With the COVID relief plan poised for final passage, the first significant enhancement of the Affordable Care Act is about to become law, more than a decade after it was enacted.
Here’s how the COVID relief plan will increase ACA premium help from the federal government, making coverage more affordable for millions of people.
However, remember that any day now the Supreme Court will rule on the constitutionality of the ACA, likely sealing its fate positively or negatively for years to come.
Under the COVID relief plan, the 12 holdout states will be getting a big financial incentive to expand Medicaid under the ACA. I tend to doubt many will in the near future, but they’ll be leaving a lot of federal money on the table.
Today is the beginning of the new pandemic special enrollment period for Obamacare. Or, is it Bidencare now?
8.9 million uninsured people are eligible for ACA health coverage with a free or reduced premium in the special enrollment period created by President Biden that begins today.
This will be the first ACA enrollment period since 2016 with a significant outreach campaign. (And, the campaign in that 2016 open enrollment was curtailed at the very end in January by the incoming Trump administration.)
As the Biden Administration takes office, expect a bunch of executive actions. Many will be about undoing what Trump did. Some can take effect immediately, while others will take time to go through the regulatory process.
Here's what might happen in health care. (thread)
COVID will be the Biden Administration’s top health care priority. Expect them to:
Put scientists and public health experts front and center.
Send a clear message on masks.
Provide a bigger federal role in vaccination.
Reenter the World Health Organization.
Possible Biden Administration actions on the ACA and Medicaid:
Reopen ACA enrollment and restore massive cuts to outreach and navigators.
Restrict enrollment in short-term plans not required to cover preexisting conditions.
Prohibit Medicaid work requirements and “block grants.”
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.
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.