early and often

Bring Back the Public Option!

Biden’s “battle for the soul of America” rerun won’t be enough against Trump. He needs to give voters something real.

Photo: Drew Angerer/Getty Images
Photo: Drew Angerer/Getty Images

Joe Biden, to the surprise of few, is a presidential candidate again. Incumbents rarely step aside if another term is on the offering, and there are many compelling reasons for Biden to run once more. In two years, with Democrats narrowly in control of Congress, Biden was able to rack up a string of domestic achievements that could pay significant dividends in the decades to come. Two major pieces of legislation, the Inflation Reduction Act and the CHIPS and Science Act, have planted the seeds of a new national industrial policy that will, over time, help to undo the damage of the free-trade agreements that crushed American labor. The federal government has helped kick-start a new green manufacturing revolution — no small feat with Democrats barely in charge of the Senate. Biden secured several more policy wins that eluded past presidents, including capping the cost of insulin for seniors on Medicare and pumping billions of federal dollars into transportation and infrastructure projects. He even became the president who codified protections for same-sex couples into federal law.

Luckily for Biden, none of these policy victories were especially polarizing. Barack Obama lost a large House majority after the passage of the Affordable Care Act. Thanks, in part, to the demise of Roe v. Wade, Democrats avoided the typical backlash in the midterms, buoying Biden further. Even at age 80, he has united the party behind him. There are no formidable primary challengers. His campaign team can increasingly look forward to a rematch with Donald Trump, who maintains comfortable leads in Republican primary polls. As alienating as ever and facing down the possibility of indictments in two different states, he is just the opponent Biden craves.

And Biden longs for Trump, in part, because he’s yet to offer a compelling vision for a second term.

The president has no new policy agenda, and he very well may need one. “It’s time to finish the job,” Biden declared, as if his presidency were a home-repair project. His campaign-announcement video, running three minutes, was an encapsulation of the kind of campaign messaging that paid off for Biden during the midterms and certainly proved effective in 2020, when Trump was the incumbent and COVID was the primary terror. Grainy footage opens on the January 6 riot and then quickly cuts to a protest sign outside the Supreme Court that announces, “Abortion Is Healthcare.” The Biden campaign, again, cloaks the president in patriotic imagery and warns of “MAGA extremists” unraveling democracy. His 2020 argument — a “battle for the soul of America” against Trumpism — has been resuscitated in full.

In 2024, with the pandemic faded and even the end of Roe being a two-year-old issue, Biden may have to craft a new approach. He will be 81 going on 82. Democrats are unlikely to retain the Senate, but Biden can’t campaign that way — he needs to offer hope and a concrete rationale for another four years as president that will take him to his 86th birthday. He could argue, forcefully, for a federal codification of abortion rights, but he seems unwilling to take up that fight in a visceral way. If he’s serious about finishing the job, as he maintains, he could revive a cause he spoke about in his last campaign and mostly abandoned when he became president: universal health care.

It’s strange, historically speaking, that the aim to provide free or cheap health care to every American has fallen off the Democratic radar. For decades, it was a leading campaign issue; it became a large part of First Lady Hillary Clinton’s portfolio in the White House and would end up consuming most of Obama’s first term. In 2016, Bernie Sanders rose to prominence promising the passage of Medicare for All, his far-reaching version of single-payer health care. Clinton, then running for president herself, was dismissive of the idea, but even the moderate wing of the Democratic Party was vowing to, at the very minimum, fulfill Obama’s original promise of the ACA and create a public option to compete with private insurers in the marketplace. (Joe Lieberman killed it.) The 2020 Democratic primary was, at points, a battle of ambitious health-care proposals, with progressives lashing out at Pete Buttigieg for offering a “Medicare for All who want it” plan that would have preserved private insurance while creating a government-funded option for anyone who desired that sort of coverage.

Biden himself, a past supporter of the public option, has been mum on the idea of late. The logistical rationale is reasonable enough: Democrats don’t control the House anymore and only had a 50-50 majority in the Senate in 2021 and 2022. But it was notable Biden, in his willingness to pitch various very expensive spending plans, never stumped on the public option. For all the accomplishments of those two years, there was a large degree of unfocused spending, with few tangible policy programs left behind that voters can immediately benefit from. Green industrial policy will only excite you so much if you’ve got a health-care bill running close to $1,000 a month, or you’ve racked up tremendous debt after an extended hospital stay.

Biden could build a presidential campaign around implementing the public option and dare Trump or any Republican to oppose him. Much of the wariness around health-care reform has receded. Republicans spent a decade trying and failing to repeal the ACA. In the last few years, they’ve ignored it. Trump himself doesn’t talk about Obamacare anymore. Even Republican-run states have expanded Medicaid coverage. Health care is a broad and winning issue, and a government option on the state marketplaces would be overwhelmingly popular, since members of labor unions or those granted stronger private plans won’t have to fear giving their coverage up. Momentum, on the state level, has slowly built around the concept, with Minnesota moving closer to implementing one.

Democrats, come 2025, may lack the votes in Congress to pass a public option on the federal level. Indeed, if Republicans control the House or the Senate and Biden wins a second term, he will be blocked on almost every domestic front. But a campaign is about striving to avoid that outcome or forcing the opposition, at the very minimum, to adopt an unpopular stance, like denying the public the choice of cheap health insurance. Biden has the ability to put Republicans on the defensive — if he chooses to do so.

Biden defeated Trump in 2020 by framing the election as one that would determine the future of American democracy. Trump tried to overturn the results and has lied about the outcome since, insisting he somehow won. Election-denying acolytes ran everywhere in the 2022 midterms and came, in certain states, very close to winning. Democrats are terrified of the Republican far right, and fear can always push up turnout from the base.

Will it all be enough? Lost in the din of Fox’s firing of Tucker Carlson and the liberal punditocracy’s supreme confidence that MAGA is on the wane is the reality that Trump, in 2023, may be running the most disciplined campaign of his life. He remains deeply alienating, but his approval ratings are no more dismal than Biden’s. In the GOP primary, Trump’s team has effectively dismantled Ron DeSantis, his top rival, before the Florida governor has even become an official candidate. Some of Trump’s attacks on DeSantis have come, ironically enough, from the left, and it will be much harder to credibly accuse Biden of wanting to slash Social Security or Medicare. But Trump’s dominance of the primary is evidence, in part, that he is going to be formidable — that any kind of landslide scenario, like the one alluded to by recent Biden endorser Bernie Sanders, is not plausible. Trump, as the Republican nominee, is a sizable threat to win the Electoral College.

To win in 2024, Biden may not be able to replicate the conditions of 2020 — or even 2022. Three years ago, Trump’s shambolic response to the pandemic was an overriding campaign issue, as were his destabilizing public utterances and tweets. Biden emerged as the Democratic nominee with a simple argument: He was the safest candidate to take on Trump because he was the most likely to win. Many Democrats and independents believed eight consecutive years of Trump could terminally weaken the American republic. It may have been a chaotic and confusing time, but the campaigns themselves were stark and extraordinarily direct. Few voters wanted to really know Biden’s plan for anything. They wanted to know if Biden could make Trump go away. Now Biden will hope that’s all voters really want again: yet another bulwark against Trump and his movement. If voters are demanding more, Democrats may come to regret consolidating so quickly around an elderly incumbent, especially with their growing bench of national contenders.

Bring Back the Public Option!