LAS VEGAS — How union benefits would be affected by Democratic presidential candidates’ health insurance plans will likely get national attention tonight as six of the contenders seeking to oust President Donald Trump face off.

That is true even with much of the attention expected to focus on the newcomer to the stage, billionaire former New York City Mayor Mike Bloomberg.

Culinary Workers Local 226 is always a big deal in Nevada politics, but the union's critique of “Medicare for All” government-run coverage has put them even more in the spotlight ahead of Saturday's Democratic caucus here.

The union last week criticized plans to establish a single-payer health care system, which would transition everyone in the United States to a government insurance plan that would cover medically-necessary services. Such a plan would effectively eliminate private insurance coverage that unions have fought to get for members in negotiations over the years.

Some Democratic presidential hopefuls are proposing a public option, which would create a government-run plan to compete with private plans on the insurance exchanges set up under the 2010 health care law.

The culinary union, combined with Bartenders Union Local 165, represent roughly 60,000 workers in Nevada, including employees at most of the Las Vegas Strip casinos. In Democratic politics, the union has had an outsized influence.

So, there was no shortage of headlines when union educational materials ahead of the early voting period that ran Saturday to Tuesday said Vermont independent Sen. Bernie Sanders, the clear leader in Nevada polls, would "End Culinary Healthcare."

Sanders defends plan

"We must provide guaranteed health care for all. As someone who has the strongest lifetime pro-labor record of anyone in Congress, I would never do anything to diminish the health care that unions and workers have fought for," Sanders said in a statement responding to the union. "Under Medicare for All, health care will be preserved and expanded for all, including unionized casino workers and service staff, uninsured food service workers, and striking workers fighting for their rights."

Sanders defended his health care plan when asked by CQ Roll Call on Capitol Hill last week about the Culinary Union’s opposition, noting that other unions back his proposal.

“We think that most unions around this country are supportive of Medicare for All because they understand that at the end of the day, if we want good wages and pensions and benefits for the workers, we can't be arguing about health care benefits every negotiating contract session,” he said Thursday.

But fellow presidential hopeful Sen. Elizabeth Warren, D-Mass., vying for many of the same voters as Sanders, said the slower implementation process for her version of Medicare for All, would meet the needs of the union.

"I've actually worked with the Culinary Union to make sure that the plan I've put forward is one that works for them. It has special provisions for union-negotiated plans," Warren said in an NBC News interview following an event at Cardenas Market, a grocery store that frequently hosts events for the Latino population of East Las Vegas.

Attacks on union members

Warren expressed concern about the way the union was being treated.

"I am particularly worried about what happened in the attacks on members of the culinary union, particularly on the women in leadership," Warren said in the interview. Sanders has said such attacks on the union leaders aren't acceptable after some said they were harassed online by Sanders supporters.

"We have our first health center, and we did that health center because we want the members to have quality care and at the same time controlling the cost," Geoconda Argüello-Kline, the secretary-treasurer of Culinary 226, said in an interview.

Democratic Rep. Dan Kildee, who represents Flint, Mich., and is a co-sponsor of a House measure to establish Medicare for All, said the debate hasn’t yet touched on how to compensate union members who previously gave up wage increases for insurance coverage, adding that he thought that could be resolved.

“That's a big part of the compensation that they have negotiated for over the years and very often given up wage increases so they could get health insurance benefits,” he said.

Argüello-Kline said during the early voting period that her role was to provide information to her members. She said the union held seven town halls with 2020 candidates this cycle and conducted polls and surveys of workers on their views.

Sanders was among the candidates to meet with the union membership.

"He was here in the town hall, and he explained to the members how they stand with the Medicare for All, and we put in a scorecard with seven of the presidential candidates," Argüello-Kline said. "We want better health care for every single person, but we want to have choices, too. That's part of what we want, you know, and it's part of what is in other countries."

"In other countries, you have the choice … you can have your government health care, but if you have your own good health care, you can keep your own good health care for yourself," she said.

Culinary and several other union offices have served as early voting locations for the Nevada State Democratic Party this week, including the International Brotherhood of Electrical Workers and the Service Employees International Union Nevada Local 1107.

In a sign of the importance of the health care messaging, Sen. Amy Klobuchar, D-Minn., released two Nevada ads Wednesday focused on the topic.

"You deserve a president who’s focused on a health care plan to lower premiums, she said in one of the ads. "Not a pipe dream that risks your financial future."

Lee Saunders, the president of the American Federation of State, County and Municipal Employees, said in a statement in response to CQ Roll Call that it was “completely appropriate” for the culinary workers to question how a new federal program would affect benefits they fought to get. But the focus also should be on what Trump is doing, Saunders said.

"AFSCME members are also eager to discuss ways to achieve quality, affordable health care for all Americans. But right now, it feels like we’re trying to stuff all the suitcases in the family car before we’ve decided where we’re going on vacation," Saunders said. "The bottom line is this: every Democratic candidate wants to expand access to quality, affordable health care for working families; the Trump administration wants to take it away. That’s literally all that matters right now.”

It's noteworthy that not all share the extent of the concerns about Medicare for All. The SEIU leadership said in a statement earlier this week that it was a “false choice” to say the only options were Medicare for All or union benefits.

"While some working people have good healthcare plans through their jobs, many do not. Access to quality healthcare shouldn't be based on luck. It should be a right," the statement said.

Public option praised

Democratic presidential candidate and businessman Tom Steyer said he didn't know how the culinary union's concerns about Medicare for All would affect the race.

"I'm not for Medicare for All," Steyer told reporters Saturday night. "I've studied this for years, and I share with Bernie Sanders the desire for health care to be a right for every American. And I share with him the desire to use the power of the federal government to drive down costs because they're way too high, and we're basically getting ripped off by drug companies and private hospitals and insurance companies."

Steyer is among the candidates favoring a new public option within the existing framework of the 2010 health care law.

"If the public option is so fantastic the way I hope it can be, and we can succeed in driving down those costs, then either [the Culinary Union's] costs will go down along with it, or they can go to their employers and say give us the money" to buy into the public plan, Steyer said.