While most angst on the American left is focused on the possibility that Donald Trump will be the next president, there is also debate among Democrats over what direction the party should take if Hillary Clinton is elected.

One of the best demonstrations of the intraparty conflict is the debate over health care.

Many liberals who were frustrated with a health care reform that largely kept the insurance-driven system intact have been emboldened by Bernie Sanders’s strong performance in the primaries, during which he repeatedly called for the establishment of a single-payer health care system. In response to the pressure from Sanders on the issue, Clinton unveiled a number of health policies aimed at courting progressives, most prominently a pledge to work for a “public option” insurance program.

Following the lead of their party’s standard bearer, 33 Senate Democrats are co-sponsoring a resolution in support of a public option. A number of moderate Democrats, however, have not signaled their support, most conspicuously Tim Kaine, Clinton’s vice presidential candidate.

A Kaine spokesperson told Politico that Kaine is in support of a “workable public option,” despite the senator’s silence on the resolution.

Meanwhile, other moderates who have avoided the resolution are echoing the types of statements Clinton made early during her presidential campaign, when she emphasized protecting and strengthening the Affordable Care Act.

A public option was originally part of the ACA floated by the president in 2009, but it was ultimately scrapped as a result of opposition from some moderate Democrats.

The current debate over the public option, however, is largely academic. Republicans will almost surely retain control of the House of Representatives after the election and are likely to stay in control of the Senate. Even if Clinton wins the White House, it is highly unlikely she will be able to push through any significant health care reforms, let a lone a public option that Republicans detest on principle.

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