By Suzanne Wikle

Recognizing that in the midst of a pandemic, access to health care is more important than ever, the Biden-Harris administration has acted quickly to remove some barriers to health insurance. 

Strengthening Medicaid. In the short time they’ve been in office, the Biden-Harris Administration has taken swift action to strengthen Medicaid by providing certainty to states about funding and reversing course on harmful provisions allowed in recent years. 

HHS has informed states they intend to keep the Public Health Emergency (PHE) in place through at least the end of 2021. While the PHE is in place, states are receiving additional federal funding for their Medicaid program; in exchange for those funds they are prohibited from disenrolling anyone from Medicaid. By letting states know that they can count on receiving the enhanced federal dollars at least through March 2022 (the end of the quarter following the end of the PHE), states can have more certainty while building their state budgets. Given that states are likely facing budgetary shortfalls and struggles, this reassurance from HHS regarding federal Medicaid dollars is very helpful. 

Today the Biden-Harris administration directed agencies to re-examine demonstrations and waivers in Medicaid that may reduce coverage or undermine the program, including work requirements. The Trump Administration approved waivers for eight states to implement “work requirements” (an additional seven are pending), but the data is clear these policies are racist and cause people to lose Medicaid even when they do meet the work reporting requirements. Several courts have struck down this policy from the Trump era, but unfortunately the Supreme Court agreed to hear the case this spring. We urge the Biden administration to fully reverse course on Medicaid work reporting requirements in order to ensure Medicaid remains as it was intended–to provide medical care to those who otherwise cannot afford care. We also urge the administration to reverse course on the Healthy Adult Opportunities guidance encouraging states to request block grant funding for Medicaid. Rescinding these two policies are necessary steps to protect and strengthen Medicaid. 

Opening Marketplace Enrollment. Today’s Executive Order opens enrollment in the federal marketplace from February 15 to May 15, allowing people who are uninsured and live in the 30 states that use the federal marketplace to enroll in health insurance. People with qualifying incomes can receive premium subsidies and those with lower incomes can also receive help paying out of pocket costs. People will not need a “qualifying life event” for this enrollment. It’s estimated that nearly nine million people will be eligible for coverage with no premium or subsidies to offset their premium cost. 

It’s estimated that nearly 15 million people lost health insurance in 2020 due to job loss. Although a loss of employer insurance does allow someone a special enrollment period to purchase insurance through the marketplace, it’s likely that many people were not aware of this and missed their window of opportunity. The open enrollment period is also important for those who are working but don’t receive health benefits and are uninsured. People of color are more likely to be in this group because generations of systemic racism has led to communities of color being more likely to work in jobs with low wages, working involuntarily part-time when they want full-time hours, and work in sectors that are less likely to offer health benefits. Uninsurance was on the rise before the pandemic and has likely only gotten much worse in the past year. Youth and young adults in particular are experiencing high rates of uninsurance, with nearly 23 percent reporting they don’t have health insurance.  

Additionally, because the Trump administration slashed outreach, advertisement, and enrollment assistance money for the annual open enrollment period in recent years, people may have failed to enroll during the annual open enrollment period. We urge the Biden-Harris Administration to include ample resources for outreach and education so people know about this opportunity. We are glad to see $50 million being allocated to outreach efforts during the special enrollment period, and we urge the Biden-Harris Administration to further increase funds for outreach and enrollment as necessary. 

Combined, the efforts to strengthen Medicaid and provide an open enrollment period for Marketplace coverage will ensure that more people have affordable health insurance. We applaud the Biden-Harris administration for their quick action, while also encouraging them to continue working to ensure that everyone has access to the health care they need.