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Since the collapse of the GOP effort to repeal and replace the Affordable Care Act, single payer has gained new life on the left. Sen. Bernie Sanders released his “Medicare for all" plan yesterday, and a majority of House Democrats have signed on to another version proposed by Rep. John Conyers.

Expand chart
Data: Kaiser Family Foundation Polls; Note: 2008-09 is an average of 7 polls; Chart: Andrew Witherspoon / Axios

The big picture: Politically, single payer — the idea of having the government pay for health care rather than private insurers — can help rally the left much like the prospect of repealing the ACA rallied the right. But it could also help Republicans, who own the problems in health care now, switch the target to the Democrats and their sweeping new health reform plan.

The pros for Democrats:

  • As the chart shows, single payer is popular among Democrats, with about two thirds in favor. But it has also gained popularity among independents in recent years, with over half supporting it. Republicans, not surprisingly, aren't so crazy about it.
  • Single payer is a big idea many Democrats can rally around. It excites the base and party activists by establishing health care as a right, achieving universal coverage, and eliminating insurance companies. This analysis is about politics, but most advocates of single payer advance the idea because they believe in it, not as a political calculation.

The cons for Democrats:

  • They could lose a one-time opportunity to tar Republicans with the damage their ACA replacement plan would have done to millions of people, according to the multiple analyses that showed lost coverage and higher premiums for vulnerable people.
  • By campaigning on their own sweeping health reform plan, Democrats could give Republicans a fighting chance to change the subject.
  • More targeted policy ideas, such as Medicaid buy-in options for the ACA marketplaces and a Medicare buy-in for 50-64 year olds, could also be popular on the left and the center, while offering far smaller targets than a sweeping single-payer plan would.

Reality check: Single payer is popular, but polling today doesn't tell us much about where the public will be if there is a national debate about actual single-payer legislation in the Congress. ACA repeal had the support of about half the public in Kaiser Family Foundation polling in late 2016 and early 2017, but fell to closer to 30 percent once there was an replacement plan under the microscope.

Support for single-payer falls by 10 to 20 percentage points when people are read common criticisms, such as that it will increase taxes or give the government too much control over health care. Arguments in favor, including that single payer will make health a basic right or reduce administrative costs, increase support by similar amounts.

We cannot simulate what will happen in a real debate, which depends on the actual details of the legislation and the power of the arguments made.

Be smart: This is more than just a health policy debate. It is also a proxy debate about the future of the Democratic Party. The party can swing left trying to build energy in the base, or it can move to the center, trying to capture the votes of many of the more conservative working people who voted for President Trump.

Don't forget: Most Americans are far less focused on sweeping health policy ideas than they are on lowering their out-of-pocket costs. Health reformers – left, right, or center – who make the connection between their policy ideas and these pocketbook concerns may capture the most voters.

Go deeper

28 U.S. citizens depart Afghanistan on Qatar Airways flight

Passengers board a Qatar Airways aircraft bound to Qatar at the airport in Kabul on September 10, 2021. Photo: Aamir Qureshi/AFP via Getty Images

The State Department on Saturday confirmed that a Qatar Airways charter flight left Kabul on Friday with 28 U.S. citizens and seven lawful permanent residents on board.

The big picture: Friday's flight is the third such airlift by Qatar Airways since the Taliban takeover of Afghanistan, AP reports.

Updated 1 hour ago - Politics & Policy

Smaller than expected "Justice for J6" rally met with large police presence

Police officers watch as demonstrators gather for the "Justice for J6" rally in Washington, D.C., on Sept. 18, 2021. Photo: Andrew Caballero-Reynolds/AFP via Getty Images

A few hundred demonstrators were met by a heavy law enforcement presence on Saturday at the "Justice for J6" rally outside the fenced-off U.S. Capitol, AP reports.

The latest: Four people were arrested at the rally, including one person with a gun, one with a knife and two with outstanding warrants, per the U.S. Capitol Police.

DHS to increase deportation flights to Haiti from Del Rio

Migrants walk across the Rio Grande River carrying supplies back to a makeshift encampment under the international bridge between Del Rio, Texas, and Acuña, Mexico. Officials are struggling to provide food, water, shelter and sanitation, forcing migrants to cross the Rio Grande several times per day for basic necessities. Photo: Jordan Vonderhaar via Getty Images

The Department of Homeland Security on Saturday announced plans to ramp up deportation flights to Haiti out of the small Texas border town Del Rio, starting as soon as Sunday.

Why it matters: Reports have emerged of more than 10,000 migrants, primarily from Haiti, crowded in a temporary camp under the international bridge in Del Rio. Hoping to find refuge in the United States, they've had to bear with filthy conditions and the scorching sun for days, per an NBC News affiliate.