9 Ways Biden Will Cancel Trump’s ACA Changes


Nov 5, 2020 |

Health Issues – Joe Biden looks likely to secure enough electoral votes to serve as the 46th president of the United States.

What does a Biden victory mean for the Affordable Care Act (ACA)?

Significant steps can be taken to expand access to ACA coverage using executive authority—through immediate operational changes, new rules on a whole host of topics, and new positions in court.

ACA implementation is an ongoing (and, it turns out, iterative) process that can involve important tweaks and changes to the many hundreds of pages of regulations and thousands of pages of guidance.

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Doing so takes time and can involve multiple agencies and the White House, but there are few other barriers to making changes.

A Biden administration will have a significant amount of work waiting for it to simply reverse the last four years of the Trump administration’s efforts to undermine the ACA.

In fact, an entire lawsuit has been devoted to the President’s “death-by-a-thousand-cuts” campaign against the ACA. A Biden administration could reverse these changes so long as it adheres to the rules about rulemaking.

Targets for rollbacks are Trump-era policies are many. A non-exhaustive list includes:

  • extending the open enrollment period back to 90 days,
  • undoing many other changes in the “market stabilization” rule,
  • revising the premium adjustment percentage methodology,
  • rolling back prior guidance on Section 1332 waivers,
  • eliminating the “double billing” rule for abortion services,
  • revising rules on Section 1557 and provider conscience protections,
  • addressing broad exemptions to the contraceptive mandate,
  • curbing state options for selecting a new essential health benefits package, and
  • promoting access to nonprofit navigators …

More changes could be coming even before inauguration: the proposed payment rule for 2022 is currently under review by the Office of Management and Budget and could be issued soon … Read more.

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