Health insurers are beginning to strategize on how to deal with healthcare proposals pushed by Democrats and a future Joe Biden White House from a public option to “Medicare at 60” and expanded Medicaid benefits under a stronger Affordable Care Act.

Health insurers don’t like the idea of a public option, which would be a government-run plan offered alongside commercial choices sold by health insurance companies on marketplaces under the ACA. Biden supports a public option while the Donald Trump White House continues its efforts to repeal the ACA, the 10-year-old law also known as Obamacare that has expanded health coverage to more than 22 million Americans.

But health insurance companies aren’t opposed to bolstering benefits under the ACA incrementally and particularly support expanded Medicaid coverage. And these health insurers are relieved Biden isn’t carrying the single payer “Medicare for All” platform of Sen. Bernie Sanders who campaigned on that proposal before suspending his campaign and endorsing Biden.

A snapshot into the thinking of health insurance plans could be heard last week from the top executive of the nation’s largest health insurance company, UnitedHealth Group, who was asked about some of Biden’s and Democratic proposals on the company’s second quarter earnings call last week. Though analysts didn’t directly name the former Vice President, one analyst said a lot of investors are asking about the public option and UnitedHealth’s chief executive provided a detailed response.

“Generally speaking, we’re not a strong supporter of these public option proposals, and primarily because they disrupt current coverage platforms, which consumers value and appreciate,” UnitedHealth Group CEO David Wichmann told analysts who follow the company.

“We believe there’s a near universal coverage system already in America today,” Wichmann said. “It’s obviously not complete and it has some gaps, but we believe those gaps can be closed and think that consumers much prefer that we leverage the existing commercial Medicare and Medicaid markets to provide the types of coverage options and coverages that are necessary for America.”

The thoughts of health insurance executives and the Wall Street analysts who follow the industry on Democratic and Biden proposals come with President Donald Trump’s re-election campaign in jeopardy with polls showing the former vice president ahead by double-digit percentages. “Things do not look great for President’s Trump re-election chances at this juncture,” healthcare analysts at Mizuho Securities USA said last month in their “Washington mid-year review” report.

A Biden win plus Democratic control of the U.S. House of Representatives and the U.S. Senate would likely bring about efforts to expand healthcare coverage under the ACA, analysts say.

Health insurers like UnitedHealth are proponents of Medicaid expansion under the ACA in part because practically all U.S. states contract with private health plans to provide the benefits to poor and low-income Americans.

There are now 37 states that have adopted Medicaid expansion after voters in Oklahoma last month approved a ballot initiative to extend Medicaid benefits to 200,000 low-income adults. Medicaid expansion has been a boon to UnitedHealth, CVS Health’s Aetna health plan unit, Centene, Anthem and Molina as well as many Blue Cross and Blue Shield plans.

“We’re obviously strong supporters of the states that have not expanded to expand,” Wichmann said. “We believe Medicaid is a strong coverage option.” 

Health insurers also sell Medicare Advantage plans, which are fast-growing private plans that provide seniors benefits via contracts with the federal government. Biden and the Trump administration are proponents of Medicare Advantage and would likely to continue efforts to see more access to such coverage though Biden supports traditional Medicare as well.

Wichmann said UnitedHealth favors ways to “ensure that Americans are getting the coverages that are made available to them by states, federal governments, and the private insurance system.”