No Vice President Biden, you don't have a mandate for that

 Vice President Joseph Biden is widely acclaimed as the winner of the 2020 presidential election.  I join in that acclamation and urge every good American to do the same.  The rest of you know who and what you are.

Already, however, the presumptive, and somewhat presumptuous, President-elect is writing checks with his mouth that his slender (thank goodness) mandate won't be able to cash.  In remarks yesterday concerning the foolish and politically inept challenge to the Affordable Care Act (ACA) by the current administration, President-elect Biden indicated that, once actually in office he intended to move quickly to expand ACA coverage dramatically, yet somehow decrease health care costs.  These policy goals are recklessly profligate and irresponsible in the first instance and complete rubbish in the second.

ACA was recklessly profligate and irresponsible when it was enacted in 2010.  At that point, subsidies to the state-run health insurance exchanges and subsidies (tax credits) to individual health insurance customers were projected by the Congressional Budget Office (CBO) to average about $47 billion a year  over a 10-year span.  Two years later, CBO projected those costs to run about $73 billion a year, a 55 percent increase, over an 11-year span.  I know I'm old-fashioned, but even the original $47 billion sounded like real money to me.

As far as the reduced costs go, they are always illusory.  It's like the siding salesmen and other sharpsters who tell you the utilities savings alone will pay for the project.  It just ain't so.  And the usual go-to for restraining costs, reducing payments to  health care professionals will eventually lead to a decline in the quantity and quality of the industry's labor supply.  Will all die cold and poor while our health care team is out looking for leeches.

ACA , is  part of the fundamental structure of our society now, as the Supreme Court seems ready to keep it. Ignoring your fiduciary duty by massively expanding the program is not, however, within your narrow mandate President-elect Biden, no matter what the electorate in the great state of Georgia have to say in a few weeks.