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Illustration: Axios Visuals

Health care has become the framework that defines the broader ideological and stylistic divisions within the Democratic primary — a contest between political revolution and Medicare for All vs. bipartisan compromise and a public option.

Yes, but: It's kind of a false choice. Passing either of those health care plans would require a knock-down, drag-out party-line brawl just as intense as the fight over the Affordable Care Act.

Why it matters: No single issue has highlighted the differences among the Democratic candidates more efficiently — or more often — than health care, and Medicare for All, specifically.

  • It’s more than simple policy differences; in some cases, the policies aren’t even all that different. It has, instead, become a core extension of each candidate’s bigger political identity — whether they wanted it to or not.
  • Bernie Sanders and Joe Biden have already clashed over Medicare for All vs. a public option that Biden brands as "building on Obamacare," and that surely will continue after Biden's strong showing last night.

Ultimately, though, any Democratic president would run into many of the same brick walls trying to get any of these health care plans passed.

  • The health care industry, led by hospitals, has already poured millions of dollars into ads in key primary states opposing not only Medicare for All, but also a public option and even the narrowest proposals to let some people buy into Medicare.
  • Industry managed to kill a public option in the Affordable Care Act, when Democrats had 60 Senate seats. If they have a majority in 2021, it’ll likely be razor-thin.

My thought bubble: Democrats' health care plans have so far mattered a lot as a prism through which the candidates and their supporters have expressed big-picture principles and their theories of change.

  • But these are not the same battle lines that would guide any real effort to significantly expand government-run health insurance.

Go deeper

46 mins ago - Technology

Exclusive: Facebook's blackout didn't dent political ad reach

Photo: Valera Golovniov/SOPA Images/LightRocket via Getty Images

Americans saw more political ads on Facebook in the week before the 2020 election than they did the prior week despite the company's blackout on new political ads during that period, according to Global Witness, a human rights group that espouses tech regulation.

Why it matters: The presidential election was a key stress test for Facebook and other leading online platforms looking to prove that they can curb misinformation. Critics contend measures like the ad blackout barely made a dent.

Wall Street wonders how bad it has to get

Illustration: Aïda Amer/Axios

Wall Street is working out how bad the economy will have to get for Congress to feel motivated to move on economic support.

Why it matters: A pre-Thanksgiving data dump showed more evidence of a floundering economic recovery. But the slow drip of crumbling economic data may not be enough to push Washington past a gridlock to halt the economic backslide.

3 hours ago - Health

Moderna to file for FDA emergency use authorization for COVID-19 vaccine

Photo illustration by STR/NurPhoto via Getty Images

Moderna announced that it plans to file with the FDA Monday for an emergency use authorization for its coronavirus vaccine, which the company said has an efficacy rate of 94.1%.

Why it matters: Moderna will become the second company to file for a vaccine EUA after Pfizer did the same earlier this month, potentially paving the way for the U.S. to have two COVID-19 vaccines in distribution by the end of the year. The company said its vaccine has a 100% efficacy rate against severe COVID cases.