The former vice president has sketched out a big health agenda: ramping up the federal response to COVID-19, boosting the Affordable Care Act, creating a new “public option” to cover uninsured Americans, and expanding Medicare and Medicaid.
But the president-elect’s long to-do list on health is likely to face significant roadblocks in Congress and the courts, experts say.
For instance, Biden’s ambitious proposals on COVID-19 — including his recent call for a national mask mandate — could be waylaid by legal challenges and run into political hurdles on Capitol Hill, where he may face a divided Congress.
Joseph Antos, PhD, a health policy expert with the conservative American Enterprise Institute, predicts Biden will encounter the same type of congressional “gridlock situation” that President Barack Obama ran into during his second term.
“We have a situation that has been like this for a very, very long time — lack of cooperation, lack of recognition that either party is capable of rising above their own electoral views to deal with problems that the country actually has.”
Antos also suggests that Biden may also face enormous political pressure to address the economic fallout from the coronavirus, including record unemployment and business closures, before anything else.
“I think it’s really going to be efforts that are intended to promote economic development and promote the economy,” he says.
In addition, Biden’s plans to expand Obamacare might face a new challenge from the Supreme Court in the year ahead. This month, the high court will take up a new case seeking to overturn the law.
Even so, experts say Biden’s plans on COVID-19 and expanding health care are likely to define his tenure in the White House as a central focus of his presidency.
“Health care will be at the very top of the list of the president’s priorities,” says Sabrina Corlette, JD, co-director of the Center on Health Insurance Reforms at Georgetown University’s McCourt School of Public Policy. “I do think, however, that the administration is going to be very preoccupied with the response to COVID-19 and the economic fallout … particularly in the first year.”
Here’s a closer look at what we can expect from a Biden presidency.
COVID-19: Federalizing response efforts
Biden will move to federalize the response to COVID-19. He has said he will take back major responsibilities from the states — such as setting national policies on mask wearing, social distancing, and the reopening of schools and businesses, based on CDC guidance. In the days leading up to the election, Biden called for a national mask mandate, after waffling on the issue throughout the summer.
He has said he will let public health science drive political policy. Biden is also planning to create his own task force to advise officials during the transition on managing the new surge in COVID-19 cases, vaccine safety and protecting at-risk populations, Politico reported this week. He received a virtual briefing on the pandemic from a panel of experts as he awaited the election’s outcome.
“I think we will no longer have this confused and contradictory public messaging,” Corlette says, “but I also think there will be humility and the recognition that the evidence is evolving — that we don’t have all the answers, but we’re learning as we go.”
But national mandates on masks and social distancing will be challenging to enforce, experts say. They are also likely to face pushback from business interests, opposition from public officials in GOP-led states, and even legal challenges.