As Joe Biden begins the transition that will see him inaugurated as the 46th President of the United States, the President-Elect wants the nation's health care system to become easier to navigate, and with more choice and reduced costs available to more Americans. Seeking to protect and strengthen the Affordable Care Act (ACA), Biden will attempt to pour an additional $750 billion into the program over the coming decade to ensure the best health insurance companies (opens in new tab) are also accessible to those with pre-existing medical conditions.
The President-Elect plans to expand eligibility for Medicare and Medicaid, and to make changes to the best Medicare Part D plans (opens in new tab) in favor of an integrated offer. Also high on the health agenda are changes to current legislation around drug prices and ‘surprise’ medical billing, plus a more proactive approach to tackling the ongoing COVID-19 pandemic. Let’s take a closer look at what the proposed changes may mean for your health insurance, at a time when some of you may be wondering will Joe Biden be good for your finances (opens in new tab).
The Affordable Care Act
Biden has proposed several add-ons to the Affordable Care Act (ACA), which under the Obama-Biden administration saw the number of Americans lacking health insurance fall by almost 40%, from 44 million to 27 million (opens in new tab). Planning to build on that progress, Biden seeks to work towards an ambitious target of insuring 97% of Americans by retaining private insurance but offering a public option.
Administered by the federal office, the public option would be available to Americans who are too young for Medicare and who currently either don’t have coverage, can’t afford coverage, or don’t like their employer-based coverage. The public option would see lower prices being negotiated with health care providers, with those savings being passed on to consumers in the form of lower premiums.
Alongside this would be an increase in the value of tax credits, aimed at lowering premiums and extending coverage to more Americans. The 400% income cap on tax credit eligibility would be scrapped, and the amount that any family spends on health insurance would be capped at 8.5% of their total income.
But Biden’s ability to even get started on moving these changes forward hinges on the ruling of the Supreme Court, which today started hearing arguments on the constitutionality of the ACA. If their spring ruling goes in favor of the ACA, Biden can begin building on the law, but with a likely Republican majority controlling the Senate, that won’t be easy.
Drug Prices and medical billing
In an attempt to lower the skyrocketing costs of prescription drugs, Biden will seek to repeal the current law that bans Medicare from being able to negotiate lower drug prices with pharmaceutical companies. New drugs launching in the market that have little competition will also be subject to restrictions, with an independent review board to be tasked with assessing their value and recommending a reasonable price.
Price increases of all medicines will be prohibited beyond the general inflation rate, and consumers will be allowed to import safety-certified prescription drugs from other countries to provide much-needed competition to the highly priced US pharmaceutical market.
Biden also plans to put an end to surprise billing where patients are being charged out-of-network rates in situations where they have no control, such as hospitalizations. That means those requiring surgery, for example, who choose an in-network hospital but are allocated an out-of-network surgeon, would no longer receive an unexpected bill at the end.
Medicare and Medicaid
Seeking to expand eligibility for both these programs, Biden will push to lower the Medicare enrollment age to 60 and incorporate dental insurance (opens in new tab), hearing coverage and vision insurance (opens in new tab). This would be a significant change for Medicare as it stands now with its current enrollment age of 65 and a requirement to purchase a supplementary policy for additional coverage.
Medicaid would also see changes, with Biden ensuring that eligible Americans living in the 14 states (opens in new tab) that did not adopt the ACA’s expansion of Medicaid eligibility to get coverage through premium-free access to the public option.
The coronavirus pandemic
President-Elect Joe Biden has said that he will “listen to the science” as he promises to tackle COVID-19 head-on. Pledging to double the number of drive-by testing stations, address the shortages of personal protective equipment, and ensure free coronavirus testing regardless of insurance status, he is also seeking to subsidize health insurance coverage for those who have lost their jobs during the pandemic and are relying on COBRA health insurance.
Scrapping plans to leave the World Health Organization (WHO), Biden will strengthen ties with the US Centers for Disease Control and Prevention (CDC) to continually monitor and adjust social distancing guidelines, and inject $25 billion into vaccine development and distribution.