Insurance Industry Changes With Biden Administration

With the recent change in administrations, many in the insurance industry are wondering what the future will look like. On January 28^th we got a bit more insight, as President Biden signed an executive order with the goal “to protect and strengthen Medicaid and the ACA and to make high-quality healthcare accessible and affordable for every American”

Within the language of the order, the Department of Health and Human Services (HHS), the Secretary of the Treasury, the Secretary of labor and any other agencies involved with Medicaid and the ACA have been tasked with reviewing the previous administration’s policies. Biden has previously also signed an executive order opening a special enrollment period to individuals and families in states with marketplaces served by the Healthcare.gov platform.  

This three month long special enrollment period (SPE) will be bolstered with increased funding for outreach and marketing to those Americans who are uncovered during this extremely vulnerable time. Starting February 15^th, consumers may use Healthcare.gov to enroll in new plans, add dependents or select a more fitting plan. 36 states will be participating in the SPE, and the administration is encouraging remaining states to participate with their own markets, as well. California will be holding the SPE from February 1^st through May 15^th

The executive order regarding policy review is aimed at any policies which undermine protections for patients with pre-existing conditions, reduce coverage, reduce affordability of coverage, or establish barriers to coverage. According to Jocelyn Guyer, managing director at Manatt Health, likely focal points include the ten-year waivers approved by the HHS at the end of the previous administration. The atypically long time allotments to use funding for hospitals was granted to states such as Indiana, Texas and Florida. Another likely target is Healthy Adult Opportunity, issued by the Centers for Medicare and Medicaid Services during the Trump administration. The act creates flexibility for states to administer and design their Medicaid programs. Critics of the act say that it too closely resembles a block-grant, which is highly unpopular due to their tendency to limit federal funding and availability of Medicaid to those who need it most.

Going forward, President Biden has proposed to subsidize COBRA coverage through Sept 30, 2021. The move is aimed at increasing access to healthcare coverage as the country faces record high unemployment during a deadly pandemic. “Roughly two to three million people lost employer-sponsored health insurance between March and September, and even families who have maintained coverage may struggle to pay premiums and afford care” says the administration.

Another move aimed at increasing coverage for Americans is Biden’s request for Congress to expand and increase the value of the ACA’s premium tax credits. The overarching goal is for enrollees not to have to pay more than 8.5% of their income for coverage. For those who are earning less than 400% of the national poverty level, the administration is requesting increased tax credits. There will likely be rapid developments, as the current administration is prioritizing access to healthcare and is planning systemic overhauls to ensure continued access to medical care. 

Written by Sara Boren