallying on college campuses in an effort to capture the support of young voters. He has courted labor support, particularly in counties along the Mississippi River. And he has held multiple “Unidos con Bernie” events with Latino voters.

With $33.7 million cash on hand at the beginning of October, he will likely have plenty of money to spend in the state going forward on staffing and advertising. (On Friday, his campaign plans to go on air with an upbeat new television ad, about climate and green jobs in Iowa.)

Aides are sensitive to any comparison of the Sanders campaign of 2020 to the Sanders campaign of 2016: Unlike then, when voters only had to choose between him and Clinton, they now have a wealth of options. To win in Iowa this cycle, he need only secure a larger percentage of the vote than his opponents.

But he has struggled to expand his support in the state, and there are some signs it may be diminishing: According to a poll last month from The Des Moines Register and CNN, only 25% of those who said they caucused for Sanders in 2016 said they would do so again, while 32% said they would support Warren and 12% said they would support Buttigieg.

In recent months, Sanders has begun holding smaller town hall-style events that give audience members the opportunity to share their own deeply personal stories. Advisers hope the events will inspire voters to work together to change what Sanders views as a broken system. (The campaign recently cut a television ad from one of these town halls in Iowa that featured a woman telling a horrific story about medical debt.)

Sanders is staking his success on supporters like Morgan Baethke, 58, of Indianola, Iowa, who was one of about 100 people who came to hear him speak in Marshalltown, the first stop on a two-day “end corporate greed” tour.

Baethke, who works in retail, said he tries to convince other voters to caucus for Sanders by knocking on doors and participating in parades and festivals.

But he also revealed a fundamental tension endemic to the Sanders campaign’s organizing strategy: He said that he prefers to speak to voters in a neighboring county rather than his own.

“I don’t feel comfortable in my home county looking at customers who I deal with during the day, going to their house in the evening, knocking on their door and saying, ‘Would you support Bernie Sanders?’” he said.

This article originally appeared in

Bernie Sanders Almost Won Iowa in 2016. He Knows He Can't Slip Now.

MARSHALLTOWN, Iowa — On a trip to Iowa in June, Sen. Bernie Sanders confided in aides about a central gamble of his second bid for the White House.

Sanders made his mark, but it did not occur onstage: His presidential campaign confirmed that he had secured the endorsements of two of the most prominent left-wing women of color in Congress, Reps. Alexandria Ocasio-Cortez of New York and Ilhan Omar of Minnesota.

Sanders appeared alongside Ocasio-Cortez Saturday at Queensbridge Park in New York at his first rally since his heart attack. She announced her support and hailed the Democratic primary field.

“No one wanted to question the system, and in 2016, he fundamentally changed politics in America,” she told an enthusiastic and diverse crowd. “We right now have one of the best Democratic presidential primary fields in a generation and much of that is thanks to the work that Bernie Sanders has done in his entire life.”

Sanders hailed Ocasio-Cortez as “an inspiration to millions of young people not just here in New York but across this country who now understand the importance of political participation and standing up for justice.” He said: “I am so delighted that Alexandria is part of our campaign, and I look forward to traveling with her all over this country.”

Sanders briefly, and somewhat indirectly, addressed his health. “I am happy to report to you that I am more than ready, more ready than ever, to carry on with you the epic struggle that we face today,” he said. “I am more than ready to assume the office of president of the United States.”

He added: “To put it bluntly, I am back.”

It was a theme that dominated the afternoon, as progressive activists and leaders paraded onto the stage to offer words of support. There was his wife, Jane Sanders, who declared him “healthy” and “more than ready to continue his lifelong struggle to fight for the working people of America.”

There was Michael Moore, the filmmaker, who said he was “glad” Sanders was 78. “We will benefit from his wisdom.”

And there was Tiffany Cabán, who nearly won the Queens district attorney race earlier this year; Carmen Yulin Cruz, the mayor of San Juan; and Nina Turner, a vocal supporter at his rallies on the campaign trail.

Beyond serving as a show of strength, their message aligned with one his campaign is aggressively trying to project: That he is building a multiracial, working-class coalition of voters and that his campaign speaks to men and women, to white voters and minorities.

It is a message he needs now more than ever.

The endorsements jolted the primary race, signaling that Sanders, 78, was still a formidable contender just as it had increasingly seemed like a contest between Sen. Elizabeth Warren and former Vice President Joe Biden. They also shifted the conversation away from his health issues and his age, infusing his campaign with a renewed sense of vitality.

