Biden’s campaign declined to comment to POLITICO on who will serve on the task forces, other than to say they would “represent the diverse viewpoints of the Democratic Party.”

Single-payer activists said the fact that Biden recently proposed lowering the Medicare eligibility age to 60 — “Medicare for Some,” as one dubbed it — shows their pressure campaign is already working. The policy change could have a huge impact by immediately enrolling up to 23 million more people in Medicare, according to a new analysis by the consulting firm Avalere.

"That's only a very, very, very first step," said Jeff Weaver, Sanders’ longtime adviser. Still, he added, "That's a lot of people. Clearly not where we need to get to by any stretch of the imagination. But not nothing. And what people have to understand is that even that concession is a result of the movement around Medicare for All pushing the envelope on this.”

Biden released his plan to expand Medicare shortly after Sanders dropped out earlier this month. Sanders and Biden aides were already negotiating behind the scenes in the weeks before he exited the race, and health care was one of several issues they discussed.

“Bernie and Biden talked and [Biden’s decision to lower the age of Medicare enrollees to 60] came out of that,” said Wendell Potter, a former insurance executive turned Medicare for All activist. “I can’t imagine that that’s all Bernie is going to be asking for, or that’s all that Biden will say is needed to get us to a better health care system.”

The health care task force is one of six the Sanders and Biden campaigns are putting together on various policy issues, including the economy, climate change and criminal justice.

As the coronavirus consumes the attention of elected officials and advocates alike, advocates said the turmoil may provide an opening to win over skeptics of single-payer. A Morning Consult-POLITICO poll found that public support for Medicare for All has shot to a nine-month high amid the pandemic.

“Looking back at history, Britain achieved its universal health care system in the ruins of depression and war, when they didn’t have two shillings to rub together," said Adam Gaffney, president of Physicians for a National Health Program. "Paradoxically, this may in fact be an opportunity.”

As Medicare for All activists try to force Biden to the left on health care, though, they’ll be contending with a health care industry pushing hard in the opposite direction. The Partnership for America’s Health Care Future, a lobbying behemoth backed by the biggest players in the hospital and insurance industries, spent $4.5 million on advertising combating Medicare for All during the presidential primary, according to TV data from Advertising Analytics.

The group argues Biden's decisive victory was another nail in the coffin for the single-payer dream.

“This is now the third cycle where it just never made it — if you look at 2016, 2018 and 2020,” said Lauren Crawford Shaver, executive director of the Partnership for America’s Health Care Future, of Medicare for All. “It didn’t ever hit a critical mass of support. Voters ultimately didn’t pick it as what they wanted to see.”

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But in a sign that the Partnership for America’s Health Care Future doesn’t see health reform efforts as completely dead yet, it continues to advertise on Facebook promoting the industry’s efforts during the pandemic.

In addition to fighting single-payer, the Partnership also opposes Biden’s public option plan. Donors in the health care and pharmaceutical industries contributed $3.7 million to Biden and outside groups supporting him, according to the Center for Responsive Politics' Open Secrets.

At his first fundraiser during the campaign, Independence Health Group CEO Dan Hilferty was a co-host. And throughout the campaign, Biden warned that Medicare for All would strip union members of their hard-won benefits, bankrupt the federal government and erase progress made under the Affordable Care Act.

Despite the enormous challenge facing them, progressives are drawing up a list of areas where they believe they can potentially push Biden in a more liberal direction on health care.

Weaver said the Biden-Sanders health care task force will likely discuss lowering the Medicare eligibility age to 55 and creating a universal health care insurance program for children.

El-Sayed also listed expanding Medicare for young people as they age out of their parents’ health care plans when they turn 26 as an additional potential place where progressives could win a concession. Other activists and lawmakers mentioned allowing employers to purchase group coverage through the public option, and adopting Sanders and Jayapal’s legislation to guarantee health care coverage to all uninsured people during the coronavirus pandemic.

“The most urgent priority is to support Medicare in this crisis for those without insurance,” said Ro Khanna, Sanders’ former campaign co-chair. “Sanders and Jayapal’s bill does that and would be a great starting point. Why offer to pay for COBRA when we can put folks on Medicare?”

Both El-Sayed and Jayapal declined to comment on whether they had been asked to sit on the Biden-Sanders health care task force. However, Jayapal said she has been “thinking through” what the group should look like with both politicians' teams.

“I hope I can work with Biden as our Democratic nominee and help him and his team to get to a place where they see what must be done with his leadership,” she said.

Progressives said they will also push for liberal appointees to health care-focused posts in Biden's potential administration, such as the heads of Health and Human Services and the Centers for Disease Control and Prevention.

Biden’s vice presidential pick is the subject of especially close scrutiny.

Single-payer advocates are particularly fearful of Biden choosing Michigan Gov. Gretchen Whitmer, whose father was the CEO of Blue Cross Blue Shield of Michigan. In their view, such a decision would signal a very different approach to health care than some options — such as Sen. Elizabeth Warren, who called for initially implementing a public option and then transitioning to Medicare for All.

“For Biden to even pretend that he's going to put together task forces and listen to progressives while considering Whitmer for VP — they’re polar opposites,” said Bridget Huff, chairwoman of the Progressive Caucus of the Michigan Democratic Party. “He couldn't find someone less friendly to Medicare for All.”

A Whitmer spokesman declined to comment, but her home-state Rep. Andy Levin, a member of the Congressional Progressive Caucus, defended her health care record. Whitmer has said she supports Medicare for All “in concept,” though she said it was unrealistic for Michigan during her gubernatorial campaign.

One move of Biden's that has heartened the left, however, has been his recent support of free testing, treatment and vaccinations for Covid-19 — a kind of “Medicare for All Who Catch the Virus” — though they would like him to promote the idea more.

In fact, progressives feel the coronavirus pandemic has made the case for Medicare for All for them. How can Biden argue that those who like their private insurance can keep it, they argue, as tens of millions of people are thrown off their plans when they become unemployed? And how can he say people shouldn't be on the hook for coronavirus treatment but should be allowed to go broke if they get cancer?

But few, if any, believe there is any chance of Biden ever backing single-payer, meaning their hopes have been dashed for four years at least.

"Our general read of the issues has been that the quote unquote establishment is going to tell the left to f--- off on Medicare for All,” said Julian Brave NoiseCat of the liberal think tank Data for Progress. However, he said, other progressive ideas, such as the government manufacturing generic prescription drugs, are "very popular."



