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Biden changes health coverage, women’s health funding policies

Consumers will be able to enroll in plans in special enrollment period

A demonstrator makes a sign outside the U.S. Supreme Court as it hears oral arguments that challenge the Affordable Care Act in Washington on Nov. 10, 2020. President Joe Biden is announcing executive actions on health care coverage and women's health on Jan. 28.
A demonstrator makes a sign outside the U.S. Supreme Court as it hears oral arguments that challenge the Affordable Care Act in Washington on Nov. 10, 2020. President Joe Biden is announcing executive actions on health care coverage and women's health on Jan. 28. (Caroline Brehman/CQ Roll Call)

The Biden administration announced two wide-ranging health care executive actions on Thursday — one expanding access to reproductive health care and another supporting enrollment in the individual insurance market and Medicaid.

President Joe Biden signed the documents early Thursday afternoon, saying the action would “undo the damage Trump has done.”

“There is nothing new that we’re doing here other than restoring the Affordable Care Act and restoring Medicaid to the way it was before Trump became president,” said Biden, who spoke from the Oval Office and did not take questions. “The second order I’m signing relates to protecting women’s health at home and abroad.”

“We’ve got a lot to do and the first thing we’ve got to do is get this COVID package passed,” he added, calling on Congress to clear additional relief to respond to the pandemic.

The two executive actions instruct the Department of Health and Human Services to reconsider existing Trump administration policies.

The first order focuses on the 2010 health care law, and directs HHS to open a special enrollment period on for individuals to enroll in insurance coverage from Feb. 15, 2021 through May 15, 2021.

National open enrollment ended Dec. 15, 2020, but the White House says the new period is necessary because millions of unenrolled Americans are eligible for federal assistance. The White House has not yet provided projections on how many would benefit or what the marketing and outreach budget would be.

A nominee for Centers for Medicare and Medicaid Services administrator, who would be at the helm of much of this policy, has not been named yet.

HHS will be reviewing and reconsidering policies that are antithetical to the purpose of coverage under the health law and Medicaid. 

Those policies to be reviewed include any efforts to undermine protections for pre-existing health conditions or the individual market or that make receiving marketplace coverage harder or more expensive.

A Biden White House official on Thursday stressed the importance of protecting access to Medicaid, the federal-state program for the poor, and said CMS would be instructed to review any waivers that reduce coverage. This will likely include Medicaid waivers that some states have sought to add work requirements as a condition of Medicaid expansion coverage.

The Supreme Court is expected to hear oral arguments this year related to the Trump administration’s approval of work requirements in Arkansas and New Hampshire.

Reproductive health

Biden’s actions on reproductive health include ending funding restrictions to nongovernmental organizations that perform or promote abortions outside the United States, and starting the process to lift a Trump administration rule that prohibits funding to family planning providers who perform abortions or provide abortion referrals.

The first change, to what’s often called the Mexico City Policy, prohibits international aid to NGOs that support abortion abroad. It has been instituted during every Republican presidency since Ronald Reagan in 1984.

Former President Donald Trump revived the policy in 2017, and his Secretary of State Mike Pompeo announced an expansion in 2019 that would extend the restrictions to foreign organizations that fund those NGOs.

Under Trump, any NGOs that received federal funding could not provide abortions, abortion counseling or referrals, even with separate funding streams. The money allocated for women’s health was unchanged, but distributed differently among organizations.

Abortion-rights advocates have said shifting this funding away from these groups could have contributed to rising rates of HIV/AIDS.

The second major step would start the process of rolling back changes to Title X, the nation’s federally funded family planning program.

Under Trump, organizations that provide or refer for abortions were barred from winning federal funds, even if those funds are not used for abortion.

Planned Parenthood Federation of America President and CEO Alexis McGill Johnson said that Biden’s steps, while necessary, will not ensure that all family planning planning clinics that have had to close will be able to reopen.

“The honest answer is due to the number of variables in play, we’re not sure,” she told reporters prior to the announcement. “I can say for certain that the gag has caused incredible harm to patients across the country.”

Planned Parenthood officials and other advocates hope more administrative action on women’s health is in store.

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