They are saying that well being care wasn’t on the poll this election. Political scientists will write dissertations about what Individuals had been voting for (or towards) on the polls this yr, however by most accounts, well being care was not excessive on the checklist of priorities. And but, in the case of well being care entry, fairness, and affordability, there may be a lot to lose. In gentle of the election outcomes, it can require concerted and aggressive efforts amongst policymakers and advocates to protect positive aspects in insurance coverage protection, enhancements in well being fairness, and enhanced well being care affordability. At CHIR, our mission has all the time been, and can stay, to help these efforts by balanced, evidence-based analysis, evaluation, and strategic recommendation.
Well being Entry, Fairness, and Affordability: Ending on a Excessive Notice
The Biden administration will depart workplace with a report of unprecedented progress in well being protection and affordability. The numbers of people who find themselves uninsured is at an all-time low. Protection by the Reasonably priced Care Act (ACA) Marketplaces is at an all-time excessive, thanks largely to the improved premium tax credit (PTCs) enacted in 2021 and prolonged by 2025 within the Inflation Discount Act. The improved PTCs have dramatically improved protection affordability for hundreds of thousands of individuals, saving the typical Market enrollee $700 per yr.
We’ve additionally seen vital progress decreasing historic inequities in well being protection entry for individuals of shade. Beneath the Biden administration, the variety of Latino enrollees within the Marketplaces elevated 185 p.c, the variety of Black enrollees grew 204 p.c, and enrollment for American Indian/Alaska Native communities doubled. These positive aspects are attributable to the improved PTCs, but additionally to the numerous investments the Biden administration has made in Market outreach and help, in addition to reductions in paperwork burdens that disproportionately hinder enrollment amongst individuals of shade. In a current regulation, the Administration opened the doorways for “Dreamers” – Deferred Motion for Childhood Arrivals (DACA) recipients – to acquire inexpensive Market protection.
This administration ushered in dramatic enhancements in affordability for Medicare enrollees, together with an annual cap on prescription drug prices, entry to vaccines with out cost-sharing, and a $35 restrict on month-to-month insulin prescriptions. The Inflation Discount Act additionally gave Medicare new powers to barter costs with pharmaceutical producers, which is projected to avoid wasting enrollees $1.5 billion in private out-of-pocket prices in 2026 alone.
The Biden administration has additionally persistently defended the ACA’s protections for individuals with pre-existing circumstances, cracking down on “junk plans” that received’t cowl individuals in less-than-perfect well being. The present U.S. Division of Justice can also be defending in court docket the ACA’s requirement that insurance coverage firms cowl, with out cost-sharing, really useful preventive providers and life-saving vaccines.
Lastly, the administration’s implementation of the No Surprises Act has protected hundreds of thousands of Individuals from surprising medical payments from out-of-network suppliers. They usually proceed efforts to make sure that the regulation’s dispute decision course of doesn’t end in larger general premiums for shoppers, regardless of authorized challenges.
The Work to Come: Navigating Uncertainty, Defending the Progress Made
The precise well being care agenda of the incoming Trump administration is unclear, however coverage proposals from the Heritage Basis’s “Undertaking 2025” and the Republican Examine Committee have known as for vital cuts in funding for medical insurance protection and a roll again of the ACA’s pre-existing situation protections, in addition to the elimination of essential protections for LGBTQ+ individuals, pregnant people, and those that have had abortions or miscarriages. These proposals, if carried out, would end in a vital lack of well being care entry and a rise in well being care prices for hundreds of thousands of Individuals.
Over the approaching weeks and months we’ll be taught extra concerning the new administration’s well being care agenda. For CHIR, we stand able to work with policymakers and advocates of all political persuasions to protect the historic positive aspects made previously 4 years and construct on that progress, at each the federal stage and within the states. In acknowledgment of the uncertainty wrought by final evening’s election outcomes, and the large quantity of labor forward, we share beneath a quote from the late Senator Edward Kennedy. The Senator was a key architect of the ACA and essentially the most tireless advocate for common, equitable well being protection in our lifetimes:
“For all these whose cares have been our concern, the work goes on, the trigger endures, the hope nonetheless lives, and the dream shall by no means die.”
