Eight days into his term in office, President Joe Biden took a small step to expand health coverage during the Covid-19 pandemic – one that Donald Trump turned down last year.
In an executive order that Biden signed Thursday, the president instructs the U.S. Department of Health to open a special enrollment period for HealthCare.gov so Americans can sign a new health insurance plan that is subsidized by the federal government. From February 15 to May 15, uninsured people can register on the federal website and select a health insurance plan. (HealthCare.gov serves most states, but not all; Biden officials said they expected states that operate their own insurance markets to open up too.)
“These actions show a strong commitment from the Biden-Harris administration to protect the Affordable Care Act and build on it to meet the health needs created by the pandemic, reduce health costs, protect access to reproductive health care and improve our health care improve system easier to navigate and fairer, ”the White House said in a statement announcing the order.
Health insurers and Democrats in Congress had asked Trump to allow a special enrollment period last spring as the pandemic worsened. But the previous government ultimately decided against it.
Biden’s order thus signals a postponement of the federal government’s willingness to apply the law on affordable care in an emergency. However, it is more an open question how many people will benefit from this new health insurance option.
Biden administrators did not have a specific projection. The normal registration period only ended in mid-December. Anyone who loses their job or has a child can enroll after one of these major life changes. It is fair to ask who Biden’s special enrollment deadline is for.
The new administration seems to have one goal in mind: Americans who are eligible for government assistance to buy coverage through the ACA but have never learned of their options. This could represent some of the millions of people who lost their health insurance during the Covid-19 pandemic. It could also include some of the 30 million or so people who were not insured before the current economic crisis.
The Biden administration is planning an ad blitz around the special enrollment deadline, although officials have not given their efforts a dollar. ACA reach and advertising had been dramatically reduced under President Trump, another way Biden’s actions represent a new direction for federal health policy.
In theory, many people can be reached. According to a survey by the Commonwealth Fund, around 40 percent of uninsured Americans were eligible for government assistance through the ACA in 2018. More than half of the uninsured cited one of three reasons for the lack of health insurance: they didn’t think they could afford it, they didn’t think they were eligible, or they didn’t know the marketplaces. A study by the Kaiser Family Foundation estimates that 4 million people are legally entitled to free coverage.
It remains to be seen if another two month sign-up window, even if backed by a new ad campaign, will come through to them. But it was also one of the few simple steps Biden could take to expand health insurance.
Otherwise, Biden still has a long way to go to reverse Trump’s health care policies or push his own new policies forward. Much of this will require going through the complicated rulemaking process, and new guidelines to expand reporting will likely depend on the action of Congress. It will take some time. Experts told me before Biden took office that the new government must be diligent in issuing new regulations as Republican judges are likely to be skeptical of Biden’s executive action.
The executive order, signed by Biden on Thursday, begins the process by officially ordering federal agencies to review Trump guidelines that could cause people to lose cover. Medicaid’s work demands are a specifically called for scrutiny policy that was determined to keep Trump’s lieutenants from falling out of power.
In as many ways as possible, Biden is trying to signal a hiatus from Trump.
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