The Trump Administration encouraged states to use ACA and Medicaid waivers to restrict coverage, including Medicaid work requirements.
The Biden Administration could instead encourage states to expand coverage and improve affordability and give them the flexibility to do so.
Even with the new Democratic majority in the Senate, a robust public option will be difficult to pass, and Medicare for all is not in the cards in the near term.
But, with waivers, one or more states could potentially show how it could work.
Democrats will now have an opportunity to pass significant health reforms through Congress.
But, with razor thin majorities in both the House and the Senate, executive actions the Biden administration can take on health care will be just as important.
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We've been debating surprise bills for so long, it's easy to lose track of how bonkers these bills are.
For example: You get taken to the nearest ER (because, it's an emergency). Your insurer covers it. But, the hospital or ER doctors send you extra bills, because...they can.
Another example of a surprise medical bill:
You do your research and pick an in-network hospital for your planned procedure. But, an out-of-network anesthesiologist shows up in the operating room and sends you a surprise extra bill over and above what your insurer pays.
A lot of President-Elect Biden's sweeping health care plans will be stymied if Republicans maintain control of the Senate, but he can and probably will reverse much of what President Trump has done in health care administratively.
Some Trump actions Biden can reverse:
Short-term plans not covering pre-existing conditions
ACA outreach cuts
Work requirements and funding caps in Medicaid
Gender identity discrimination
Family planning funding restrictions
Immigration limits for those using health benefits
Possibly the most important thing President-Elect Biden can do in health care at this moment in history is approach the pandemic with facts, science, and empathy. None of those things require an act of Congress.
President Trump and many other candidates opposing the ACA say they support protecting people with pre-existing conditions. Now seems like a good time to ask how they would do that if the ACA gets struck down, which is all of a sudden more likely.
Overturning the ACA is not only about pre-existing condition protections. It's also about the Medicaid expansion, closing the Medicare drug coverage donut hole, preventive services, Medicare payments to hospitals, taxes, and much more.
The number of Americans uninsured increased by 2.3 million from 2016 to 2019, after dropping by 20 million in the years following passage of the Affordable Care Act in 2010.
There was a big increase in the share of Hispanics uninsured in 2019 -- 18.7%, up from 17.9% in 2018. Hispanics are the group most likely to be uninsured, and are being hit particularly hard by COVID-19 right now.