{"id":18935,"date":"2020-11-17T09:35:19","date_gmt":"2020-11-17T14:35:19","guid":{"rendered":"http:\/\/thepapergown.zocdoc.com\/?p=18935"},"modified":"2023-03-22T15:07:16","modified_gmt":"2023-03-22T20:07:16","slug":"how-will-healthcare-change-under-biden","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/guides\/how-will-healthcare-change-under-biden\/","title":{"rendered":"How Will Healthcare Change Under Biden?"},"content":{"rendered":"

The information included in this article was current as of publication, however, information changes rapidly regarding Covid-19 and may be out of date.<\/i><\/span><\/p>\n

\n

On the presidential campaign trail, Joe Biden promised to protect and build on the Affordable Care Act, a significant accomplishment of the Obama-Biden administration. During his presidency, Donald Trump subsequently weakened the ACA through executive orders that changed how individuals obtain coverage and care, as well as through support for legal challenges that sought to strike down the law. Despite these efforts, the ACA currently remains intact.<\/span><\/p>\n

Once Biden takes office as president in January, he\u2019ll likely move to reverse many of the actions Trump took to undermine the ACA. <\/span>How much change Biden can effect is contingent on the outcomes of two ongoing contests: 1) the runoff elections in Georgia for two US Senate seats, and 2) <\/span>California v. Texas<\/span><\/i>, the latest challenge to the ACA in the Supreme Court.<\/span><\/p>\n

Georgia\u2019s runoff election, scheduled for January 5, 2021, has implications for the balance of power in the US Senate. Democratic victories would create a 50-50 split between Democrats and Republicans, with Vice President-elect Kamala Harris as the tiebreaker. The Supreme Court case could uphold or diminish the ACA\u2019s legality; the court\u2019s decision is expected in spring 2021.<\/span><\/p>\n

Given these uncertainties, Biden’s more ambitious proposals, such as creating a public option for health insurance and lowering the Medicare eligibility age to 60, probably won’t become realities. Still, he will be able to reverse Trump\u2019s executive orders.<\/span><\/p>\n

\u201cThere were hundreds of Trump executive orders,\u201d says Mark Pauly, a professor of healthcare management at the Wharton School of the University of Pennsylvania. \u201cThe most important are those that permitted alternatives to Obamacare insurance, like short-term plans going three years, and the orders or rules applying to Medicaid programs that were more permissive in terms of states being allowed to restrict access. Biden could reverse these on Day 1. They have to be sent for review, but proposals to revoke these things could be put in place immediately.\u201d<\/span><\/p>\n

Given Biden\u2019s executive order powers, here are the most likely healthcare changes we\u2019ll see during his first term:<\/span><\/p>\n

Bye-bye \u201cskinny\u201d healthcare plans<\/span><\/h2>\n

Trump\u2019s Health and Human Services, Labor and Treasury departments announced in summer 2018 that Americans could enroll in short-term, limited-duration insurance plans, also known as nonqualified short-term or \u201cskinny\u201d plans. These plans aren\u2019t subject to the ACA\u2019s <\/span>essential health benefits requirement<\/span><\/a>, meaning they don\u2019t need to insure people with preexisting conditions or include coverage for services such as prescription drugs, mental healthcare and substance abuse treatment. These \u201cjust-in-case\u201d plans were intended for transitional periods of up to three months, but the Trump administration extended that period to three years.<\/span><\/p>\n

The impact:<\/b> Reversing Trump\u2019s expansion of skinny plans will force some people to purchase costlier health insurance plans, but it will also close the loophole allowing for cheaper insurance plans with minimal coverage. \u201cExtending short-term plans is contrary to the idea of having comprehensive insurance,\u201d says Gerald Kominski, a professor of health policy and management at the UCLA Center for Health Policy Research. \u201cIt was a way to whittle away at the edges, giving people the option to buy cheap plans if they\u2019re healthy \u2014 gambling they\u2019ll remain healthy for a couple of years and save a helluva lot of money. But since the ACA is still in effect, they can always give up the skinny policy and go back into the marketplace, and be guaranteed not to be charged more for their preexisting condition.\u201d<\/span><\/p>\n

Renewed ACA enrollment efforts<\/span><\/h2>\n

While in office, Trump cut funding to the ACA, specifically slashing budgets for promotion and assistance to consumers selecting plans. Trump officials also cut the open enrollment period on the federal exchange from 12 weeks to six weeks, and ignored requests from insurers and governors to open a special enrollment period to allow the uninsured to select policies during COVID.<\/span><\/p>\n

The impact:<\/b> Reversing Trump\u2019s measures to curtail enrollment in health insurance plans through the federal marketplace will result in more uninsured people getting coverage. \u201cBiden can increase the administrative budget for advertising and expand the enrollment period for ACA with executive orders,\u201d says Robert J. Blendon, a professor of health policy and political analysis at Harvard University. \u201cHe can encourage and make it easier for individuals to sign up and enroll.\u201d<\/span><\/p>\n

