As Republican leaders draft President Donald Trump’s big bill of $4.5 trillion in tax breaks and $1.5 trillion in spending cuts, dozens of more moderate Republicans from contested congressional districts have positioned themselves at the center of the negotiating table.

And just like the Trump administration, Biden is expected to aggressively wield the rule-making powers of the executive branch to address health insurance coverage and prescription drug costs. With COVID-19 surging across the country, Biden's top health care priority is whipping the federal government’s response into shape. “We’re going to work quickly with the Congress to dramatically ramp up health care protections, get Americans universal coverage, lower health care costs, as soon as humanly possible,” the president-elect said earlier this week. A factor that may work in Biden's favor is that many Republicans want to change the subject on health care. Coronavirus relief legislation could provide an early vehicle for some broader health care changes.