- Open Enrollment Extension
On January 28, Biden signed an Executive Order to reopen the healthcare marketplace for an extended three-month period of February 15-May 15, 2021. This extension of open enrollment gives Americans more options to replace insurance coverage lost due to COVID-19, including Marketplace premium tax credits for coverage.
- More Medicare Coverage
In addition to extending Americans more time to enroll, the Biden Administration is also advocating to lower the age of Medicare eligibility from 65 to 60 years of age. Individuals age 60-64 could buy into the program on a voluntary basis and obtain coverage. Americans who retire before the age of 65 or otherwise leave their employer plans are also open to purchase the public option through ACA.
- Removal of Medicaid Work Requirements
Another feature in Biden’s plan is reversing Medicaid work requirements from the Trump Administration, which critics argued were burdensome for Americans with jobs and oftentimes led to coverage losses. Those opposed to the requirements also felt like they are in odds to the central goal of Medicaid, which is to provide over 77 million Americans with medical assistance.
- Public Option for the Coverage Gap
In the twelve states that haven’t yet offered expansion of Medicaid coverage, which impacts more than two million uninsured adults, Biden’s plan includes a premium-free public option. This will greatly benefit the uninsured population whose income is above Medicaid eligibility but below the lower limit for Marketplace premium tax credits. This population, known as the “Coverage Gap,” includes residents of Wyoming, Texas, South Dakota, Wisconsin, Mississippi, Tennessee, Alabama, Georgia, North Carolina, South Carolina, Kansas and Florida.
- Home and Community Based Service (HCBS) Expansion
In Biden’s efforts to provide healthcare to more Americans, he plans to also expand access to home and community-based services. This will be done by eliminating current waitlists and providing states with an option to convert current HCBS waivers into a new state option plan with an enhanced federal match. Under the plan, Medicaid beneficiaries receive treatment in their own home or community rather than an institution or isolated setting. Recipients of these programs are targeted population groups, including people with intellectual or developmental disabilities (IDD), physical disabilities and/or mental illness.
- COVID-19 Pandemic Plan
There is no doubt the ongoing pandemic takes center stage with the new administration. Among the list of COVID-19 response initiatives, Biden is focused on a series of actions meant to speed up response to the virus and weaken the spread. This is outlined in Biden’s $400 billion request to Congress, which includes:
- $20B for national vaccine program that would partner with states, localities and tribal nations to fast-track vaccine rollout
- $50B to expand testing, including added support for labs and purchasing rapid antigen test
- Funding 100,000 public health workers to aid in contract tracing
- Expanding paid leave programs to allow more workers to stay home if sick
Additionally, the Administration is establishing a COVID-19 Pandemic Testing Board and a Public Health Workforce Program (U.S. Public Health Job Corps) in conjunction with the establishment of the COVID-19 Health Equity Task Force.
In summary, Biden has been tasked with establishing a healthcare system that is more patient-friendly, value-based and accessible to all Americans regardless of factors such as age or socioeconomic background. The COVID-19 pandemic has accelerated some of these trends, and time will tell how the new administration responds.