President Joe Biden has, not once since his inauguration, mentioned the public health insurance option he and every single competitive Senate Democratic challenger promised voters during the 2020 election.

The idea of creating a government-run health insurance plan that people could buy into has completely disappeared from the political conversation in Washington. Instead, Democrats have opted to deliver tens of billions of dollars of new government subsidies demanded by private health insurers that have funneled millions of dollars into Democratic campaign coffers.

In their latest spending bill, Democrats once again chose to give $42 billion in additional subsidies to private health insurers to help steer people into plans that feature high out-of-pocket costs and routine claim denials, as those insurers continue to raise premiums.