One of the most urgent priorities of the new Biden Administration will be tackling the COVID pandemic and providing health care security to millions of Americans. So, we will likely see President-elect Biden use his executive authority to advance many of his healthcare priorities very early in his Administration.
The most immediate issue that the President-elect intends to focus on is the federal government’s response to COVID-19. President-elect Biden has already formed a coronavirus advisory board composed of medical professionals and scientists. He has announced that the United States will re-enter the World Health Organization as soon as he takes office.
President-elect Biden has also laid out a national plan to address the virus. In addition to ensuring that vaccines are safe and effective, he plans to invest $25 billion in a vaccine manufacturing and distribution plan to ensure that vaccines are distributed to all Americans at no cost. He is working closely with scientists to develop strategies to curb the increasing rates of infection and plans to increase testing, contract tracing and PPE production. President-elect Biden also plans to encourage all states to establish a mask mandate and to establish a renewable federal fund for state and local governments.
President-elect Biden may also use his authority to reopen the ACA’s insurance marketplaces to the uninsured, restore funds for enrollment outreach and temporarily fund more subsidies. While he will need Congressional approval for some of his more progressive proposals (like a public option and lowering Medicare eligibility from 65 to 60), he has the ability to get rid of Medicaid waivers and explore policies to encourage governors to expand Medicaid in states that haven’t yet done so.
President-elect Biden has said that his goal is to make sure that no American buying insurance on the individual marketplace pays more than 8.5 percent of their annual income on healthcare. He wants to do this by increasing subsidies for the ACA exchanges and increasing cost-sharing for deductibles and copays. He also plans to remove the prohibition on receiving exchange subsidies if you are offered affordable health coverage by your employer. While this would be a big help to patients, it does have the potential to destabilize employer-provided health insurance, since so many would likely switch from their employer plans to the exchanges. Opponents have argued that unless the employer mandate is changed, this would increase federal government spending and may result in businesses having to pay higher taxes. Although unlikely, opponents have also argued that it has the potential to lead employers to stop offering coverage altogether.
The repeal of the ACA could also have the potential to be a major issue for the new administration if that were to happen. Supporters of the ACA are hopeful, given this week’s Supreme Court oral arguments, that they will sever the mandate provision but, most importantly, leave this critical law in place. The Supreme Court is not likely to issue its decision until June. Repealing the ACA would have significant implications including the potential elimination of health insurance for up to 20 million people if Medicaid recipients are included, as well as the elimination of annual/lifetime dollar limits on essential health benefits, the end of dependent coverage up to age 23, and the elimination of protections for pre-existing conditions.
Last, but certainly not least, President-elect Biden also plans to dramatically shift the White House’s focus to address racial justice and health equity, protect immigrant families, safeguard reproductive freedom, and work with Congress to address surprise billing issues and the rising cost of prescription drugs. Healthcare and health policy will see a major shift under the new Administration and is likely to be front and center for the next four years.
Michael Kempner is founder and CEO of MWWPR.