They are saying that well being care wasn’t on the poll this election. Political scientists will write dissertations about what People had been voting for (or in opposition to) on the polls this 12 months, however by most accounts, well being care was not excessive on the record of priorities. And but, in relation to well being care entry, fairness, and affordability, there may be a lot to lose. In mild of the election outcomes, it should 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 at all times been, and can stay, to assist 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 document 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 Inexpensive 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 12 months.
We’ve additionally seen vital progress decreasing historic inequities in well being protection entry for individuals of coloration. Below 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 in addition 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 coloration. In a current regulation, the Administration opened the doorways for “Dreamers” – Deferred Motion for Childhood Arrivals (DACA) recipients – to acquire reasonably priced 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 constantly 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 be defending in courtroom 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 People from sudden medical payments from out-of-network suppliers. And so they proceed efforts to make sure that the regulation’s dispute decision course of doesn’t lead to greater 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 “Challenge 2025” and the Republican Research Committee have referred to 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 vital protections for LGBTQ+ individuals, pregnant people, and people who have had abortions or miscarriages. These proposals, if applied, would lead to a vital lack of well being care entry and a rise in well being care prices for hundreds of thousands of People.
Over the approaching weeks and months we are going to study 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 prior to now 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 great 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.”
