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Photo: Mark Wilson/Getty Images

Insurers and hospitals came out swinging yesterday against Democrats' proposal to let people older than 50 buy into Medicare — a reminder that almost any expansion of public health coverage will provoke a battle with the health care industry.

Between the lines: Politically, an age-restricted Medicare buy-in is about as moderate as it gets for Democrats in the age of "Medicare for All."

  • It is not a proposal for universal coverage, and it's a far cry from trying to eliminate private insurance. It would be optional, only a relatively small slice of people would have the option, and they would need to pay a monthly premium.

Yes, but: Being on the more moderate end of the political spectrum does not shield you from a fight.

  • Expanding Medicare would hurt hospitals' bottom lines, because Medicare pays hospitals less than private insurance does.
  • That's why the Federation of American Hospitals said yesterday that the idea "would harm more Americans than it would help."
  • The buy-in plan would primarily compete with employer-based health coverage (that's what people between 50 and 65 are likely to have). And America's Health Insurance Plans said the idea "is a slippery slope to government-run health care for every American."

The bottom line: Any proposal that would compete with (never mind eliminate) private coverage, particularly employer coverage, will meet this kind of resistance.

That's why Medicaid is the public program Democrats and industry can agree to love. Expanded access to Medicaid has rarely been an alternative to commercial insurance — it's usually an alternative to being uninsured.

  • The uninsured were the primary beneficiaries of the Affordable Care Act's Medicaid expansion, and the Medicaid buy-in proposals now popping in the states are aimed at the people who are most likely to be foregoing private ACA coverage because of its cost.

Go deeper: The detail that could make Medicare for All generous — and expensive

Go deeper

Dan Primack, author of Pro Rata
5 mins ago - Economy & Business

Filings show Sweetgreen isn't profitable, despite claims

Illustration: Sarah Grillo/Axios

Restaurant chain Sweetgreen on Monday filed to go public, and revealed that it lost money in each year since 2014.

Why it matters: The company lied when it repeatedly told reporters it was profitable.

U.S. border cities again see low violent crime rates

Expand chart
Data: FBI, Kansas Bureau of Investigation, U.S. Census Bureau; Chart: Jared Whalen/Axios

Reported violent crime in the United States rose in 2020 for the first time in four years, but violent crime rates in 11 of the largest communities along the U.S.-Mexico border stayed below the national average, an Axios analysis found. 

Why it matters: Year after year, data showing low violent crime rates in majority-Mexican American and Mexican immigrant border communities dispels myths of the U.S.-Mexico border as a region filled with crime and chaos.

Biden to Dems: This is my make-or-break moment

President Biden walks with House Speaker Nancy Pelosi after addressing the House Democratic caucus on Thursday. Photo: Jim Watson/AFP via Getty Images

President Biden told the House Democratic caucus Thursday "my presidency will be determined" by the votes he wants in the next week on his $1.75 trillion social safety net expansion and $1.2 trillion infrastructure package.

Driving the news: Biden made the comment, according to a source in the room, as he tried to rally support for the $1.75 trillion package. House Speaker Nancy Pelosi acted immediately, calling for a vote on the $1.2 trillion bipartisan infrastructure bill later in the day.