On Wednesday, January 20, 2021, Joseph Robinette Biden Jr. was sworn in as the 46th US President and Kamala Harris, as the first Black Vice-President. They took office at a moment of major events, crises, and aspirations in the United States of America: healthcare crisis, profound economic challenges, political crises, cries for unity and racial justice, and after a tumultuous four years that shattered the fabric of American society. Starting his Inaugural Address, President Joe Biden said: “This is America’s day. This is democracy’s day.” One of his top priorities was Healthcare reform. Now, some of the key provisions in his Healthcare plan, especially on Medicare, have been dropped. Then, recently speculations on 2024 US presidential elections have been building up.
In the last months, the focus was on endless dicussions and political negotiations on the economic plan and budgets, with the disagreements among democrats, especially from Senators Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ) being one of the roadblock, beyond the challenges from Republicans. Now, the discussions are on the $1.75 trillion plan, a significantly pared-down version of a $3.5 trillion budget resolution introduced by Democrats early this year. Because Democrats need all 50 of the caucus’s senators on board to pass the bill via budget reconciliation, significant cuts, such as long-term investments in paid family leave, free community college, and Medicare coverage of dental and vision services, have been made to get Senators Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ) on board.
What Happened to Joe Biden's and Kamala Harris' Initial Healthcare agenda?
The initial agenda of Joe Biden and Kamala Harris could be summarized into around 9 key areas, with Healthcare being one the most important pieces ( US 2020 Elections: Agenda of Joe Biden and Kamala Harris - Key Points ).
In summary, the healthcare agenda included:
- Expanding Obamacare by offering all Americans a public insurance option;
- Expanding medicare coverage to Vision and dental services;
- Lower costs for medicare;
- Reducing medicare age requirement from 65 to 60 years old.
Now, the Healthcare provision has basically been dropped from the final version of Joe Biden's $1.75 trillion plan. The burning questions are whether healthcare reform has become a low priority, even when it included the obvious rational options to lift the US Economy and improve people lives by prioritizing health care for the overall US population.
Two examples can be pointed out:
1- Expanding Affordable Care Act (Obamacare) by offering all Americans a public insurance option
In fact, there appear to be contradictions between the economical goals and the foundations and requirements of a sound economy. One of the contradictions is how an economy can rely on the workforce made of people worried about their healthcare coverage or how they will manage to cover their health costs when they get old. Expanding Obamacare by offering all Americans a public insurance option would seem an obvious decision: it would make more an economical sense to address such potential worries of the critical workforce the economy would rely on.
2- Lower costs for medicare, Reducing medicare age requirement from 65 to 60 years old.
It is well known that it is mostly in old ages that most people start suffering from or dealing with vision, dental and aural health conditions. And these conditions are often critical. How then does a health insurance aimed at the old people not cover such prevalent health conditions?
One comment often heard about Medicare dental and vision coverage gap goes as follows: "Current Medicare coverage is like giving an umbrella full of holes to someone under a heavy rain, having a health insurance for women that does not cover mammography and OBGYN services or one, for men, that does not cover Prostate-Specific Antigen (PSA) tests."
It is well agreed that young and old ages are relative notions. Demographers Sergei Scherbov and Warren Sanderson at the International Institute for Applied Systems Analysis put it well in their book “Prospective Longevity: A New Vision of Population Aging,” where they point to life expectancy. But, even in the USA, life expectancy depends on class, gender, race, and economic conditions. Hence, Medicare coverage should account for these factors as well.
But more importantly, there are even more scientific reasons why Medicare coverage should start well before 65 years old.
Scientifically, according to CDC (see here Percent of US Adults 55 and Over with Chronic Conditions ), most people 55+ years old, around 78%, or 69.5% for Age 55 to 64 years suffer from one or more aged related conditions, such as diabetes, cardiovascular disease, chronic obstructive pulmonary disease, asthma, cancer, or arthritis. These conditions are often so serious for the people in the age range of 55-64 years old to be active in some types of jobs, even if they are not disabled, and hence would need to have non-work related healthcare medicare coverage.
Even without that scientific argument, it is well known that most people would fall back to Medicare coverage only if necessary, but not as a preference. Hence, there is a widespread puzzle on why politicians from both sides could not agree to expand Medicare coverarage to people 60 years-old or more.
Joe Biden's Plan Discussions Mixed with 2024 Presidential Elections Speculations around Opting-out, Donald Trump, Pete Buttigieg, and Stacy Abrams.
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The significantly pared-down version of a $3.5 trillion budget resolution introduced by Democrats early this year has been hampered by several factors: republican opposition, resistances from democratic factions, and, lately speculations on 2024 Presidential elections.
On 2024 Presidential elections, there are increasing speculations about former President Donald Trump getting ready for a determined comeback to unseat Joe Biden, who beat him in the 2020 elections. The speculations on Donald Trump seeking the presidency have been fueled by his controversial actions since he lost elections.
Now, there are even more fueled speculations on the democratic side. The latest rumors on the 2024 elections have formed with assumptions that Joe Biden may opt-out and let Vice-President ran for the US Presidency. However, according to the rumors, this may not be easy: Vice-President Kamala Harris may face tough primary election challenges from potential popular democrat candidates like Pete Buttigieg or Stacy Abrams.
Pete Buttigieg is a former military officer serving as the United States secretary of transportation since February 3, 2021. He has been an active supporter of Joe Biden's agenda, has opposed Republican efforts to repeal the Patient Protection and Affordable Care Act and has favored Medicare for All.
Stacey Abrams (see Stacey Yvonne Abrams: AfroAmerica Network Woman of Year 2018 and Joe Biden's Top Black Women VP Pick Contender) founded two groups, the New Georgia Project and then Fair Fight, that have been central to a movement of voter registration in Georgia over the elections in the recent years. These include more than 800,000 new voters between 2018 and the 2020 election. With her efforts, Joe Biden and Kamala Harris won the state and Reverend Raphael Warnock and Jon Ossof, democrats, captured the 2 Georgian U.S. Senate seats (Georgia US Senate Runoff Election: Jon Ossoff, Rev Raphael Warnock, and Stacey Abrams Make History). She has been also fighting for medicaid expansion.
Hence, if the speculations happen to be true, the democrats may be looking at the candidates who will push to advance Joe Biden and Kamala Harris's agenda and key policies, including Medicare expansion to age 60 years old or more, Medicare dental and eye coverage, and medicaid expansion across the nation.
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