“There’s been some degree of criticism overall — Bernie Sanders can’t win because his movement is tapped out,” Faiz Shakir, Sanders’ campaign manager, said. “This discounted that.”

But if the endorsements were an obvious indication that Sanders was not ready to surrender the party’s left flank to Warren, it is not clear how much they will ultimately change the race — in part because there are signs that voters are not taking their cues from endorsements. Warren, for instance, has attracted huge crowds, posted some of the biggest fundraising numbers, and surged to the top of national and early-state polls despite lacking endorsements from a single governor, big-city mayor or senator outside her home state. At the same time, Sen. Kamala Harris of California is struggling to gain momentum even though she has the backing of politicians across the country, including her state’s governor, Gavin Newsom.

Sanders’ endorsements could inject fresh energy into a campaign that in some respects needed it badly. Consistently trailing Biden and Warren in recent polls and struggling to expand his base, he spent the last two weeks facing a barrage of questions about his health. His campaign made a show of financial strength this month when it reported it had collected $25.3 million between July and September — the most of any candidate in that period — but the announcement was quickly eclipsed by news of his heart attack.

Sanders’ campaign is hoping that endorsements from Ocasio-Cortez and Omar — and possibly Rep. Rashida Tlaib of Michigan— prove that he is building a multiracial, working-class coalition of voters. His aides are also confident that the women will motivate young people, a group that was critical to his success in 2016 and that his allies know he must win over again, both optically and for actual votes.

“I don’t think anyone would question or doubt that they, more than a lot of people, have the ability to inspire young people,” Shakir said, referring to Ocasio-Cortez and Omar. “That in itself is going to be tremendous.”

The endorsements underscore how Sanders is striving to portray himself as the candidate furthest to the left. In recent months, as support for Warren has swelled, Sanders has unveiled policy proposals that have gone beyond hers — including plans to completely eliminate student debt and medical debt, and to impose a wealth tax that would apply to more households and is steeper for rich people than the one Warren has proposed.

Several Democratic officials and strategists said the endorsements of Ocasio-Cortez and Omar could stoke enthusiasm among the far left and perhaps prompt some of Warren’s supporters to take a second look at Sanders.

But some said the endorsements might not do much to grow his existing coalition, pointing out that the two women carry a similar anti-establishment, populist message that already appeals to Sanders’ voter base. Some suggested the endorsements could even help Warren by making her appear more moderate and pragmatic in comparison with Sanders.

Although Ocasio-Cortez and Omar have a big following nationally, and have become preferred targets of President Donald Trump’s, their support may not help woo voters, particularly in critical early states.

Jess Morales Rocketto, a Democratic strategist who worked on Hillary Clinton’s 2016 campaign, said the endorsements could give Sanders a fundraising bump and more media attention. But she was skeptical that the new support would sway undecided voters.

“I don’t know that a congresswoman from New York, one from Minnesota, one from Michigan are superinfluential to voters in Iowa, New Hampshire, Nevada and South Carolina,” she said.

Sanders’ allies said the visual imagery alone — an older man standing with younger women of color — could be enough of a benefit, especially as he continues to fight the perception that his voter base is skewed white and male.

Cori Bush, who was endorsed by Ocasio-Cortez in her unsuccessful bid for Congress last year in St. Louis, said the endorsements from the two women “knocks away that whole Bernie Bro idea.”

She also said their support “wipes away the idea that maybe he’s not the progressive champion anymore,” she said.

Last month, the Working Families Party, an influential liberal group that backed Sanders in 2016, endorsed Warren. The announcement infuriated his supporters. But it also sent a message: It was time for progressives to pick a side and starting organizing.

Maurice Mitchell, the Working Families Party’s national director, dismissed the notion that the dueling endorsements would splinter the left.

“We’ve said from the beginning that progressives need to get involved, and that’s exactly what they did,” he said, referring to Ocasio-Cortez and Omar. “It’s a good thing for our movement that folks choose one of these candidates.”

Mitchell said his group — which endorsed Ocasio-Cortez’s opponent, then-Rep. Joseph Crowley, in the 2018 primary — planned to marshal its network of volunteers across the country to work with voters to nominate Warren.

