The Biden Administration expands health coverage amid the Coronavirus pandemic.
President Joe Biden’s latest executive orders on Thursday reopen Obama’s health insurance marketplaces, and restore coverage mandates that had been undermined by Donald Trump, including care for those with pre-existing medical conditions.
The orders also lift Trump’s restrictions on Medicaid, especially on work requirements imposed by some states on the poor trying to obtain coverage.
In a separate action, Biden overturned Trump’s restrictions on the use of taxpayer dollars for clinics that provide family planning service, including counselling of patients on abortion, in the US and abroad.
Trump had issued his orders weakening Obamacare after he failed to overturn the Affordable Care Act in Congress, notably because of the vote of cancer-stricken GOP Sen. John McCain. The commands pushed people to buy short-term plans with no coverage of pre-existing medical conditions.
Biden summarized his actions: “The best way to describe them: to undo the damage Trump has done. There’s nothing new that we’re doing here, other than restoring the Affordable Care Act and restoring the Medicaid to the way it was.”
As he spoke, the US Coronavirus death rose to 433,067, an increase of 3,872 in 24 hours. Confirmed cases are 25,762,726, a rise of 164,664.
“More Pathways to Obtain Coverage”
Biden’s order opens a special enrollment period, on February 15 through May 15, for coverage. It will be accompanied by paid advertising, direct outreach to consumers, and partnerships with community organizations and advocacy groups.
Normally, residents of the 36 states relying on the federal market can only buy insurance during a six-week period in the fall. It was barely advertised by the Trump Administration last year.
In contrast, most of the 14 states with their own Affordable Care Act marketplaces opened enrollment during the early months of the Coronavirus pandemic and promoted the option.
The insurance industry supported Thursday’s orders. Matt Eyles, the president and chief executive of America’s Health Insurance Plans, said Biden had created “more pathways for Americans to obtain coverage that is so essential to their health, well-being and peace of mind”.
About 15 million Americans are uninsured and are eligible for marketplace coverage, according to the Kaiser Family Foundation, with about four million eligible for plans with no cost in premiums. The Foundation adds that up to 3 million people have lost employer-based coverage during the pandemic.
Action on Family Planning and Abortion
Biden’s actions on family planning and abortion counselling revising the global “gag rule” imposed by Ronald Reagan in 1981, and subsequently reversed and reinstated by successive Democratic and Republican administrations.
Dr. Natalia Kanem, the executive director of the United Nations Population Fund, said Biden’s order will be of great assistance for family planning and other health services for women and girls in poor countries.
“We now have the support of a very important member state,” Kanem said.
Biden directed the Department of Health and Human Services to, “as soon as practicable, consider whether to suspend, revise, or rescind” the domestic version of the “gag rule” — Trump Administration regulations that prohibit federally funded family-planning clinics from provision of abortion counselling.
The Guttmacher Institute assessed last year that the rules cut the “national family planning network’s patient capacity in half, jeopardizing care for 1.6 million female patients nationwide”.
Supporting Medicaid
Another Biden order directed federal agencies to review policies, including waivers granted to states, that discourage participation in Medicaid by poor and disabled people.
The Trump Administration approved waivers in 12 states requiring certain Medicaid beneficiaries to work a minimum number of hours a week or risk losing their benefits. Four of those pilot programs have been overturned by courts.
Another Trump waiver, completed this month in Tennessee, gave the state a block grant to cover its Medicaid population while loosening many rules about operation of the program.
Last week, 116 medical and patient advocacy organizations wrote to Health Secretary-designate Xavier Becerra, asking him to “immediately take action” to withdraw waivers allowing work requirements in Medicaid and to reject pending proposals for the requirements from seven more states.
