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John Cornyn (Tex.), a senior Republican who just won reelection. “If it’s Medicare-for-all, I don’t think there’s much chance,” he said in an interview Monday, referring to a broader government role in health care than Biden favors. Cornyn did not specifically address the president-elect’s plan, but said that if the Democrats end up barely in control of the Senate, with a 50-50 split among senators and a Democratic Vice President-elect Kamala D. Harris in a position to break ties, “we’re obviously going to have to work together to do things.” He added: “It’s probably going to be frustrating to the progressives, because they’re not going to be able to get everything they want.” Even in a Senate barely in Democratic control, some of Biden’s health-care proposals might face impediments, outside experts said. Although Democrats tend to favor allowing more consumers to get federal insurance subsidies, “the Achilles’ heel for improving the subsidies is how to pay for it,” said Robert Laszewski, a longtime health-care adviser with clients across the industry. Despite Biden’s pledge Tuesday to move quickly, it remains uncertain for now how soon congressional Democrats — or his administration, once it begins on Jan. 20 — will want to take up the health-care changes he espouses. When Obama assumed office in 2009, with Biden as his vice president, he announced before a joint session of Congress in February that he would start collaborating with Capitol Hill on major health-care changes. Congressional Democrats began working within a few use this link months on bills that evolved into the ACA.


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