What is less obvious is the role Ocasio-Cortez and Omar will play for the Sanders campaign. Waleed Shahid, communications director for the progressive group Justice Democrats, which helped propel Ocasio-Cortez’s congressional campaign, said the two women can mobilize their own networks of volunteers and donors. He pointed to Ocasio-Cortez’s influence this year in the Democratic primary for district attorney in Queens, where her support for Tiffany Cabán helped to nearly lift her to victory.

And because the two congresswomen represent the activist base of the party, he said, they could galvanize progressive activists around the country.

But perhaps above all, the endorsements will help dispel questions about Sanders’ viability post-heart attack, he said.

“Some voters do have questions around his age,” Mitchell said. “Voters who have that question in mind are probably thinking twice about that now that they see the youngest leaders of the Democratic Party supporting Bernie.”

Sanders Says He's Back, Revitalized by a Big Endorsement

NEW YORK — Sen. Bernie Sanders of Vermont needed a big moment at the Democratic debate Tuesday. Absent from the campaign trail after suffering a heart attack two weeks earlier, he and his aides were aware that his performance and his health would be under intense scrutiny.

Alexandria Ocasio-Cortez Is Endorsing Bernie Sanders. Will That Matter?

Sen. Bernie Sanders of Vermont needed a big moment at the Democratic debate Tuesday. Absent from the campaign trail after suffering a heart attack two weeks earlier, he and his aides were aware that his performance and his health would be under intense scrutiny.

Speaking to reporters outside his home in Burlington, following a visit with a local cardiologist, Sanders gave no indication he was planning to drop out of the race and said he would continue to campaign actively.

“We were doing, you know, in some cases five or six meetings a day, three or four rallies and town meetings and meeting with groups of people,” Sanders said. “I don’t think I’m going to do that.”

“I think we’re going to change the nature of the campaign a bit,” he added. “Make sure that I have the strength to do what I have to do.”

Asked to clarify what he meant when he said the campaign would change, he replied: “Probably not doing four rallies a day.”

Standing next to his wife, Jane, Sanders, 78, also acknowledged that his heart attack could be a factor for voters considering whether to support him.

“Everything that happens every day weighs on how people feel about you,” he said. “And my own view is that — and I think it’s the voters’ view — you look at the totality of who a candidate is. You look at what that candidate stands for, the integrity of that candidate, the history of that candidate.”

Sanders returned to Burlington over the weekend after being hospitalized in Las Vegas for three days last week, recovering from a heart attack. His campaign said he felt chest pains during events last Tuesday, and he was taken to the hospital, where two stents were inserted into an artery.

Since then, his campaign has insisted that Sanders does not intend to drop out of the race. During a telephone call with staff members Monday, Sanders said he felt “more strongly about the need for a political revolution today than I did when I began this campaign.”

On Tuesday, Jane Sanders downplayed the decision to slow the campaign’s pace down, saying it was “something that the entire campaign, and especially me, have been saying for months — not for his health but for the ability to keep up that kind of a pace for everybody else, too.”

Known for keeping a grueling schedule on the campaign trail, Sanders will often crisscross a state with multiple stops for big rallies and smaller town hall-style events and gatherings.

In a Democratic primary where the three leading candidates are in their 70s, Sanders’ health issue has intensified the scrutiny on age as a factor in running for president. Many Democratic voters have said they worried about nominating a septuagenarian candidate.

Sanders, who finished second to Hillary Clinton in the 2016 primary, has been among the top three Democratic contenders since he entered the race in February. But in recent weeks has been passed by Elizabeth Warren in national polls and polls of early nominating states like Iowa and New Hampshire.

Still, he remains a formidable challenger; just last week he announced a third-quarter fundraising total of $25.3 million, the largest in the Democratic field.

In the 2016 presidential campaign, Sanders’ doctor said that the senator was “in overall very good health.” His ailments included gout; a mild elevation of cholesterol; an inflammation of out-pouches in the bowel known as diverticulitis; and hormone replacement therapy for an underactive thyroid gland. He had no reported history of heart disease.

Sanders Says He Will 'Change the Nature' of His Campaign After Heart Attack

BURLINGTON, Vt. — Sen. Bernie Sanders, a week after suffering a heart attack in Las Vegas, said Tuesday that he planned to slow down his pace on the campaign trail and acknowledged that voters would likely consider his health when deciding whether to vote for him.

