Sally Pipes: Biden a moderate? Sanders, AOC plans for candidate suggest this instead

Presumptive Democratic presidential nominee Joe Biden has long been considered a political moderate. A new report from his "unity" task forces should put that reputation to rest.

The 110-page document offers detailed policy recommendations for an incoming Biden administration. It would represent the most left-wing governing program of any president in American history.

Perhaps that shouldn't be surprising. One of the primary purposes of the unity task forces was to line up the base support of Sen. Bernie Sanders, I-Vt., behind Biden. To do so, the former vice president gave Sanders and several of his acolytes, including Rep. Alexandria Ocasio-Cortez, D- N.Y., prominent roles on the project.

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The resulting policy wish-list is what one would expect from a coterie of extreme progressives.

Take health care. The task force did not endorse “Medicare-for-All.” But it asserted that "all Americans have a right to quality, affordable health care" – and wants to push the country toward single-payer in slow motion. The Biden camp wants to lower the eligibility age for Medicare to 60. Never mind that the program's flagship hospital insurance trust fund will become insolvent in 2026. Adding millions more people to the program would compound the financial stresses on the program.

That proposal seems downright restrained compared to the new public insurance option the task force envisions. This government-run health plan would be available to all Americans through ObamaCare's exchanges with no deductibles and no copays for primary care.

Low-income people who don't qualify for Medicaid would be automatically enrolled in this public option free of charge. Similarly, in states that haven't expanded Medicaid under ObamaCare, a Biden administration would make this public option available without any premiums – at least for patients who meet the Affordable Care Act's Medicaid eligibility requirements.

Biden's spendthrift plans don't stop with Medicare and Social Security. His task forces also propose to remake the nation's energy sector.

As described, this represents the largest growth in public health insurance since the Great Society. In practice, however, it will lead to single-payer.

To understand how, consider the task force report's recommendation that the public option keep costs down by "negotiating prices with doctors and hospitals, just like Medicare." Of course, Medicare doesn't negotiate with providers so much as it unilaterally underpays them. The American Hospital Association estimates that hospitals receive 87 cents for every dollar they spend treating Medicare beneficiaries. Total underpayments by Medicare in 2018 were nearly $57 billion.

Private insurers, by contrast, pay hospitals 241 percent of what Medicare would have paid, according to research from the RAND Corporation.

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The federal government's ability to dictate its payment rates – and run enormous deficits – would enable Biden's public option to easily beat private plans on price. This, in turn, would lead to a mass exodus of patients from the private market to the artificially inexpensive public option. Unable to compete, private insurers would leave the market, and the public option would become the only option. 

The task force's vision for Social Security is no less ambitious. The entitlement's trust fund is set to run out in just 15 years. Yet a Biden administration would make the program vastly more generous by, for instance, increasing the minimum benefit, boosting payments to surviving spouses and adopting a more aggressive cost-of-living adjustment. Cost-lowering measures, such as raising the retirement age or means-testing the program, would be prohibited.

Biden's spendthrift plans don't stop with Medicare and Social Security. His task forces also propose to remake the nation's energy sector to achieve net-zero carbon emissions by 2050. The report also calls for $50,000 in student debt relief to anyone working in public service, a $15 federal minimum wage and universal pre-K.

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Then there are the less specific – but no less expensive – recommendations the task force saw fit to include. Among them are investments "in the care economy – child care, adult care, elder care" and a plan to create well-paying jobs through "an unprecedented investment in public infrastructure."

All of this from a candidate who differentiated himself in the Democratic primary as the voice of moderation – and whom many Americans still see as a middle-of-the-road pragmatist. If he wins the presidency, Biden may end up the best friend progressives ever had.

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