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Data: The Urban Institute; Note: 2020 estimates assumes all reforms fully phased in and in equilibrium, "Household spending" is for those 64 and under; Chart: Andrew Witherspoon/Axios

Democrats aren't debating small differences in health policy — a public option would be radically different than a shift to a single payer system, and a new analysis by the Urban Institute and the Commonwealth Fund illustrates just how big those differences are.

By the numbers: A public option — even a robust one — would cost the federal government an additional $1.5 trillion over 10 years. Full-blown single payer would result in a federal spending increase of $34 trillion.

Yes, but: More federal spending doesn't necessarily mean the health care system as a whole is getting more expensive.

Details: The analysis doesn't look at any specific piece of legislation or any particular Democratic candidate's plan, but it covers the spectrum of what's been proposed.

  • National cost savings generally come at the expense of providers, as their payment rates would be regulated under expanded government coverage.

Go deeper

Ben Geman, author of Generate
Sep 30, 2020 - Energy & Environment

Climate's surprise appearance in the debate

Illustration: Annelise Capossela/Axios

The debate was a mess as moderator Chris Wallace struggled with President Trump's interruptions. But let's analyze the climate parts anyway without normalizing the whole thing.

Why it matters: The contest provided a collision over the topic between Trump and Joe Biden, and underscored the two candidates' immense differences.

Biden's two-step negotiating process

President Biden departs Geneva. Photo: Martial Trezzini/Pool/AFP via Getty

President Biden's summit "reset" was less about trying to make a friend out of Russia than reframing what the U.S. believes can be accomplished by engaging with President Vladimir Putin.

Driving the news: The Geneva meeting yielded no immediate breakthroughs beyond agreements about ambassadors returning to work and plans to launch talks on nuclear security. But in classic Biden fashion — aviators on, jacket off and a one-liner about invading Russia he had to clarify was a joke — the U.S. president used a post-summit news conference to explain his approach.

Scoop: NRCC to accept cryptocurrency donations

Illustration: Sarah Grillo/Axios

The Republicans' House campaign arm will begin accepting contributions in cryptocurrency, Axios has learned.

Why it matters: The National Republican Congressional Committee is the first national party committee to solicit crypto donations. That puts it at the forefront of a disruptive financial technology that could test campaign finance rules.