Now that we have a new president-elect, what can we expect from Joe Biden and his team in terms of health care?

Candidate Joe Biden made it clear that his first priority as president would be addressing the health and economic crisis caused by the COVID-19 pandemic.

But as President, Biden will almost certainly turn his attention to an issue that has been a hallmark of the Barack Obama administration and played a major role in the 2020 election: health care.

Throughout the campaign, Biden said he would build on the infrastructure of the Affordable Care Act instead of starting from scratch with an entirely new health plan.

How much of that infrastructure will remain in January depends on a case now before the US Supreme Court known as California v. Texas, stands. The case raises the question of whether the ACA can pass now that the individual mandate penalty has been removed. Oral disputes in the case are expected to be heard in the US Supreme Court this month.

In October 2017, President Trump installed an executive order to crack down on Obamacare. However, these early efforts to improve Obamacare either failed to appear in court, were criticized for preferring the employer over the employee, or sought to circumvent existing ACA regulations to cover pre-existing conditions.

Mr Biden can certainly revoke these orders. And he could issue his own to restore ACA coverage.

Steps Mr Biden could take to lift Trump-era restrictions include:

  • Extension of the open registration period to 90 days;
  • Introduction of new special registration deadlines;
  • Eliminate the double billing rule for abortion services;
  • Handling of extensive exceptions to the contraceptive mandate; and
  • Curbing Government Options For Selecting A New Package With Substantial Health Benefits.

However, it must continue to work with the Senate and House of Representatives regardless of what type of legislation is being considered. And right now the Senate is waiting for the results of four Senate seats. The Republicans have a narrow two-seat head start. And the house is waiting for the results of about 25 seats. Right now the Democrats are 409 to 435 ahead.

Vox reports that the core of the Biden plan would be to provide health insurance through the existing Obamacare marketplaces to those who wish. This new insurance would also cover those denied coverage, approximately 4.4 million people living in states that would not expand their state Medicaid programs. The Kaiser Family Foundation lists 14 states that have refused to expand their programs.

The alleged 46th president has also proposed other health policy changes that he claims would improve access and reduce costs. This includes:

  • A public insurance option. Mr Biden has suggested offering public health insurance like Medicare. According to his campaign documents, this option would allow individuals to negotiate prices with vendors.
  • Medicaid extension. Biden has made expanding coverage for low-income people a priority, especially in the 14 states that didn’t offer residents enhanced Medicaid eligibility through the ACA.
  • Mr Biden has proposed offering eligible residents of these states premium-free access to the public option, which his campaign has estimated at around 4.9 million.
  • Extend Tax Credits. The president-elect has proposed additional and more generous tax credits that he believes would allow more families to take out more generous insurance plans.
  • “Surprise billing” restriction. Mr Biden suggests preventing healthcare providers from charging patients outside the network for fees when the patient has no control over the provider they see – as can happen when one person is hospitalized and cared for by multiple providers becomes.

According to gov.track.gov, Mr. Biden was the main sponsor of 42 bills that came into effect during his Senate years from 2003 to 2008. Again, 42 bills are a respectable number according to the website; Few bills, the website says, ever make it to a president’s desk. And in those years, the Democrats weren’t always in control. So he obviously had to cross the corridor from time to time and did so successfully.

That said, a Biden administration will have its hands full simply to reverse the Trump administration’s restrictions on the ACA. It remains to be seen whether Mr Biden will receive the legislative support he is likely to need to significantly expand and strengthen the Affordable Care Act.

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