Name: Forget Medicare for All — even a public option will still be tough to pass
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Forget Medicare for All — even a public option will still be tough to pass

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President-elect Joe Biden’s incremental approach will face opposition from Republicans, powerful health care lobbies and even moderate Democrats.POLITICO illustrationFor President-elect Joe Biden, creating a public option to compete with private health insurance may be no easier to pass than it was a decade ago.His campaign promise to lower Medicare’s eligibility age and advance a robust public option to compete with private health insurance was seen as an olive branch to progressives agitating for a total government overhaul like “Medicare for All.”But Biden’s more incremental approach still will face opposition from Republicans and powerful health care lobbies, which have spent the past two years preparing a furious assault against further expansion of government coverage if Democrats took back control of Washington. Republicans certainly won’t support a public option, and Democrats’ narrow majorities in both congressional chambers leave Biden with little room for error.A strong public option was stripped out of Obamacare because moderates saw it as toxic. While centrist Democrats now back the idea and polls show strong public support for it, Democratic leaders in Congress could be wary of getting bogged down in another health care fight when they will be facing other priorities, like battling the pandemic and providing more economic relief. And even if Biden gets through a version of the public option, the health care industry could still water it down through negotiations — as was the case in when it created the nation’s first public option two years ago.“The public option is very popular, and I think there’s a broad consensus across the party to do a public option — but what does it mean?” said Whitney Brennan, a communication strategist for Firehouse Strategies who worked for moderate Democratic lawmakers during Obamacare’s drafting. “The devil is in the details, and how it’s structured is where the fight is.”Biden also has an easier path to expanding coverage. He could instead focus on bolstering Obamacare, with the law expected to survive the . Public sentiment has grown more favorable to the law after the GOP’s failed repeal attempt, and Biden’s pledge to provide more subsidies to help more middle-class families afford private coverage has broad support among Democrats and deep-pocketed health care interests. He could also dangle more financial incentives for the remaining 12 Medicaid expansion holdout states to extend coverage to low-income adults. It’s possible he could do these things through a fast-track budget measure that only needs a simple majority in both chambers.Still, that’s unlikely to satisfy progressives disenchanted with the idea of propping up a private health insurance system that saddles customers with high out-of-pocket costs and even “surprise” medical bills. Some experts think Biden could use emergency powers to temporarily install new subsidies to help millions who have lost coverage during the pandemic, but that would only be a stopgap measure.No matter what happens in Congress, Biden will be able to wield executive power to undo some of President Donald Trump’s attacks on Obamacare. He can immediately restore funds to market the law’s coverage options, extend the annual enrollment season and, unlike Trump, make it easier for more people to buy coverage outside of the typical sign-up window during the pandemic. He’s also likely to try unwinding a host of Trump’s regulatory actions, like an expansion of cheaper and skimpier health insurance options that don’t comply with Obamacare, restrictions on poor immigrants’ access to public benefits like Medicaid and narrower access to birth control.

President-elect Joe Biden’s incremental approach will face opposition from Republicans, powerful health care lobbies and even moderate Democrats.POLITICO illustrationFor President-elect Joe Biden, creating a public option to compete with private health insurance may be no easier to pass than it was a decade ago.His campaign promise to lower Medicare’s eligibility age and advance a robust public option to compete with private health insurance was seen as an olive branch to progressives agitating for a total government overhaul like “Medicare for All.”But Biden’s more incremental approach...

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Susannah Luthi

Politico, known originally as The Politico, is an American political journalism company based in Arlington County, Virginia, that covers politics and policy in the United States and internationally. It distributes content through its website, television, printed newspapers, radio, and podcasts. Its coverage in Washington, D.C. includes the U.S. Congress, lobbying, the media, and the presidency.

Forget Medicare for All — even a public option will still be tough to pass

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