Joe Biden plans to reopen the Affordable Care Act's insurance marketplaces later this week, so people who lost their insurance due to the coronavirus pandemic can get covered again, the Washington Post reports. In addition to an executive order reopening the exchanges, Biden will also start undoing some of the changes the previous administration authorized that made Medicaid harder for people to get, according to unnamed insiders. The federal exchanges are likely to reopen quickly and then stay open for several months.

Normally, signups for individual plans through the federal Obamacare exchange are only available during the fall open enrollment period. People can also apply to enroll at other times during the year if they lose their insurance after losing a job, but they have to have paperwork proving that's the case, and many people just plain don't know that's an option. So the Biden administration will also advertise that the exchanges are open, reversing yet another of the prior president's attacks on Obamacare.

Imagine that, taking steps to get healthcare to people during a pandemic!


As the Post notes, taking actions to quickly start dealing with the pandemic has been Biden's initial focus, so the executive order reopening ACA signups will be the first action he's taken on the larger campaign issue of making healthcare more broadly available. Why, it's almost as if he inherited a five-alarm fire.

In addition to the expected orders on Obamacare and Medicaid, Biden also said yesterday that he wants the government to increase the number of coronavirus vaccinations to 1.5 million a day, since vaccination rates are already getting close to the million-a-day dose goal he had originally set. If that higher goal can be met, the nation would be able to get closer to herd immunity, possibly by early summer.

HHS officials said off the record that the ACA reopening is likely to be formally announced at an event Thursday; sources "inside and outside the administration" said that the special enrollment period will be available to anyone who qualifies for coverage and "has been harmed by the coronavirus." Presumably, there'd be no need to document a job loss; back in the spring, the New York Times noted that special enrollment periods don't require the same paperwork applicants would normally need after losing coverage.

Also, this is pretty good, and another huge change from the last four years:

The reopening of HealthCare.gov will be accompanied by an infusion of federal support to draw attention to the opportunity through advertising and other outreach efforts. This, too, reverses the Trump administration's stance that supporting such outreach was wasteful. During its first two years, it slashed money for advertising and for community groups known as navigators that helped people enroll.

It is not clear whether restoring outreach will be part of Biden's order or will be done more quietly within federal health-care agencies.

While some states that run their own ACA exchanges reopened them for special enrollment periods back in the spring, the person who held the presidency before Biden chose not to, even as unemployment was going through the roof and people were losing their coverage. And no, the prior administration didn't even take any action to let the public know they could sign up for the ACA if they lost their job-based insurance. Why would they do that?

In addition to reopening Obamacare enrollment, Biden is also expected to order some kind of reversal of the burdens that the Trump administration allowed to be placed on Medicaid, which drove down the number of people using the program. What exactly that order will look like isn't 100 percent clear yet, the Post reports.

It is unclear whether Biden's order will undo a Trump-era rule allowing states to impose work requirements, or simply direct federal health officials to review rules to make sure they expand coverage to the program that insures about 70 million low-income people in the United States.

Those work-requirement rules are already on hold due to federal lawsuits; the Supreme Court is considering overturning those rulings by lower courts. On top of that, the Supremes may or may not decide to rule in the Trump administration's favor in that very dumb lawsuit to throw out Obamacare altogether .

The other Trump directive on Medicaid that's likely to get the axe is a proposal that would have allowed states to convert Medicaid to a limited block-grant program, a longtime rightwing wet dream that would cap the amount of Medicaid funding, no matter how many people might qualify. Currently, the federal and state governments share funding for all who qualify, so a block grant program would be a great way to cut benefits and make poor people suffer like God wants them to. That plan, you may recall, had the cheerfully Orwellian name "Healthy Adult Opportunity."

Several of Biden's other plans for fixing the damage done to Obamacare and Medicaid, and expanding the ACA so it actually covers millions of Americans who are currently uninsured, will need to be passed by Congress. Those include things like setting up a "public option," a federally run health plan that people could buy on the exchange, and expanding premium subsidies for lower-income people buying private ACA plans (that's part of the Biden stimulus plan). Also, in the dozen states that haven't expanded Medicaid, Biden wants to expand ACA eligibility and premium subsidies to people whose income is too high for regular Medicaid, but don't qualify for the ACA — a hole created back when the Supreme Court held that states could opt out of Medicaid expansion.

Why, yes, those do sound like things that could be passed if the Senate got rid of the filibuster!

[WaPo / WaPo]

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Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.

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