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On Health Care, Biden May Focus on Reversing Trump’s Changes

Michael Rainey
·3 min read

President-elect Joe Biden has major plans to enhance health care in the U.S., but his options may be limited if, as expected, Republicans maintain their hold on the Senate in the next Congress.

Given the likelihood of what amounts to a GOP veto over major changes in policy, the Biden administration is expected to focus more on undoing much of what Donald Trump has done over the last four years, says Paige Winfield Cunningham of The Washington Post, while leaving more substantial changes such as the creation of a public option for health insurance to a future date, if and when Democrats gain control of both houses of Congress.

Larry Levitt of the Kaiser Family Foundation said Monday that Biden “can and probably will reverse much of what President Trump has done in health care administratively.” In addition to changing the federal approach to the coronavirus pandemic so that it includes “facts, science, and empathy,” Levitt said that Biden could make meaningful changes to health care policy without Congressional approval in multiple areas, including:

  • restoring funds for Obamacare outreach

  • requiring short-term health care plans to cover pre-existing conditions

  • rolling back work requirements in Medicaid

  • eliminating restrictions on the use of health care for immigrants

  • reversing Trump rules on abortion and birth control.

“Beyond using administrative authority to undo much of what President Trump has done,” Levitt added, “I’d look for President-Elect Biden to use executive powers creatively to expand coverage, increase consumer protections, and make health care more affordable.”

Backing up the ACA: Winfield Cunningham says Biden is expected to rely on many former Obama administration officials to staff the Department of Health and Human Services and to provide advice to

the White House. This will mark a significant change in the administration of the Affordable Care Act, which was targeted for elimination during the Trump years – a multi-pronged Republican effort that will reach the Supreme Court Tuesday, when the justices will hear arguments about the constitutional validity of the ACA in a suit backed by the White House.

The high court isn’t expected to render a verdict in the case until next spring, but the Biden administration could take steps to defend the ACA before then. “There are a couple of things Congress could do to make it so there's actually nothing to litigate — so the Supreme Court wouldn't have to decide this case, it would just go away,” Sabrina Corlette of the Center on Health Insurance Reforms at Georgetown University, told NPR. “I don't think the litigation is a win for Republicans politically, and so they may just be perfectly happy to work out a deal,” she added.

If Biden is unable to make a deal and the Supreme Court decides against the ACA, lawmakers would have to scramble next year to address the expected fallout, which could include the loss of health insurance for roughly 20 million people and the elimination of protections for patients with pre-existing conditions.

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