President Biden will sign executive order to reopen Affordable Care Act enrollment

WASHINGTON — President Joe Biden will reopen enrollment on the federal Affordable Care Act exchanges on Thursday as part of a series of executive actions related to health care, taking a step to help uninsured Americans that his predecessor rejected.

It’s Biden’s first move toward delivering on his campaign promise to bolster the landmark health reform law that he championed as vice president. And it comes as more Americans could be facing the loss of coverage because of the pandemic-fueled economic downturn.

Open enrollment on the federal exchanges, which the Trump administration cut in half to six weeks, ended on December 15. But Biden has the power to reopen sign-ups, which will allow the uninsured to select policies under a special enrollment period. Biden’s order calls on the Department of Health and Human Services to reopen enrollment to those who need coverage from February 15 until May 15.

Former President Donald Trump refused to do this last year, despite heavy lobbying from elected officials of both parties and the health care industry. Eleven states that run their own Obamacare exchanges, along with the District of Columbia, allowed their uninsured residents to obtain coverage outside the usual time frame.

Thursday’s executive orders will focus on health care. Biden will also sign measures aimed at strengthening Medicaid, as well as rescinding the Mexico City Policy on abortion and reviewing the Title X abortion referral restrictions.
Biden has turned to executive actions in his first days in office to swiftly start putting in place his agenda and to wipe out that of his predecessor.

His early orders have included mandating masks on federal property, reversing Trump’s ban on transgender Americans joining the military, providing additional nutrition assistance and accelerating the manufacturing and delivery of supplies for vaccination and testing.

LGBTQ activists are applauding President-elect Biden’s decision to tap Dr. Rachel Levine as assistant health secretary.

As part of Thursday’s executive measures, Biden will direct federal agencies to re-examine a multitude of actions taken by his predecessor. They include policies that weaken protections for people with pre-existing conditions and that undermine the Obamacare exchanges or other health insurance markets.

He also wants agencies to review measures that make it more difficult to enroll in Medicaid and the Affordable Care Act and that reduce affordability or financial assistance, including for dependents.

And the President is asking agencies to look at Affordable Care Act and Medicaid waivers and demonstration projects that the Trump administration approved or put in place that may reduce coverage or undermine the programs, including work requirements.

The agencies will also consider whether additional actions are needed to strengthen and protect access to health care.

Increasing the number of insured Americans by strengthening the Affordable Care Act was at the heart of Biden’s health care campaign promises. However, his two main measures — creating a government-run public option and increasing Obamacare’s federal premium subsidies — will require Congress and face plenty of opposition.

Reopening enrollment is a much easier lift, though it’s unclear how much impact it will have.

Anyone who loses job-based health insurance coverage is already eligible to sign up on the exchanges within 60 days of becoming uninsured. Enrollment in the first five months of 2020 jumped 46% compared to the same period the year before, the Trump administration said in June.

Also, more people have appeared to hold on to job-based coverage than expected, while those who have lost their employment and most of their income have turned to Medicaid. Between February and August, Medicaid enrollment jumped by more than 5.8 million people, or 9.1%, according to federal data released in late December.

During the most recent open enrollment period, overall Obamacare sign-ups for 2021 coverage increased when comparing the 36 states participating on the federal exchange both this year and last year — the only time that happened under Trump. But the number of new consumers for 2021 slid somewhat.

Nearly 9 million people could get free or subsidized bronze plans on the Affordable Care Act exchanges during a special enrollment period, according to a Kaiser Family Foundation analysis released Wednesday. Bronze plans typically have lower premiums, but higher deductibles and out-of-pocket costs.

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