It is looking like nipping the public option in the bud is going to be the first priority.
Biden (who ran his first fundraiser sharing a stage with the Republican CEO of Blue Cross Blue Shield) has made it clear that this will essentially just be Medicaid under a different label:
“It’s only for those people who are so poor they qualify for Medicaid they can get that free in most states, except governors who want to deny people who are poor Medicaid... Anyone who qualifies for Medicaid would automatically be enrolled in the public option. The vast majority of the American people would still not be in that option.”
As Biden famously put it, "nothing will fundamentally change", and this is certainly the expectation among his real constituents:
"It’s not our expectation that a change in the administration will transform our relationship and direction from a regulatory standpoint"
This is of course notwithstanding having promised a strong, competitive public option throughout the campaign - just like Obama, who likewise immediately broke this same promise en route to be thoroughly routed in 2010, paving the way for a decade of unprecedented Republican legislative control, gerrymandering + voter suppression (which again worked a charm for the Democrats in their own primary) + dark money.
For the Democrats' base of comfortable professional class boomers and failed professional class millennials, promises like these don't actually mean anything: the assumption is that anyone who voted for Trump is a racist barbarian who is probably too stupid to even want affordable health care. And now Harry Potter has outmagic-ed the troll under the bridge, breaking his evil spell across the land, and we can all go back to brunch and ignoring politics. They actually believe Democrat Party elders who tell them that we have to make health care
even worse because the Republican base demands it. America is a 'conservative' country, after all.
But this is wrong. Support for the public option - never mind Medicare for All -
is 70% nationwide, more than 20 points more popular than Biden himself. Once again, the Democrats will be the Party that spends four years promising to do something about healthcare, by far the most important political issue in America, and that breaks every promise before the votes are even counted. Once again, they are the party that subsidises universally loathed health insurers and compels voters to pay hundreds if not thousands of dollars a month for low quality insurance that they cannot even afford to use:
Behind closed doors there is probably great relief in some quarters that the Republicans have done so well in the Senate and the House, as it makes the Democrats' primary task of servicing capital by managing the base's expectations that much easier.
And Jim Clyburn,
who takes more money from pharmaceutical and health insurance companies than anyone else in the House or Senate, can expect handsome rewards for his
enormously valuable services.