Joe Biden will come to the presidency with close to a clean slate on the issue of federal-state-local relations. How will he tackle the big issues he can't escape?

The best insight into the former vice president's approach to federalism comes from his work in directing the Obama administration's American Recovery and Reinvestment Act. The core of that effort was pumping out more than $800 billion to stimulate the economy following the 2008 economic collapse, an amount that at the time seemed nearly unthinkable. A big chunk of the money went to state and local governments for health care and infrastructure.

Biden's strategy: Get the money out fast, warn state and local governments about the risks of mismanaging the cash, and reinforce that warning with full transparency. His office created a website, remarkable for the time, that allowed anyone to track, in real time, what money was flowing where, for which projects. It was a GIS-based map that drilled down to what was happening, quite literally, on any block anywhere in the country.

The do-it-fast, do-it-in-the-spotlight approach is something sure to carry over into Biden's administration. So too, perhaps, is the idea of having the vice president play a central role in directing such an effort, which might be a clue to Kamala Harris' the role in the next four years.

But what will be Biden's federalism agenda for 2021 and beyond? Here are five issues where he's likely to act.

Distributing the COVID-19 vaccine: We will soon add to the battle about containing the virus the question of how best to distribute a vaccine (or, more likely, vaccines). This is sure to be even more difficult than the mask/no-mask melee of the last months. There's the tough question of who gets it first, but even more difficult is the puzzle of how to get shots to the arms of hundreds of millions of Americans.

The Trump administration is leaving behind an 11-page "Operation Warp Speed" game plan to distribute the vaccine. It's remarkably thorough, and it builds on the assumption that the effort will work through partnerships between the federal and state governments and between government and the private sector.

But that's not so much an answer as it is a door into much bigger questions. Just what role will the states play in the vaccination process? Although government has gotten much better at supply chain management since the disaster of Hurricane Katrina, the production and distribution of the vaccine will be a supply chain challenge unlike anything the government has seen in recent decades. The Defense Department will be deploying its vast expertise to help the effort, but the federal government itself doesn't have the capacity to get the vaccine into the hands of those giving the inoculations. The states inevitably will play a big role in directing the front-line effort.

State and local governments have administered a bit more than 155 million coronavirus tests in the first 10 months of the pandemic, and that has been an enormous struggle. We will have the bulk of more than 330 million Americans to vaccinate, and some vaccines will require a booster within a few weeks. To meet the demands of the vaccine, we'll need to quadruple the distribution capacity, and we'll need to do that in half the time we've spent testing Americans for the virus.

Moreover, state governments simply don't have the capacity to store and distribute the vaccine at the super-cold temperatures many of them will require. That means that companies like CVS, Walgreens and Walmart will inevitably be on the front lines to deliver at least some of the vaccines, with heavy transportation support from UPS and FedEx. But if much of the effort will be in private hands, what role will already taxed state public health systems play? The vaccinations will require unprecedented collaboration between state governments and private companies, in a complex system where public trust is already suffering.

So how will the Biden administration attack the problem of running the vaccine supply chain — and of managing the ticklish balance between the feds and the states and between the states and private companies?

Investing in infrastructure: If any bipartisan deal seemed possible in the early months of the Trump administration, it was for a big infrastructure program. Trump had doubled Hillary Clinton's infrastructure plan with a pledge to invest $1 trillion. State and local governments eagerly put together their lists and lobbied hard for the plan, and even in the tumultuous start of the Trump administration it seemed the one big initiative that might pass Congress.

But Republicans on Capitol Hill regularly blocked the plan, asking how the federal government would pay for it (although Democrats grumbled that Republicans had no such worries about the big tax cut plans Congress passed). Now, with state and local governments reeling from the effects of the COVID-19 economic collapse, will Biden step forward with a new infrastructure plan? He campaigned on just that, and House Speaker Nancy Pelosi has offered it as a possible bipartisan deal. But Senate Majority Leader Mitch McConnell and his chamber's Republicans remain as implacable as ever on infrastructure, and they'd like nothing better than to spike Biden's ambitions.

Can Biden roll his infrastructure promises, especially to large Democratic cities that proved so important in helping him win the presidency, into a state and local government relief bill? That raises the larger question of Biden's plan for the next phase of economic stimulus.

Providing fiscal aid from Washington: Before the election, one of the biggest stumbling blocks to a bipartisan stimulus bill was the size of federal relief to state and local governments. Democrats initially wanted $900 billion. Republicans drew the line at no more than $400 million. Democrats will now want more than that and, with the election behind them, Republicans might not be inclined to give even that much. That, in turn, will only double down on McConnell's role in shaping Biden's prospects on the Hill.

We're going to have another stimulus bill, perhaps in December and certainly by the early days of the Biden administration. How will Biden steer his way through the need for a stimulus, Democrats' eagerness to capitalize on Biden's victory for a sweeter deal, the Republicans' readiness to embarrass Biden on the first outing, and Republican grudges about the role that Philadelphia and Milwaukee and Detroit played in pushing Biden over the top?

Healing the health-care divide: COVID-19 isn't going away anytime soon, and that's going to heat up the debate over providing health care — and Medicaid-based health insurance — to poorer Americans. There will be a pledge to ensure that every American can get the vaccine, regardless of income, and that's a step down the road of providing help to Americans who lost health coverage after COVID-19 layoffs and continue to struggle to get back on their feet.

If the Republicans win their challenge to the Affordable Care Act before the U.S. Supreme Court, they'll face their recurring dilemma about how to protect elements of Obamacare that people like, especially coverage for pre-existing conditions. If the Democrats win in the high court, there will be an effort to expand coverage even more. One way or another, the front lines of these national health-care battles will end up in the states. Does that mean that the health-care divides in the U.S. are sure only to grow as the states go in different directions?

Unifying the country: Biden's speech after winning the election called this "a time to heal," and he clearly sees his most important job as bringing a divided country together. Many of these divisions, however, depend far more than we often acknowledge on the decisions of state and local governments. One of this year's most horrific events, the killing of George Floyd, occurred at the hands of Minneapolis police officers, but it also reflected the broader problem of policing in many communities across the country. And Trump's campaign promise to keep the suburbs safe was a dog whistle about the spread of Section 8 subsidized housing beyond the cities.

No matter how soaring Biden's rhetoric, his success in healing America will depend ultimately on building partnerships with state and local governments. The forces of national polarization grow from local divisions, in fierce debates raging from policing to housing to homelessness to mask-wearing and, especially, to race.

It's hard to imagine an election where the federalism issues were more hidden below the surface but more clear in their underlying importance. Biden's administration might have an explicit federalism strategy, or it might pick these issues off one at a time. One way or another, we're surely heading for a massive rethinking of federal-state-local relations in the months to come.