Rollback of work requirements for Medicaid<\/span><\/h2>\n

Medicaid<\/span><\/a>, a program jointly funded by the federal and state governments and overseen by states, provides health insurance to low-income and disabled individuals, as well as select health services to the elderly. In early 2018, the Centers for Medicare and Medicaid Services announced that states could require Medicaid recipients to either work or enroll in school or job-training programs for a certain number of hours each week to keep or apply for Medicaid coverage. In Arkansas, the only state to impose these work requirements, more than 18,000 people lost insurance coverage in 2018, according to the Arkansas Department of Human Services.<\/span><\/p>\n

The impact:<\/b> As Biden has promised to expand Medicaid, expect requirements and restrictions to roll back as the federal government offers states financial incentives to provide more people with coverage. \u201cBiden will try to get states to expand Medicaid,\u201d Pauly says. \u201cStates will take the government\u2019s money and expand Medicaid to all low-income people.\u201d<\/span><\/p>\n

Planned Parenthood funding<\/span><\/h2>\n

In 2017, Trump signed a bill allowing states to withhold federal money from organizations that provide abortion services, including Planned Parenthood. And in 2019, the Trump administration implemented the \u201c<\/span>Protect Life\u201d rule<\/span><\/a> affecting health clinics receiving Title X federal funding. The rule restricts clinics from providing or even counseling patients about abortion services. The affected clinics typically serve about <\/span>4 million low-income people each year<\/span><\/a>. Last summer, Planned Parenthood decided to withdraw from Title X rather than abide by the new requirements; about 900 clinics had <\/span>dropped out of the program<\/span><\/a> by the start of 2020<\/span>.<\/span><\/p>\n

The impact:<\/b> The Biden administration is likely to reinstitute an Obama-era directive that states cannot bar Medicaid funds from going to qualified providers that separately provide abortions, such as Planned Parenthood. (Medicaid funding does not cover abortions, except in cases of rape or incest, or when the mother’s life is at risk.) Biden will likely also revoke the Trump administration rule barring federally funded health care providers in the Title X family planning program from referring patients for abortions. \u201cPlanned Parenthood provides prenatal and family planning services to millions of women all over the country,\u201d Kominski says. \u201cThese were significant cuts. The funding will be restored pretty quickly under Biden.\u201d<\/span><\/p>\n

Restoration of individual mandate<\/span><\/h2>\n

In 2018, Congress voted to get rid of the individual mandate, which imposed a financial penalty on anyone who sidestepped the ACA requirement to obtain basic health insurance. The individual mandate was designed as a cost-control measure: It incentivized healthy people to buy into the insurance marketplace, thus lowering everyone\u2019s premiums. A $0 penalty for not having health insurance went into effect in 2019. The penalty being reduced to nothing, combined with slashed HealthCare.gov sign-up advertising budgets, resulted in fewer insured Americans. The number of uninsured Americans increased by 2.3 million from 2016 to 2019, to 29.2 million (that\u2019s 10.8 percent of the population), including 726,000 children, according to the <\/span>US Census Bureau<\/span><\/a>.<\/span><\/p>\n

The impact:<\/b> Biden doesn\u2019t need to reimpose the individual mandate, as it never went away. \u201cCongress didn\u2019t repeal the individual mandate,\u201d Kominski says. \u201cThey zeroed it out. That it\u2019s zero today does not mean it\u2019s eliminated \u2014 it\u2019s been modified. It\u2019s like changing the tax code. Another Congress could increase it, reinstituting it through budget conciliation.\u201d While a Republican-led Senate may be unlikely to raise the individual mandate to a significant amount, a 50-50 Senate would make it more realistic.\u00a0\u00a0<\/span><\/p>\n

Aggressive measures to combat COVID<\/span><\/h2>\n

Biden\u2019s administration is tasked with addressing a global health emergency. Facing a nationwide surge in COVID infections and deaths, Biden will issue orders to contain the spread of the virus and improve the country\u2019s chances of limiting its casualties. These orders will likely include a national mask mandate, efforts to secure and bolster the country\u2019s personal protective equipment supply, rejoining the World Health Organization and coordinating plans for testing and vaccine distribution.\u00a0<\/span><\/p>\n

The impact:<\/b> Trump repeatedly disagreed with his health officials on COVID and deferred to governors\u2019 responses to the virus. Biden has pledged to \u201clisten to science\u201d in his approach to fighting COVID and to establish a pandemic testing board to coordinate a nationwide response.<\/span><\/p>\n

\n

Ready to book a doctor’s appointment? Visit Zocdoc.<\/span><\/a><\/span><\/h1>\n","protected":false},"excerpt":{"rendered":"

Experts share their best predictions, from more aggressive anti-COVID policies to a restored individual mandate. <\/p>\n","protected":false},"author":20,"featured_media":18937,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[227],"tags":[112,149,33],"class_list":["post-18935","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guides","tag-aca","tag-covid19","tag-healthcare","reviewer-dr-nassim-assefi"],"yoast_head":"\nHow Will Healthcare Change Under Biden? - Guides<\/title>\n<meta name=\"description\" content=\"Experts share their best predictions, from more aggressive anti-COVID policies to a restored individual mandate.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.zocdoc.com\/blog\/guides\/how-will-healthcare-change-under-biden\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"How Will Healthcare Change Under Biden? 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