Donald Trump’s exit from office — and the Republicans’ demotion to minority party — bodes well for patients in the United States, as the number of uninsured rose from twenty-seven million to nearly thirty million from 2016 to 2019. His administration’s willful sabotage of the already inadequate Affordable Care Act proved effective, with bottomed-out insurance navigator budgets, narrowed enrollment windows, and a so-called “public charge rule” that intimidated eligible immigrants from gaining health care benefits.

Add to that the yearlong pandemic, and the case for Medicare for All has rarely been more obvious. Millions have been thrown off their job-based health insurance at the same time insurance companies rake in record profits. The newly uninsured lucky enough to be absorbed by their state Medicaid program will likely experience the instability of insurance “churn” as they drift under and over the income threshold. The rapid expansion of rolls will strain state budgets and administrative capacities.

Meanwhile, hospitals relying on reimbursement are dangerously cash-strapped even as they’re slammed with COVID-19 cases. And millions of us are waiting for a largely publicly financed vaccine whose production was curtailed by a profit-driven intellectual property regime and whose rollout has been slow largely because years of austerity have starved public health departments.