During the 2020 Democratic Presidential Primary, calls grew for the United States to join nearly every other developed country in implementing a system that would guarantee health care coverage for every American, regardless of income or job status.
When Joe Biden emerged as the clear front-runner, he made it clear that, if he wins the presidency, he will implement some kind of expansion to the Affordable Care Act, also known as Obamacare.
Then the United States was thrust into one of the greatest health crises in its history with the COVID-19 pandemic. But how will this crisis change Democrat or Republican perspectives on health care?
Donald Trump hasn’t changed course. He has continued to dismantle Obamacare as he has been doing for years, according to CNN. He campaigned against Obamacare, and has taken many steps to weaken it, such as limiting Medicare expansions in primarily Republican-controlled states where more vulnerable populations like Black and rural Americans are now being hit hard by COVID-19.
He has also rejected calls to re-open Affordable Care Act exchanges which would allow some of the 30 million newly-unemployed Americans to purchase health care plans.
Senator Bernie Sanders, Biden’s main opponent and supporter of a “single-payer,” truly universal health system, has used the pandemic as an example of why it is so crucial. “In this unprecedented moment in American history,” he wrote in a Guardian op-ed along with Pramila Jayapal, “... [l]et us, finally, guarantee healthcare to all our people as a human right.”
He points out that because health coverage is tied to Americans’ jobs, more than 30 million Americans are now without insurance, citing that as a fundamental flaw in our system.
Biden, however, hasn’t changed his mind, as CNBC reports, saying the cost of single-payer is too high. He still supports a “public option.”
He has, however, begun to collaborate with Sanders and former opponent Senator Elizabeth Warren, who also supports a form of single-payer health care, according to the New York Times. He recently created task forces with Sanders and fellow progressive Representative Alexandria Ocasio-Cortez, and has argued for ideas like canceling rent during the crisis, taking down systemic racism, and fighting climate change.
But is he shifting on health care? Many of the senators and activists he has tapped for these task forces support single-payer, and rumors that Warren is being considered as a Vice Presidential pick have been growing.
For their part, health insurance companies have been cautiously optimistic. Politico reports that many of the largest ones have been moving back into the Obamacare markets.
Because health insurance companies are for-profit businesses, reports that insurers were still making money under Obamacare, and that Obamacare patients are more profitable than Medicare patients, seem to have influenced this.
Under Trump and the Republican’s plan, most low-income and unemployed people would be forced to use Medicare or go to emergency rooms - in both scenarios the costs are paid by taxpayers.
Under a single-payer plan, health insurance companies would be completely dismantled, and the system would no longer be profit-based.
It appears Biden’s plan would be the best of both worlds for health insurance companies. But if the pandemic continues, a Democrat wins the election, and calls for single-payer continue to grow, they may have to fight for their continued existence.