Sanders, 78, had entered the hospital Tuesday night after experiencing chest pain at a campaign event, and doctors had inserted two stents in a blocked artery, a relatively common procedure. But the campaign did not confirm he had a heart attack until Friday, leaving open questions about Sanders’ condition as he remained off the campaign trail this week.

Television cameras filmed Sanders as he left the hospital Friday, waving to onlookers and pumping a fist, then driving off in an SUV.

“After 2 1/2 days in the hospital, I feel great, and after taking a short time off, I look forward to getting back to work,” the senator said in a statement.

His doctors in Las Vegas, Arturo E. Marchand Jr. and Arjun Gururaj, said in the statement that after Sanders experienced the chest pains Tuesday night, he went to a medical facility where he was given a diagnosis of a myocardial infarction, or heart attack.

He then was transferred to Desert Springs Hospital Medical Center, where doctors inserted the stents. He spent three nights at the hospital.

Following the medical episode, Sanders canceled his events and appearances for the week, though his campaign has said he will participate in the next Democratic debate, to be held near Columbus, Ohio, on Oct. 15.

His campaign had said Thursday that Sanders would return to his home in Burlington, Vermont, by the end of the weekend. It was not immediately clear Friday when he would fly home.

Sanders has been polling in the top tier of the Democratic primary race, behind former Vice President Joe Biden and Sen. Elizabeth Warren, and his staff is trying to project optimism about his candidacy. But the incident has cast a shadow over his campaign just as he was attempting to reinvigorate it after a summer slump that saw his standing in the polls slip.

Hoping to reverse course, he had recently begun to focus more on his electability, arguing that he is the candidate best positioned to beat President Donald Trump in the general election.

Sanders’ heart procedure has also renewed scrutiny on age in the Democratic primary, whose top candidates are all in their 70s: in addition to Sanders, Biden is 76 and Warren is 70. Trump is 73.

The Sanders campaign announced this week that it had raised $25.3 million in the third quarter, placing him ahead of Warren, his chief ideological rival, by a hair and at the top of the field in fundraising.

In a show of force, the campaign announced a $1.3 million ad buy in Iowa that it then postponed amid Sanders’ hospitalization; the ad will now begin airing Tuesday, and will run for two weeks as planned.

Sanders Had Heart Attack, His Doctors Say as He Leaves Hospital

Sen. Bernie Sanders had a heart attack this week, his presidential campaign said Friday as he left a Las Vegas hospital.

Sanders was still at an undisclosed Las Vegas hospital and his events in the coming days have been canceled. But his campaign said he would be ready to appear in the fourth debate of the primary, scheduled for Oct. 15 near Columbus, Ohio.

On Wednesday, his campaign said he experienced “some chest discomfort” during an event Tuesday evening; a medical evaluation found blockage in one artery, and two stents were inserted. He has canceled a two-day college tour this week in California, and his aides have not said when he would return to the campaign trail.

His campaign has still not said whether Sanders had a heart attack or whether he just experienced chest pain. Sanders’ wife, Jane O’Meara Sanders, traveled on Wednesday to Las Vegas and is now with him as he recovers.

Before his medical episode pulled him from the campaign trail, Sanders had been one of three front-runners in the Democratic race for the 2020 nomination. But if allies are projecting optimism about his ability to return to the race in full form, the medical episode has also cast a shadow over his campaign, which was already struggling to attract new voters. And it is likely to intensify the focus on age in the Democratic race, where the three top candidates are all in their 70s.

Sanders sent out a tweet Wednesday thanking his well-wishers and using the opportunity to plug Medicare for All.

Also Thursday, the campaign sent out a press advisory that said Carmen Yulín Cruz, the mayor of San Juan and a national co-chair on the Sanders campaign, planned to campaign for Sanders this weekend in New Hampshire.

Bernie Sanders Will Participate in Next Debate, His Campaign Says

Sen. Bernie Sanders, recovering from a procedure to treat a clogged artery, will participate in the next Democratic debate, his campaign said Thursday.

The financial haul, among the first that a candidate has announced for the third quarter, will place Sanders in the top of the field for fundraising.

It is also a much-needed boost for his campaign, as it looks to move past a summer slump that coincided with staff shake-ups in New Hampshire and Iowa and a slip in some polls in early-voting states. And it will perhaps help quell the narrative that his campaign is in decline.

