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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

Japan to release Fukushima water into sea

People near storage tanks for radioactive water at the Fukushima Dai-ichi nuclear power plant in Okuma, Fukushima Prefecture, Japan, in 2020. Photo: Tomohiro Ohsumi/Getty Images

Japan's government on Tuesday announced plans to release more than 1 million metric tons of contaminated water from the destroyed Fukushima nuclear plant into the Pacific Ocean following a treatment process.

Why it matters: While the Biden administration has said Japan appears to have met globally accepted nuclear safety standards, officials in South Korea, China and Taiwan, local residents, those in the fishing industry and green groups oppose the plans, due to begin in about two years, per the Guardian.

In photos: Twin Cities on edge after Daunte Wright shooting

Demonstrators shout "Don't shoot" at the police after curfew on April 12 as they protest the death of Daunte Wright, who was shot and killed by a police officer in Brooklyn Center, Minnesota, a day earlier. Photo: Kerem Yucel/AFP via Getty Images

There were tense scenes in the Twin Cities suburb of Brooklyn Center Monday night, after demonstrators defied a 7 p.m. curfew to protest for a second night the fatal police shooting of Daunte Wright.

The big picture: The curfew was announced following a night of protests and unrest over the killing of Wright, 20, during a traffic stop Sunday. Following peaceful protests and a daytime vigil, police again deployed tear gas during clashes with protesters Monday night, according to reporters on the scene.

In photos: Life along the U.S.-Mexico border

Children at the border of the Puerto de Anapra colonia of Ciudad Juárez, Mexico, hang on a border fence and look to Sunland Park, N.M. Photo: Russell Contreras/Axios

Axios traveled to McAllen and El Paso, Texas, and Ciudad Juárez, Mexico, to see how the communities are responding to an increase of migrants from Central America.

Of note: The region in South and West Texas are among the poorest in the nation and rarely are the regions covered in depth beyond the soundbites and press conference. Axios reporters Stef Kight and Russell Contreras walked the streets of McAllen, El Paso, Texas, and Ciudad Juárez to record images that struck them.