WASHINGTON (AP) – President Joe Biden on Thursday ordered government health insurance markets to reopen for a special enrollment window, offering uninsured Americans a refuge while the spread of COVID-19 remains dangerously high and vaccines are not yet widely available.
Biden signed an executive order instructing the insurance markets HealthCare.gov to accept new claims for subsidized benefits, something that the Donald Trump administration refused to do. He also instructed his government to consider reversing other Trump health policies, including restrictions on abortion counseling and imposing job requirements for low-income people receiving Medicaid.
“There is nothing new we are doing here, except restoring the Affordable Care Act and restoring Medicaid to what it was before Trump became president,” said Biden as he signed the guidelines in the Oval Office. He declared that he was reversing “my predecessor’s attack on women’s health”.
The actions were just the first steps of Biden, who promised to build the health care law of former President Barack Obama to achieve a goal of coverage for all. Although Biden rejects the idea of a government-administered system that Senator Bernie Sanders defended in his “Medicare for all” proposal, its more centrist approach will require Congressional membership. But opposition to “Obamacare” is profound among Republicans.
The most concrete short-term impact of Biden’s orders will come from the reopening of the HealthCare.gov insurance markets, as coverage has shrunk in the economic turmoil of the coronavirus pandemic. This is an executive action and no legislation is required.
The new “special registration period” will begin on February 15 and runs through May 15, the White House said. It will be accompanied by a promotional campaign and a call for states that manage their own insurance markets to respond to the federal enrollment opportunity.
The Biden government has extensive marketing resources, said Karen Pollitz, a health insurance expert at the non-partisan Kaiser Family Foundation. The foundation estimates that the Trump administration has not spent about $ 1.2 billion in user fees collected from insurers to help pay for the functioning of markets.
“The reason it was not spent is that the Trump administration has spent its time cutting office services that support consumer registration,” said Pollitz. “All the while, user fee revenue was coming in, (but) they were not allowed to spend it on anything other than market operations.”
Created under the Obama-era Affordable Care Act, markets offer taxpayer-subsidized coverage, regardless of a person’s medical history or pre-existing conditions, including COVID-19.
Biden also ordered an immediate reversal of a federal policy that prohibits taxpayer funding for international nonprofit health organizations that promote or provide abortions. Known as Mexico City Policy, it can be turned on or off, depending on whether Democrats or Republicans control the White House. Proponents of abortion rights call this the “global gag rule”.
The new president’s signature on a growing pile of executive orders it is bringing growing criticism from Republicans and also from some of his allies, especially after Democrats criticized Trump when he acted on his own. Biden’s team says they are looking to Congress for important legislation but he feels that certain actions are crucial in the meantime.
Some guidelines he issued on Thursday may take months to comply.
He instructed the Department of Health and Human Services to consider rescinding Trump regulations that prohibit federally funded family planning clinics from referring women for abortions.
The HHS will also review a Trump administration policy that allows states to impose work requirements as a condition for low-income people to obtain Medicaid health insurance. Job requirements have been blocked by federal courts, which have found that they have led thousands of people to lose coverage and violated Medicaid’s legal bill to provide medical services. The Supreme Court agreed to hear the question.
And Biden instructed HHS to revise Trump’s policies that could undermine protection for people with health problems, as a rule that facilitated the sale of short-term health insurance plans that don’t have to cover pre-existing medical conditions.
These changes cannot happen overnight. The repeal of a federal regulation requires a new regulation, which must follow an established legal process that involves considering different sides of an issue.
Former Trump health policy advisor Brian Blase said the Biden government needs to be careful not to rule out some policies designed to solidly help the middle class that does not qualify for financial assistance under Obama’s law.
“Obamacare’s plans are generally attractive only to people who receive large subsidies to buy them,” said Blase. He cited a Trump policy that allows employers to provide tax-free money for workers to buy individual plans.
The abortion-related actions brought immediate praise to Biden from women’s rights groups, as well as the condemnation of religious and social conservatives. Under President Trump, opponents of abortion had a free rein to try to rewrite federal policy, but now the political pendulum has returned. Trump’s abortion counseling restrictions have prompted Planned Parenthood affiliates to leave the federal family planning program.
Biden campaigned to lift long-standing federal prohibitions against taxpayer funding for most abortions, but that was not part of Thursday’s orders. A change of this magnitude for a group of laws known as the Hyde Amendment would require Congressional approval.
Biden’s nominee for Secretary of Health, California Attorney General, Xavier Becerra, has not yet been confirmed by the Senate, but the White House said it would not prevent health agencies from working immediately on the president’s guidelines.
The idea of reopening Obamacare’s health insurance markets during the pandemic was widely supported by consumer, medical and business organizations. America’s leading insurance group, America’s Health Insurance Plans, applauded Biden’s initiative.
As the number of uninsured Americans grew due to the loss of jobs in the pandemic, the Trump administration resisted calls to reopen HealthCare.gov. The failure to revoke and replace Obamacare was one of the former president’s most bitter disappointments. His government continued to try to find ways to limit the program or to unravel it entirely. A Supreme Court decision on Trump’s final legal challenge to the Affordable Care Act is expected this year.
Experts agree that the number of people without insurance has increased because of layoffs in the coronavirus economy, but official estimates are awaiting government studies later this year. While some estimates cite 5-10 million people recently uninsured, the non-partisan Congressional Budget Office says its analysis suggests a smaller number.
However, the CBO projects that almost 32 million Americans are uninsured, and of those, about 2 out of 3 are eligible for some form of subsidized coverage.
The Obama-era health law covers more than 23 million people through a combination of subsidized private insurance sold in all states and expanded Medicaid, adopted by 38 states.