Sanders received 1.4 million donations in the third quarter, his campaign said.

His third-quarter dollar total exceeds the $18 million he raised in the second quarter, which was roughly the same amount he collected during the first six weeks of his campaign at the beginning of the year. His campaign did not say how much cash it had on hand.

Sanders announced his total for the quarter just minutes after Mayor Peter Buttigieg of South Bend, Indiana, said he had raised $19.1 million in the same period.

The fundraising announcement comes as Sanders’ campaign begins a crucial phase of his presidential bid. He and his advisers had tried for months to portray the race as a battle between Sanders and Joe Biden, but the surge of Warren, his chief ideological rival, has scrambled that strategy. The top tier of candidates in the field has narrowed faster than his advisers expected, complicating matters: Rather than competing for the nomination with a half dozen candidates, he is essentially battling just two right now — Biden and Warren.

Seeking to alter the course of the race, Sanders has shifted his message in recent weeks to focus more on electability. During a recent tour of eastern Iowa and campaign stops elsewhere, he has tried to make the case to voters that of all the Democratic hopefuls, he is the candidate most likely to prevail against President Donald Trump. He has also introduced a series of audacious policy proposals, including establishing a national rent control standard, eliminating existing medical debt and instituting a wealth tax that goes further than Warren’s plan.

Yet perhaps more than ever, Sanders is betting on the grassroots appeal that propelled his 2016 campaign, a factor that his campaign says polls often fail to capture.

Rather than relying on high-dollar fundraisers — events he categorically rejects — he instead hopes to energize enthusiastic supporters who can donate to him again and again. In a show of force last month, his campaign said it had logged contributions from more than 1 million individual donors. His campaign said the average donation for the quarter was $18.07.

His strategy means he does not have to worry about donors maxing out; his campaign said more than 99.9% can give again. But it also poses challenges: Though he has a loyal army of supporters and volunteers, many of them do not donate large amounts of money, meaning he must appeal to a huge pool of donors in order to keep pace with rivals like Buttigieg, who is willing to collect large sums of money on the traditional big donor fundraising circuit.

Sanders Raises $25.3 Million in Third Quarter

Sen. Bernie Sanders raised $25.3 million in the past three months, his campaign said Tuesday, a total that continues to demonstrate his strength with small donors as he fights to maintain support in key early-voting states.

Sanders said that over the next decade, his plan would expand public housing, increase the availability of affordable housing and cap annual rent increases nationally, regardless of income, at no more than 1.5 times the rate of inflation or 3%, whichever is higher. His campaign said he would be releasing his full plan within the next month.

“We have an affordable housing crisis in Nevada, in Vermont and all over this country that must be addressed,” he told an audience of about 100 people at a union hall in Las Vegas, which was hit hard by the housing crisis a decade ago. “For too long, this is one of those issues that we just don’t talk about.”

This is the second time in the past 15 days that Sanders’ campaign has teased a policy rollout without releasing an actual proposal. Late last month, the Vermont senator said at a health care-focused event in Florence, South Carolina, that he planned to introduce legislation that would eliminate all medical debt. His campaign followed his pronouncement with a one-page overview of what the plan would entail, including canceling $81 billion of existing medical debt. The campaign also said at the time that a plan would be released within a month.

The series of soft rollouts underscore just how policy-focused the Democratic presidential primary has become. Led by Sen. Elizabeth Warren of Massachusetts, the field has been introducing policy plans at a pace that at times has been frenetic.

Sanders has long advocated for affordable housing, even during his days as mayor of Burlington, Vermont, in the 1980s. But though he suggested housing was not a front-burner topic for many politicians, other 2020 candidates have also introduced housing policies.

Warren and Julián Castro, the former housing secretary under President Barack Obama, have already released their own housing proposals. Sen. Kamala Harris of California has also introduced a bill that would allow overburdened renters to access a sliding tax credit based on factors like income and cost of rent.

Sanders said he would pay for the plan by instituting a wealth tax on the top 0.1% of U.S. households, or about 175,000 households, but provided little else in the way of specific details.

During his address, part of a weekend swing through Nevada that also featured a rally at the University of Nevada, Reno, on Friday, Sanders also attacked President Donald Trump and attempted to draw a contrast between his childhood and the president’s more privileged upbringing.

