LAS VEGAS — The union member had a pointed question for Elizabeth Warren: “What is your plan to make sure we keep our community health clinic?”
Ms. Warren, the Massachusetts senator and 2020 presidential candidate, had toured the gleaming clinic where housekeepers and bartenders in the local culinary workers’ union and their families can see a doctor, visit the dentist and pick up their prescriptions. She did not directly answer the question about health care, which has divided the Democratic candidates.
“Boy, if I get sick that’s where I want to go,” Ms. Warren said. “What you’ve got is not something we want to make harder, but you’ve got something I’m going to see replicated all around America.”
Two days later, former Vice President Joseph R. Biden Jr. received a similar tour, and was asked a similar question. His answer was unequivocal: “You will get to keep your plan.”
The candidates were wooing the Culinary Workers Local 226, which with 60,000 members has outsize political firepower in a state where organized labor still holds sway and has played a key role in electing Democrats in Nevada. In 2016, the union remained neutral during the primary, but knocked on doors and delivered enough votes for Hillary Clinton to capture the state in the general election.
Now, the union’s endorsement is one every Democratic presidential candidate is vying for before Nevada becomes the third state to vote, on Feb. 22, less than three weeks after Iowa and a week before South Carolina.
In three days at a candidates’ forum this week, the union hosted three of the top candidates, a clear show of influence.
The dominant question for the candidates was about health care: whether they support “Medicare for all,” as Ms. Warren does, which would abolish the private insurance unions have long fought for. And one answer was apparent: the vast majority of the union members want to keep their health care just the way it is.
Just minutes after Senator Bernie Sanders of Vermont finished an abbreviated version of his stump speech — $15 minimum wage, strong unions, free college tuition, sweeping changes in immigration — Elodia Muñoz stood up to ask, “Why should I give up my health care?”
Ms. Muñoz was one of hundreds of casino workers who went on strike for more than six years in the 1990s, when one of their primary demands was better health insurance.
“We have in this country a dysfunctional, broken and cruel health care system,” Mr. Sanders said, adding that he views health care as a human right.
Soon, he was interrupted by chants of “Union health care! Union health care!”
Unruffled, he addressed the question head-on.
“What we are proposing is comprehensive health care — we save money for everybody,” he said, telling union members they could have $12,000 more in wages under his plan. “Employers save money under our legislation, workers get the difference.”
Though he received loud applause, there was no shortage of skepticism of that promise as union members milled through the hall after he spoke.
“Nobody believes that, come on,” D. Taylor, the head of Unite Here, the Culinary union’s national organization, said after Mr. Sanders spoke.
Nevada’s demographics are far more diverse than any of the other early-voting states, and few groups have the diversity of the Culinary Workers Union: 54 percent Latino, 19 percent white, 15 percent Asian and 10 percent black. The majority-female union describes itself as the largest immigrant organization in the state, with members who come from 178 countries. And since the union began a citizenship initiative in 2001, more than 18,000 workers have become citizens.
These are the people who quietly make Las Vegas the tourist haven it is: the union’s members shuttle luggage, serve drinks, cook food, make beds and generally do whatever the millions of visitors who come here annually desire. Nearly 15 percent of Nevada’s work force are part of a labor union, one of the highest rates in the country, even though it is a right-to-work state, which means workers are allowed to decline membership to a union.
Beyond electoral politics, the union is a labor advocacy group, organizing multiyear strikes to fight for higher wages and — equally important in the eyes of members — health benefits.
“Nothing was a gift given to us — everything we have we have fought for,” said Geoconda Argüello-Kline, the leader of the union, who arrived as a refugee from Nicaragua 30 years ago. “We do not want to sacrifice what we have fought for. If we have to give something up, it will not work for us.”
Ms. Argüello-Kline began her career as a maid before becoming an organizer with the union, and took over the union’s highest office in 2012.
These days, Ms. Argüello-Kline often leads a raucous call-and-response in town halls: “We vote,” she says, before the union crowd shouts back: “We win!”
But whom will the union back? While Mr. Biden clearly enjoys popularity for his approach to health care, many members favor Ms. Warren and Mr. Sanders for other reasons, including their more liberal positions on immigration.
Mr. Taylor, of Unite Here, said he had not ruled out backing either Ms. Warren or Mr. Sanders.
The union has a history of effective turnout. In 2008, Unite Here endorsed Barack Obama soon after he lost in New Hampshire, providing the campaign with a key boost and helping him amass more delegates in Nevada, though he lost the popular vote to Ms. Clinton.
During the 2018 midterms, about 250 culinary workers took leave from their jobs to focus on elections, registering 10,000 new voters and knocking on 200,000 doors. Democrats won several key races, flipping a Senate seat and capturing the governor’s office for the first time since 1999.
In dozens of interviews with rank-and-file members, they voiced a broad range of opinions about the candidates: Many said they were undecided; some favored Mr. Sanders for his populist appeals and immigration proposals, others Mr. Biden because they liked his health care plans and because they believe he has the best chance to win in the general election. Ms. Warren won over some women here Monday, though several said they were disappointed she did not answer questions more directly, sticking instead to more familiar talking points that are part of her stump speech.
“Mr. Biden inspires hope for me, for the Latino community,” said Roselia Mendoza, a 49-year-old housekeeper at the Wynn hotel and casino, one of the toniest on the strip. “He both will have a kind heart and give us more rights. What we really need is hope.”
But Mr. Biden faced some skepticism for his record on immigration, with one member asking him how he would approach deportations differently than he did under the Obama administration, which deported roughly three million people.
The former vice president began by citing the “incredible pain” caused by those deportations and assured the crowd that those without criminal records would not be deported in his administration, as part of an immigration plan he announced Wednesday.
Union members repeatedly raised immigration and health care as the most important issues. Even those who were pleased with their own health plan spoke about friends and family members who have gone without needed medication or gone bankrupt to pay for hospital bills.
Selamawit Gudeta, 37, who works at the MGM Grand casino, said she has supported Mr. Sanders since 2016 and will vote for him again this time.
“He cares about workers, he cares about families, he cares about all the little people and the things I care about,” Ms. Gudeta said.
If there was any doubt about how much of an effort the candidates were making in their appeals, Mr. Biden made it plain during his town hall Wednesday. He stepped offstage and into the crowd, often speaking in hushed tones as though he were confiding in the members.
“If I end up being your president, you will never ever ever have in American history someone who is more pro-labor in the White House,” he said.
He was rewarded with the longest selfie line at the union hall in three days.