During their campaign, President Joe Biden and Vice President Kamala Harris spoke about the healthcare industry's promising future. Coming into the presidency during a pandemic meant they would need to act promptly and prioritize certain issues. Their main plans included addressing the pandemic, reimagining public healthcare, and restoring and strengthening the Affordable Care Act, among other things. The COVID-19 crisis also pushed the current administration to tackle insurance issues involving coverage quality, cost, and accessibility. While many of these plans require approval from Congress, the healthcare industry can anticipate several changes in the coming years. Here’s how the new presidential administration will tackle healthcare and how it will affect the American people.
1. More Public Coverage
In the early months of 2020, The Commonwealth Fund estimated that up to 14 million people could lose their employer-sponsored health insurance due to the insurmountable job losses caused by the COVID-19 pandemic. This potential crisis is why the Biden administration has discussed the possibility of a public insurance policy and employing several moves to help support the Affordable Care Act’s insurance exchanges. However, this proposal would need approval from Congress, and it’s unclear whether or not there would be enough support.
2. Changes to Medicare
The Biden-Harris administration has stated a common goal of making changes to Medicare to create equal opportunity for Americans in need. They plan to accomplish this feat by lowering the Medicare qualification age for seniors from 65 to 60 to expand the number of Medicare and Medicaid beneficiaries. It is still unknown if this would have any adverse effects on the current rates. Of course, the change would need Congressional approval, and while many are for it, others are hoping to rework pharmaceutical costs to reign in government healthcare spending.
3. Drug Pricing and Bill Transparency
The U.S. Department of Health and Human Services finalized the plan to lower drug costs in November 2020. This plan includes targeting rebates and promoting direct discounts for patients. While the former administration could not fulfill this plan, the Biden-Harris team will likely move forward and impose mandates while continuing the work to lower pharmaceutical costs.
The former Trump administration also encouraged bill transparency in the healthcare industry by signing an executive order that increased price transparency and competition in individual and group markets. The newly appointed administration has continued with this progress and hopes to finally end “surprise billing” by not allowing providers to charge patients out-of-network rates.
4. Affordable Care Act
Since the passing of the Affordable Care Act in 2010, President Biden has consistently stated his unwavering support for the law. He also spoke on his plans of protecting it during his campaign for the presidency. The president plans to expand the ACA and, in turn, increase access to proper medical care for the public. This expansion would include more competitive rates and revised subsidies, options for the uninsured that could cover 4 million Americans, zero surprise billing for all, and federally-funded mental health support. Once again, this developing plan needs Congress to agree on several terms, including funding, so this plan is likely to change over time.
5. Value-Based Care
Over the past four years, there has been much discussion about transitioning the healthcare industry to value-based care that would require providers to take on the majority of financial risk—and, for the most part, this plan has received bipartisan support. The current presidency is continuing this work and lowering racial disparities by closing sociological gaps and supplying more funds to community health centers. Healthcare professionals also hope to see more accountability and appeals systems to provide people with opportunities to object or appeal coverage decisions.
Want more information like this? See what else to expect from the healthcare industry in 2021.