“Unlike Donald Trump, I did not grow up in a wealthy family or live in some fancy house,” he said, a thought he has expressed before. In a rare occurrence, Sanders also mentioned his mother during his address, saying she had always wanted to move out of the 3-1/2 room rent-controlled apartment in Brooklyn, New York, where they lived when he was a boy.

“My mother’s dream was that someday we would move out of that rent-controlled apartment in Brooklyn and we would own a home of our own,” he said. “My mother died young, and her dream was never fulfilled. But during her life, at least our family was always able to afford a roof over our heads, because we were living in a rent-controlled building, which meant that for our family and all the other families in our building, rents could not be arbitrarily raised.”

As with many of his proposals, Sanders acknowledged that the cost of his housing plan would be steep.

“I have no doubt that within five minutes after this speech is made public, my critics will be jumping up and down as is usually the case and they will tell you that the plan that I am releasing is expensive,” he said. “And the truth is it is expensive.”

Sanders also promised to commit $32 billion over five years to end homelessness, and provide outreach services for people experiencing chronic homelessness. He did not say how he would end it; his campaign said more details would be in his full proposal.

Bernie Sanders, in Las Vegas, Previews Plan for Affordable Housing

LAS VEGAS — Sen. Bernie Sanders introduced a $2.5 trillion housing policy plan on Saturday that would include ending homelessness and limiting rent increases across the country by imposing a national rent control standard.

Years earlier, as his mother’s health declined and his family struggled to pay for medical treatment, he was spending more time attending to her than in classes at Brooklyn College, suffering through what his brother called “a wrecked year’’ leading to her death. Over time, he had come to believe that the American health care system was flawed and inherently unfair. In Canada, he wanted to observe firsthand the government-backed, universal model that he strongly suspected was better.

Amid tours of community centers and meetings with health care providers, Sanders more than liked what he saw.

“He was thrilled,” recalled Beth Mintz, a professor of sociology at the University of Vermont and a member of a task force that accompanied Sanders. “It gave him much more confidence in the possibility of the single-payer system as a solution.”

Decades before “Medicare for all” would propel his presidential campaigns, Sanders’ expedition to Ottawa helped forge his determination to transform the American health care system. His views burst onto the national political scene during his 2016 presidential run, when he championed a single-payer program alongside many other liberal policy ideas. Now, as he seeks the Democratic presidential nomination for a second time, he has made “Medicare for all” the most important issue of his campaign and set the agenda for the ideological discussion in the primary.

Health care dominated the first two Democratic debates this summer and will most likely be prominent again during the third debate Thursday in Houston. Other candidates support “Medicare for all,” but it is Sanders who has become singularly identified with it — “I wrote the damn bill!’’ he proclaimed in July’s debate.

A review of hundreds of pages of documents from the first chapters of his political career — including speeches, correspondences and newspaper clippings — as well as interviews with those who have known him throughout his life, show that while his democratic socialist worldview underpins his “Medicare for all” pitch, he was also guided by other factors. Chief among them were his mother’s illness and death, which instilled in him the desire to ensure everyone had access to medical care, and the adjacency of Vermont to Canada, which afforded him a blueprint for universal health care.

Together, they help explain why he has staked not only his campaign, but also much of his political legacy, on promoting “Medicare for all.’’

“You can’t overstate the impact that Vermont’s proximity to Canada had on Bernie’s thinking about how to approach reforming the American health care system,” said Jeff Weaver, who has worked with Sanders since the 1980s and remains one of his closest advisers. The pull of Canada remains strong: In July, Sanders took a bus trip from Detroit to Windsor, Ontario, with diabetes patients to highlight lower drug prices in Canada.

In an interview Sunday, Sanders described how seeing the Canadian system up close significantly shaped his own views on health care.

“It was kind of mind blowing to realize that the country 50 miles away from where I live — that people could go to the doctor whenever they wanted and not have to take out their wallet,” he said.

“That was just a profound lesson that I learned,” he said.

He also criticized the American system as “barbaric.” And he vowed — as he often does in his stump speeches — “to take on the greed and the corruption of the health care industry.”

Sanders’ health care proposal has attracted legions of supporters fed up with the rising costs of the current system, and it sets him apart from more centrist candidates like Joe Biden. But his uncompromising position also threatens to alienate voters who are pleased with the Affordable Care Act, or who do not want to give up their private insurance. His own state of Vermont so far does not have a single-payer program.

