In a week when the Biden administration broke new ground with the historic confirmation of Justice Ketanji Brown Jackson on the United States Supreme Court, the White House also experienced a setback when Barak Obama visited for the first time since 2017.
Obama’s visit marked 12 years since the former president’s health care achievement — the Affordable Care Act (ACA), informally known as Obamacare — was enacted.
At the joint appearance with his former boss, President Biden also signed an executive order directing federal agencies to identify opportunities and take steps to expand access to and availability of affordable health insurance.
The new regulation encourages agencies responsible for Americans’ access to care and coverage to make it easier for people to enroll and maintain coverage, to help people understand their options, to increase benefit generosity, to increase access to Improve healthcare providers and protect people from low-quality coverage and expand eligibility and reduce costs for public health insurance programs, including ACA, Medicare, and Medicaid. The order also calls on the authorities to reduce sickness debt, a growing problem for millions of Americans.
At the same time, the government proposed a new rule to make it easier for people to afford health insurance. In a quirk of the ACA known as “Family Mistake,” workers who are offered health insurance through their job but cannot afford it are eligible for subsidies if they purchase health insurance in the marketplace. But their family members, who would be covered by a family plan if employer-sponsored insurance was affordable, are not eligible for the same grants. The glitch leaves family members without good options; They cannot afford to buy into the employer plan and they cannot get help buying an Obamacare plan.
The Government estimates that 200,000 uninsured people could receive coverage as a result of this solution and that coverage would become more affordable for an additional million. It is unclear whether action from Congress will be required to make the proposed rule a reality.
These efforts to increase Americans’ access to health insurance come as millions of Americans may lose their insurance coverage when the federal public health emergency (PHE) — which was introduced at the beginning of the Covid-19 pandemic and has been extended several times since — ends.
For example, the first coronavirus relief package, passed in March 2020, provided federal funding to states that agreed to keep people enrolled in Medicaid during PHE. The PHE was last renewed in January 2022 and is currently expected to expire in mid-April if not renewed again. Once the PHE expires, states will lose this additional Medicaid funding and will likely seek ways to reduce their Medicaid enrollment.
Another pandemic-era policy that made health insurance more accessible was the American Rescue Plan, which expanded subsidy eligibility for Marketplace insurance plans. As a result of this legislation, the government says 9 million Americans’ premiums have been reduced by an average of $50 a month. Almost half of Marketplace insurance plan policyholders do not pay a monthly premium.
But several provisions that made coverage more affordable have expiration dates this year; some only applied in 2021.
With these threats to current coverage rates, the Biden administration hopes to prop up the ACA and prevent millions of Americans from becoming uninsured because of lower eligibility or affordability. Obama’s legacy and Biden’s future — not to mention the health and financial well-being of millions of Americans — could be at stake.