Although the election is over, it still feels like we are wrapped up in its surrounding drama. Although the election is over, however, the debate still rages between Democrats and Republicans about what to do regarding America’s healthcare system. There are substantial differences in what each party is proposing that are worth considering. If it feels overwhelming, I don’t blame you. To simplify things though, it can all be boiled down to the idea that the Republican party would like to reduce the federal government’s role in health care while Joe Biden and the Democrats would like to expand the federal government’s role. While that’s easy enough to understand, it is more nuanced and when it comes to healthcare, the differences are especially important.
Just as they were in the 2016 election, many Republican congressmen and women ran on the promise that in this term, they will be dismantling the Affordable Care Act (ACA). Whether or not this will happen remains to be seen and just as in 2016, critics are still wondering what the Republicans would replace the ACA with. Unlike 2016 though, former President Trump signed an executive order (September 2020) launching his vision for healthcare, which supporters are saying shows a future blueprint for Republicans to follow. Most notably, Trump’s executive order protects people with pre-existing conditions. While this is good news, it is something that is already guaranteed under the Affordable Care Act so it isn’t necessarily changing anything. The reason it is noteworthy though is because if the Supreme Court overturns the Affordable Care Act, as Trump has said they will, then his executive order will not be strong enough to protect Americans with pre-existing conditions. Because of this, many critics are saying the executive order was simply meant to boost his campaign rather than provide an actual healthcare solution. According to Katherine Hempstead, a senior policy adviser with the nonpartisan Robert Wood Johnson Foundation, “executive orders issued close to elections are not the same thing as actual policies.” If Biden and the Democrats really want to solidify the protections for people with pre-existing conditions, they will have to author some new legislation. Add that to their already long to-do list.
Beyond protecting people with pre-existing conditions, President Trump’s September 2020 executive order was also meant to lower medication costs, limit surprise billing for patients receiving out-of-network care, end HIV by 2030, and lower Medicare Advantage premiums. This all sounds great, but again, an executive order does not make something into law or actually create an actionable plan. Under Obama, with the passing of the Affordable Care Act, Congress wrote legislation that passed into law. If President Biden could get Congress to take some of Trump’s proposals and turn them into law, he may be able to get both sides to agree on something. Although Trump’s proposal would reduce cost for Medicare consumers, there is nothing in his order to expand coverage for people, which was a key focus of Biden’s campaign.
Due to the still-raging pandemic, many Americans rightfully feel we need expanded coverage now more than ever. Due to the unprecedented health crisis, millions of Americans are unemployed. Unemployment inevitably means more Americans are uninsured than they were four years ago since many people rely on their employer for health coverage. 41 states have seen increases in their uninsured residents. This is where Joe Biden’s plan aims to step in.
As a first step to increasing coverage for more Americans, Joe Biden would like to reduce the eligibility age for Medicare from 65 to 60. For those not in that age group, Biden has also proposed a public health insurance option for coverage through the healthcare exchange. Like the current setup, plans and prices would change based on different income brackets. Although the two candidates did not agree on much, like Trump, Joe Biden also supports a plan to reduce prescription drug costs.
The problem with Biden’s plan, however, is that due to the pandemic and unemployment, there will be heavy pressure to fund Medicare due to the decreased revenue coming in. Some experts even warn that the funds which make up Medicare Part A (which covers hospital visits) could be completely depleted within the decade. To prevent this, President Biden and his team will have to organize congress to create a longstanding plan of action.
The Supreme Court just heard a case regarding the Affordable Care Act, and although as many predicted, the Affordable Care Act was not overturned, increasing its reach will prove difficult if that is truly what Joe Biden is seeking to do. There are still many gaps that must be filled in before anything is done to change America’s current healthcare system. For Biden moving forward, the main task will be convincing congress to fund his vision, which is no easy task in these bipartisan times.
Max Gottlieb works for Senior Planning. Senior Planning helps Seniors apply for state and federal benefits to fund long term care. The process is often very complicated and Senior Planning has spent years learning the ins and outs of long term care Medicaid policy.