NEWSROOM

Even before taking office on January 20, the Biden administration shared plans for a new direction in combatting the COVID-19 pandemic. The Biden-Harris transition team seven-point plan to combat the coronavirus includes:

1. Access to regular, reliable, and free testing
2. Increases in the supply of Personal Protective Equipment (PPE)
3. Evidence-based guidance of how communities can navigate the pandemic
4. Equitable distribution of treatments and vaccines
5. Increased protections for older and higher-risk individuals
6. New defenses for predicting, preventing, and mitigating pandemic threats
7. Mask mandates nationwide

 
On January 14, the soon-to-be president announced his plans to pursue a $1.9 trillion COVID-19 relief package with Congress. It includes funding investments in supplies for financially strapped medical facilities, increased vaccine production and testing, expedited vaccine distribution (and administration of 100 million vaccines by the 100^th day in office), and expanded domestic PPE manufacturing. Now comes the hard part, negotiating with Congress on approval. Already, several members of the U.S. Senate have said the proposal is dead on arrival in their chamber.
 
On January 28, the White House announced plans to take executive action to reopen the Affordable Care Act (ACA) federally facilitated marketplace (FFM), HealthCare.gov. The goal is to help Americans who have lost health coverage during the COVID-19 pandemic. Ordinarily, enrollment in the public health exchanges is limited to an annual six-week period (slightly longer in some states) that starts in the fourth quarter. President Biden is also advocating reducing barriers for individuals to join Medicaid.
 
Another action health experts anticipate is a change in ACA subsidy eligibility, which would allow more people to qualify for tax credits to reduce their premium cost. Funds for marketing the federal and state exchanges could return as well, after a 90% reduction in the past several years. Funding of ACA navigators who assist with enrollments may return, too.
 
Under former Centers for Medicare & Medicaid Services (CMS) administrator Seema Verma, several changes governing public health insurance exchanges were announced in late 2020 and early 2021. While the Biden team may embrace some of these CMS modifications – such as reduced user fees – it may roll back others. That includes state waivers and requests to transition from the FFM to a state access model, which relies more on private web brokers or purchasing coverage directly through insurers.
 
With support from Congress, the Individual Mandate penalty could return, although there is no forecast on what amount might be imposed. The mandate was eliminated as part of a GOP tax bill in 2017, which reduced the penalty for not having ACA-compliant health coverage to zero. That helped set up a court challenge to the ACA, which is now under review by the U.S. Supreme Court.
 
The arguments in California v.Texas (or Texas v. U.S. in the lower courts) challenge the mandate and question the validity of the entire ACA if the penalty for maintaining minimum essential coverage is zero. Previously, the individual mandate was upheld by the Court as constitutional under Congress’ taxing power. A U.S. Supreme Court ruling could come any day on the current challenge – or as late as June. Some health care advocates have noted that immediate action by the new Congress could make the legal challenge moot.
 
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