Despite skepticism about his views, however, Sanders has consistently resolved to reform the health care system, even before being elected to public office. In 1972, when he was running for Senate as a candidate from Vermont’s left-wing Liberty Union Party, The Bennington Banner, a local newspaper, reported him taking an uncompromising stance: “There is absolutely no rational reason, in the United States of America today, we could not have full and total free medical care for all.”

The Challenge of Paying Medical Bills

The first seeds of Sanders’ concern were sown in Brooklyn.

A high-school track and cross-country star with an emerging political streak, Sanders had wanted to go to Harvard, friends said. But by his senior year, his mother, Dorothy Sanders, had become sick, her heart damaged from having rheumatic fever as a child.

As her health declined, her illness consumed him. He stopped going to track practice. To be closer to her, he began his freshman year at Brooklyn College.

Sanders describes his family as lower middle class. His father, an immigrant from Poland, was a paint salesman. He has said his parents frequently argued about money.

When his mother fell ill, his family moved her into a charity hospital in New Jersey. After a failed heart surgery, she died in March 1960, when she was in her mid-40s. “Bernard actually spent much more time with her than he did in class,’’ his brother, Larry, recalled in an interview in February. “It was really a kind of wrecked year and a very unhappy year.”

Then, as now, Bernie Sanders avoided speaking of his mother’s death. On Sunday, he declined to discuss his personal life, but said that his family had “struggled economically, and that’s it.”

In a 2006 interview with Vermont PBS, he offered a glimpse into how her illness shaped his thinking.

“When you talk about money and family, how do you get the money for the medical treatment that my mother needed?” he said. “I won’t go into the whole long song and dance of it. But trust me, it was something that I also have not forgotten about — the right of people to have health care, which was a little bit difficult in our family situation.”

It would still be some years, though, before health care became his political hallmark.

Sanders transferred to the University of Chicago, where he spent hours in the library reading progressive publications that would influence his political views. There, he turned his energy toward civil rights.

“We didn’t talk about health care,” said one of his roommates, Ivan Light. “It was not on the political agenda at that time. Civil rights was on the agenda.”

After moving to Vermont, he became active in politics. A perennial candidate with the Liberty Union Party in the 1970s, he focused on issues like the tax structure.

But he also began to study health care seriously. Included in a collection of papers from those days are pamphlets, articles and other material related to medical care. One publication he saved from March 1972 was titled, “Health Rights News;” its slogan was “Health care is a human right.”

That research soon began to take hold: In October 1976, when he was the Liberty Union candidate for governor, he told The Burlington Free Press that the delivery of medical care was “basically a national problem” and that he supported “public ownership of the drug companies and placing doctors on salaries.”

“I believe in socialized medicine,” he said.

John Bloch, who has known Sanders since the 1970s when they were active in Vermont politics, said he thought Sanders’ views were influenced in part by the people he lived near in the rural town of Stannard, Vermont, many of whom were in desperate need of health care.

“He didn’t just come to this as Johnny-come-lately,” Bloch said.

In the interview Sunday, Sanders said he was particularly affected at the time by a young boy who lived across the road whose teeth, he said, were rotting in his mouth.

Deb Richter, a Vermont physician and longtime advocate for single-payer health care, who has worked with Sanders on the issue for 20 years, said he had always felt that health care was a human right.

“You ask Vermonters, ‘How long has Bernie been talking about single-payer health care for all?’ and nobody can remember a time he wasn’t talking about it,’’ she said.

Turning His Sights Toward Canada

After Sanders was elected mayor of Burlington in 1981, he largely emphasized local issues, like property taxes and affordable housing. “I was the mayor of a city of 40,000 people,” Sanders said in the interview. “Talking about national health care is not exactly what you talk to the board of aldermen about.”

By then, he had also become somewhat fixated on Canada. In September 1981, he invited the director of the Quebec Insurance Board to speak about the province’s health insurance plan. Later, he demanded more accountability from the state’s health insurance company and encouraged a review of hospital budgets.

As he pondered higher office, his focus on health care intensified. Even before he announced his 1986 campaign for governor, he said he planned to run in part on controlling medical costs, according to an article in the Vermont newspaper The Times Argus.

He lost that race but gathered valuable information in the process: During his campaign, his team had polled Vermont residents on issues. “To my surprise,” Sanders said in 1987, “the issue that Vermonters felt most strongly about was the rapidly rising costs of health care.”

