ACA: Biden plans to reopen Obamacare registration

Open enrollment on federal exchanges, which the Trump administration cut in half to six weeks, ended on December 15. But Biden has the power to reopen enrollment, which will allow uninsured people to select policies during a special enrollment period.

Former President Donald Trump refused to do so last year, despite strong lobbying by elected officials from both parties and the healthcare industry. Eleven states that administer their own Obamacare grants, along with the District of Columbia, have allowed their uninsured residents to obtain coverage outside of the normal term.

Biden resorted to executive actions in his early days in office to begin to quickly put his agenda into practice and eliminate that of his predecessor.

On Tuesday, its actions focused on equality, including the creation of a police commission and the promotion of equitable housing policies. Wednesday is scheduled to focus on combating climate change, according to a calendar document seen by CNN.

This Thursday’s focus will be on health care. Biden must also sign measures to strengthen Medicaid, as well as rescind Mexico City’s policy on abortion and review Title X abortion referral restrictions.

Increasing the Affordable Care Act

The increase in the number of American policyholders through the strengthening of the Affordable Care Act was at the heart of Biden’s health campaign promises. However, its two main measures – creating a government-managed public option and increasing Obamacare’s federal award subsidies – will require Congress and face much opposition.

Reopening registrations is much easier, although it is unclear how much impact this will have.

Anyone who loses work-based health insurance coverage is already eligible to apply for scholarships within 60 days of becoming uninsured. The number of enrollments in the first five months of 2020 increased 46% compared to the same period last year, the Trump administration said in June.

In addition, more people seemed to maintain job-based coverage than expected, while those who lost their jobs and most of their income turned to Medicaid. Between February and August, Medicaid enrollments increased by more than 5.8 million people, or 9.1%, according to federal data released in late December.

During the most recent open enrollment period, Obamacare’s general enrollment for the 2021 coverage increased by comparing the 36 states that participated in the federal exchange this year and last year – the only time that has happened under Trump. But the number of new consumers in 2021 has decreased somewhat.

Making the changes work

The key to reopening applications will be to spread the word and help people apply, according to a recent discussion by the Kaiser Family Foundation with browsers that help those seeking cover in the grants. They also say that the period should last more than six weeks.

The Trump administration cut advertising by 90% and cut funding for enrollment assistance deeply – two measures that Biden must reverse. Untapped revenue from exchange user fees appears to have accumulated to more than $ 1 billion in fiscal years 2018 to 2020, according to Kaiser.

Just over half of consumers who sought coverage during the 2020 open enrollment period encountered difficulties, and nearly 5 million people sought personal help, but failed, according to an analysis by the Kaiser Family Foundation released Monday. .

Many changes are expected in the health area

Thursday’s measures are likely to be the first of many efforts to strengthen the Affordable Care Act and reverse the Trump administration’s health actions.
One of Biden’s top priorities is likely to be to save the law itself from being declared unconstitutional by the Supreme Court. Judges are currently considering a case brought by a coalition of Republican state attorney generals – and supported by the Trump administration. It revolves around Congress reducing the penalty to zero for not having health insurance for several years, which states argue that rendered the individual mandate unconstitutional and the entire law invalid.

The case will continue even if the Biden Department of Justice withdraws because it originated with Texas and other Republican-led states. But the president could work with the new Democratic majority in Congress to short-circuit the legal arguments of Republican states – setting the fine at $ 1, for example.

Biden is also likely to want to reverse several measures that the Trump administration has implemented to eliminate the Affordable Care Act. This includes extending the duration of short-term health plans to one year and, more recently, allowing Georgia to stop using the federal grant, health.gov, and switch to a private sector model. The Centers for Medicare and Medicaid Services have taken a step forward in recent weeks, establishing a path for all states to do this in 2023.

Biden’s health workers should also focus on Medicaid.

The Trump administration has made many historic changes to the health insurance program for low-income Americans, in line with the long wish list of Republicans. The authorities allowed states to introduce work requirements and just approved Tennessee’s request to transfer its federal Medicaid funding to a block grant type.
The Supreme Court recently agreed to consider approving labor requirements in Arkansas and New Hampshire, which were overturned by the lower courts.

These measures run counter to Biden’s promise to expand access to Medicaid, so his government is expected to seek to limit or undo these exemptions during his term, as well as possibly restoring criteria on the impact of exemptions on increasing coverage.

In addition, Congress limited states’ ability to reduce their Medicaid lists during the public health emergency. The Biden government may want to continue some of these provisions after they have ended.

CNN’s Betsy Klein contributed to this report.

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