“The pandemic has been a ‘clothesless emperor’ moment when it comes to insurance companies,” said Josh Orton, a Sanders delegate and member of the platform’s editorial committee who voted to approve the platform earlier this month. “When everyone is being laid off from work, it becomes clear why having insurance connected to their employer is crazy.”
Biden has maintained his opposition to Medicare for All since the primaries and criticized the plan as too costly and unrealistic at a press conference on Tuesday. And the Democratic National Committee platform committee on Monday formally ruled out supporting the system in the party’s 2020 table in an uneven vote of 36-125. The challenge for Biden will be to continue the work of a “unity task force” he established with Sanders while pursuing incremental but decidedly progressive policies such as automatic enrollment of low-income people in the public option.
“There is no doubt that the pandemic has opened the lid on some real flaws in the American health system and made them much tougher, and increases momentum towards a universal health care plan,” said Kathleen Sebelius, former secretary of health. and Human Services now advising on the Biden campaign.
Biden’s positions mark a notable change before the pandemic, when the discussion focused more on containing health costs than on expanding coverage. President Donald Trump’s budgets, for example, proposed to cut billions of Medicare dollars, despite his campaign promise to leave the program alone. Biden’s policies are also noticeably more ambitious than the Democratic-controlled House, where the public option has not been voted, let alone Medicare for all.
“This is the time for medical care on the moon,” said Irwin Redlener, founding director of the National Center for Disaster Preparedness at Columbia University, who served on the Biden campaign public health task force to earlier this year. “My feeling is that we are not going to see a moderate, moderate and gradual series of changes. I am looking forward to a huge plan that would forever change the way Americans get health care. ”
Still, some inside and outside the campaign would like to see bolder proposals approaching a single-payer healthcare system, believing that the country’s grim circumstances will make the public more receptive to progressive ideas than they think. some politicians..
“There has been a shift toward greater responsiveness to bigger solutions to our two biggest problems: coverage and affordability,” said Ezekiel Emanuel, chair of the University of Pennsylvania Department of Medical Ethics and Health Policy and a member of public health for Biden. Prevention committee. “But people’s thinking has not reached the serious situation we are in.”
The pandemic accelerated backward discussion about the precarious nature of a healthcare system focused on private, job-related coverage and the need for more government intervention, according to more than a dozen Biden healthcare advisers, members of the task force. and members of the DNC platform committee that spoke with POLITICO.
“It is even clearer at a time when many people have lost employer coverage and are struggling to survive,” said former surgeon general Vivek Murthy, a senior adviser to Biden.
This month’s unit working group recommended several proposals that go even further to the left. In addition to the strengthened public option and Medicare at age 60, the group called for free tests and treatments for Covid-19, increasing federal overlap for states expanding Medicaid, expanding Medicare benefits to include dental, vision coverage and hearing, implementing direct government bargaining on drug prices and allowing undocumented immigrants to buy Obamacare coverage without subsidy.
“We didn’t get everything we wanted. We didn’t make Biden Bernie Sanders, but we were able to make tremendous progress, “said Rep. Pramila Jayapal (D-Wash.), Lead Author of the House Medicare for All bill.
But while sentiment among the Democratic voter base may have shifted to the left, delegates and party establishment are more centrist than in 2016 because Sanders performed much worse in the primaries.
Chris Jennings, a White House policy adviser on health care under the Obama administration and one of the Biden elections for the task force, said Biden’s victory in the primaries showed that both Democrats and the general public prefers the public option over single-payer healthcare. a view supported by surveys.
“In our primary, we had a debate around two bold visions, and one won over the other,” he said. “But relative to current law, they are both very bold.”
Sarah Bianchi, one of Biden’s top economic and domestic policy advisers when she was vice president, told POLITICO that Biden’s health platform will look even bolder in the general election compared to President Donald Trump and his legislative efforts and legal to kill the Affordable Care Act.
“The difference is that we used to compare it to Medicare for all, which is why people said, ‘It’s so moderate! So incremental! ‘”, Said. “Now I am sure we will hear about this from the other side: that it is a slippery slope and it is socialism.”
The Trump campaign has already tried to paint Biden as a puppet on the left, and the health care industry through primary announcements launched the public option as the first step on the road to single-health care. payer.
Biden’s campaign recognizes that even his centrist proposals would be difficult to pass in Congress, but he is trying to use opposition from wealthy interests to boost his progressive good faith.
“The vice president is very aware that there are parts of his agenda that certain interests can oppose, perhaps because it reduces his profit margins,” Murthy said. “He is clear on the fact that it will require fighting, in some cases, and he is prepared to do it.” He is not deterred by political pressure or industry opposition. “
Arielle Kane, director of health care for the Institute for Progressive Policy who designed the health policy for the Michael Bloomberg campaign and has advised the Biden campaign, applauds this new, more aggressive rhetoric.