That finding served to galvanize his actions on health care. He quickly set up a task force and charged it with studying how to make the system more affordable.

Soon Sanders and the task force — which included an expert on the Cuban health care system, professors and a minister — were traveling to Ottawa, which had implemented a government-supported, single-payer system.

Jed Lowy, who went on the trip, recalled touring a public hospital, visiting a neighborhood community health center and speaking with physicians.

“It was interesting to see another way that health care was provided,” Lowy said.

That trip, and a later one to Montreal, reinforced Sanders’ idea that Vermont’s northern neighbor had effectively put into practice the kind of accessible, affordable system he had long sought.

At a news conference after the Ottawa visit, the task force suggested Burlington could model its health care system after Canada’s. And in unequivocal tones, Sanders said it would be “absolutely negligent” not to examine at least some aspects of the Canadian model.

In March 1988, the task force released a report recommending the creation of a national health care system.

Sanders’ focus on health care policy met some resistance at home from city employees reluctant to give up benefits they had earned.

Sanders forcefully rebutted the criticism.

“You may regard this as ‘propaganda’,” he wrote tersely in response to a letter from an angry constituent in December 1982. “I expect that you may not have talked to citizens who are taking their food money to pay for medical care.”

By the time Sanders was mounting his 1988 congressional run, he was speaking about health care in the kind of dogmatic terms he uses today, and he was broadening his vision beyond Vermont. He praised the National League of Cities for adopting a resolution to establish a national health system.

Soon after formally announcing his congressional campaign, he set forth his premier agenda item, one that he had imagined since his mother’s death some three decades earlier.

“I want to make it emphatically clear,” he said in April 1988, “that I will make health care reform a top priority as a United States congressman from the state of Vermont.”

Sanders Developed Vision for Health Care on Jaunts to Canada

BURLINGTON, Vt. — In July 1987, Bernie Sanders, then the mayor of Burlington, Vermont, arrived in Ottawa, convinced he was about to see the future of health care.

John Bloch, who has known Sanders since the 1970s, said he thought Sanders’ views were influenced in part by the people he lived near in the rural town of Stannard, Vermont, many of whom were in desperate need of health care.

Sanders Went to Canada, and a Dream of 'Medicare for All' Flourished

When asked Tuesday night whether he, too, supported the House bill, Sanders was defiant.

“No,” he said again, when pressed. “The incremental reform that I support is phasing in ‘Medicare for All.’ ”

Sanders, the independent senator from Vermont, is not one to compromise on his long-held policy positions, especially his signature stance on health care, though he has, in fact, supported non-“Medicare for All” legislation in the past, including backing a 2017 bill to allow people to buy into state Medicaid plans.

Yet more than a month into his second presidential bid, his response underscored, once again, his willingness to stand apart from a party he has not joined but hopes to helm.

His reply on Pelosi’s bill also afforded him momentary distance from ideologically similar rivals, including Sen. Elizabeth Warren of Massachusetts, who Wednesday tweeted out her own support for the Affordable Care Act.

Sanders’ unflinching position is a reminder to voters that he is unabashedly left-wing and unlikely to worry about working within the confines of the existing system anytime soon. It also reflects a schism within the Democratic Party over the best way to recapture power in Washington: Should Democrats project big, bold policy ideas that could fundamentally alter the political structure but face long odds in a hyperpartisan Congress? Or should they present incremental measures that are more likely to appeal to the center and could succeed sooner?

Some candidates, including Warren, are hoping they can bridge the gap and do both. Others are betting that there is a following for within-the-system politics. Candidates like Sen. Amy Klobuchar of Minnesota and Beto O’Rourke, the former congressman from Texas, have spent the early days of their campaigns highlighting their common-ground legislation with Republican colleagues, and former Vice President Joe Biden, expected to enter the race next month, wears his bipartisanship like a badge of honor.

It is a debate that has raged within the party since before the midterm elections last year, with some strategists suggesting that bold, disruptive ideas like the ones championed by Sanders electrify voters and spur them to the polls.

When House Speaker Nancy Pelosi introduced legislation this week to strengthen the Affordable Care Act, Democrats across the ideological spectrum were quick to express their support: moderates, liberals, even Rep. Alexandria Ocasio-Cortez, the often uncompromising progressive freshman.

Sydney Ember

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