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Biden to reopen Obamacare markets to offer medical coverage during pandemic

President Biden holds his face mask as he delivers remarks at the White House on Tuesday.
President Biden holds his face mask as he delivers remarks on the coronavirus at the White House on Tuesday.
(Evan Vucci / Associated Press)

Fulfilling a campaign promise, President Biden plans to reopen the HealthCare.gov insurance markets for a special sign-up opportunity aimed at people needing coverage in the COVID-19 pandemic.

Biden is expected to sign an executive order Thursday, said two people familiar with the plan, whose details were still being finalized. They spoke on condition of anonymity because they were not authorized to discuss the pending order ahead of a formal announcement.

Although the number of uninsured Americans has grown because of coronavirus-caused job losses, the Trump administration resisted calls to authorize a special enrollment period for uninsured people during the pandemic. Failure to repeal and replace Obamacare, as he had repeatedly vowed to do, was one of President Trump’s most bitter disappointments. His administration continued to try to limit the program or unravel it entirely.

A Supreme Court decision on Trump’s final legal challenge to the Affordable Care Act — which was passed during the Obama administration when Biden was vice president — is expected this year.

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The White House had no comment on Biden’s expected order, but the two individuals familiar with the plan said the new enrollment period would not go into effect immediately. Instead, the White House wants to provide time for the Department of Health and Human Services to mount a marketing campaign and for insurers to get ready for an influx of new customers.

The Affordable Care Act covers more than 23 million people through a mix of subsidized private insurance sold in all states and expanded Medicaid adopted by 38 states, with Southern states being the major exception. Coverage is available to people who don’t have job-based health insurance, with the Medicaid expansion geared to those with low incomes.

California Atty. Gen. Xavier Becerra parlayed his pit-bull defense of the Affordable Care Act into a place in President-elect Joe Biden’s Cabinet.

Biden’s order would directly affect HealthCare.gov, the federal insurance marketplace currently serving 36 states. The marketplace concluded a successful annual sign-up season in December, with enrollment for 2021 growing by about 7%. Final numbers for this year, including insurance markets directly run by the states, will be available soon.

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Opening the insurance markets is also likely to result in higher Medicaid enrollment, since people who qualify for that program are automatically referred.

Biden has promised to build on President Obama’s healthcare law to push the U.S. toward coverage for all. For that he’d need congressional approval, and opposition still runs deep among Republicans.

White House Press Secretary Jen Psaki signaled Tuesday that Biden is also looking at limiting or reversing Trump administration actions that allowed states to impose work requirements on able-bodied low-income adults as a condition of getting Medicaid. Such rules are seen as a way to cull the program rolls.

President-elect Biden has proposed a “public option” to compete with private insurance plans. Experts say a GOP-controlled Senate would make that impossible.

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“President Biden does not believe, as a principle, it should be difficult ... for people to gain access to healthcare,” she said. “He’s not been supportive in the past, and is not today, of putting additional restrictions in place.”

Of some 28 million uninsured Americans before the pandemic, the nonpartisan Kaiser Family Foundation estimates, more than 16 million were eligible for some form of subsidized coverage through the healthcare law.

Experts agree that the number of uninsured people has risen because of layoffs, perhaps by 5 million to 10 million, but authoritative estimates await government studies due later this year.


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