Biden reopens ACA markets
Executive order aimed at helping uninsured as virus rages
WASHINGTON — President Joe Biden on Thursday ordered government health insurance markets to reopen for a special sign-up window, offering uninsured Americans a haven as the spread of COVID-19 remains dangerously high and vaccines aren’t yet widely available.
Mr. Biden signed an executive order directing the HealthCare.gov insurance markets to take new applications for subsidized benefits, something Donald Trump’s administration had refused to do. He also instructed his administration to consider reversing other Trump health care policies, including curbs on abortion counseling and the imposition of work requirements for low-income people getting Medicaid.
“There’s nothing new that we’re doing here, other than restoring the Affordable Care Act and restoring Medicaid to the way it was before Trump became president,” Mr. Biden said as he signed the directives in the Oval Office. He declared that he was reversing “my predecessor’s attack on women’s health.”
The actions were only the first steps by Mr. Biden, who has promised to build out former President Barack Obama’s signature health care law to achieve a goal of coverage for all. While Mr. Biden rejects the idea of a government-run system that Sen. Bernie Sanders has pushed for in his “Medicare for All” proposal, his more centrist approach will require congressional buy-in. But opposition to “Obamacare” runs deep among Republicans.
The most concrete short-term impact of Mr. Biden’s orders will come from reopening HealthCare.gov insurance markets as coverage has shrunk in the economic turmoil of the pandemic. That’s an executive action, so no legislation is required.
The new “special enrollment period” will begin Feb. 15 and run through May 15, the White House said. It will be coupled with a promotional campaign and a call for states that run their own insurance markets to match the federal signup opportunity.
The Biden administration has
ample resources for marketing, said Karen Pollitz, a health insurance expert with the nonpartisan Kaiser Family Foundation. The foundation estimates that the Trump administration left unspent about $1.2 billion in user fees collected from insurers to help pay for running the marketplaces.
“The reason it wasn’t spent is the Trump administration spent its time in office cutting services that support consumer enrollment,” Ms. Pollitz said. “All the while the user fee revenue was coming in, [but] they were not allowed to spend it on anything other than marketplace operations.”
Created under the Obamaera Affordable Care Act, the marketplaces offer taxpayersubsidized coverage regardless of a person’s medical history or pre-existing conditions, including COVID-19.
Mr. Biden also ordered the immediate reversal of a federal policy that bars taxpayer funding for international health care nonprofits that promote or provide abortions. Known as the Mexico City Policy, it can be switched on or off depending on which party controls the White House. Abortion rights supporters call it the “global gag rule.”
The new president’s signing of a growing stack of executive orders is bringing increasing criticism from Republicans and also from some of his allies. Mr. Biden’s team says he’s looking to Congress for major legislation but feels that certain actions are crucial in the meantime.
Some directives he issued Thursday could take months to carry out.
He instructed the Department of Health and Human Services to consider rescinding Mr. Trump regulations that bar federally funded family planning clinics from referring women for abortions.
HHS will also re-examine a Trump administration policy that allows states to impose work requirements as a condition for low-income people to get Medicaid health insurance. Work requirements have been blocked by federal courts, which found that they led to thousands of people losing coverage and violated Medicaid’s legal charge to provide medical services. The Supreme Court has agreed to hear the issue.
And Mr. Biden directed HHS to review Trump policies that could undermine protections for people with health problems, such as a rule that facilitated the sale of short-term health insurance plans that don’t have to cover pre-existing medical conditions.
Such changes can’t happen overnight. Rescinding a federal regulation requires a new regulation, which has to follow an established legal process that involves considering different sides of an issue.
Mr. Trump resisted broad calls to reopen HealthCare.gov. Failure to repeal and replace the ACA was one of his most bitter failures.