There continue to be plenty of reasons for skepticism about the incoming Democratic administration and its plans, despite the party’s newly secured Senate majority. For one thing, despite containing some encouraging elements, Joe Biden this week signaled his intention to seek Republican votes for his COVID relief package — a move that will almost certainly water down the plan and slow its passage.

Nonetheless, Bernie Sanders’s new role as chair of the Senate Budget Committee offers some very real reason for optimism. Though he won’t, of course, have anything approaching the power that would be required to pass the agenda he ran on earlier this year, chairing the committee does give him control over the reconciliation process — the nature of which, as the New York Times put it, “effectively gives Mr. Sanders a leading role in deciding how expansive — and expensive — Mr. Biden’s ambitions for new taxes and spending will be.”

Fearmongering statements from Republican politicians should always be taken with a grain of salt. But the prospect of what a Democratic senate majority might bring was enough to spook Paul Ryan back in 2016. “Do you know who becomes chair of the Senate Budget Committee?” as he put it to a group of college Republicans four years ago. “A guy named Bernie Sanders. You ever heard of him?”

There’s certainly every indication that Sanders intends to use his new role and the increased prominence that comes with it both proactively and aggressively. The senator dropped at least one significant hint to that effect in a recent interview, which saw him revive the idea of an emergency universal health care program — a popular and potentially transformative move that could provide significant and badly needed relief to millions of people.

Though we don’t yet know the details of what Sanders will propose, it’s reasonable to assume it will resemble the legislation he tabled last spring alongside House colleague (and Congressional Progressive Caucus chair) Rep. Pramila Jayapal. The Health Care Emergency Guarantee Act, as it was called, would have covered on a short-term basis, “any health care items and services … medically necessary or appropriate for the maintenance of health or for the diagnosis, treatment, or rehabilitation of a health condition of the applicable individual.” For those with health insurance, it would have covered “the amount of any cost-sharing, including any deductibles, copayments, coinsurance or similar charges.”

If it were to become reality, such emergency legislation would presumably be set to expire once a critical mass of Americans had received a COVID vaccination. Nevertheless, even the momentary experience of something resembling universal health insurance could strengthen what is already a majority consistently in favor of the policy. The robust popularity of programs like Medicare and Medicaid certainly suggests this would be the case. As a Gallup survey released in 2015 observed:

Americans’ satisfaction with the way the healthcare system works for them varies by the type of insurance they have. Satisfaction is highest among those with veterans or military health insurance, Medicare and Medicaid, and is lower among those with employer-paid and self-paid insurance.

It’s also probable that Sanders would use an emergency version of Medicare for All to make the case for the real thing. Last spring, he used the Health Care Emergency Guarantee Act to do exactly that. “What we are seeing today,” as Sanders put it last spring,

…is the fundamental fallacies of the employer-based health care, and the reason for that is that it is likely … tens of millions of Americans are going to lose their jobs and lose their health care as well. The idea that we look at health care in America as an employee benefit is totally absurd.