Giving Everyone Healthcare Coverage: Pres. Biden’s Plan in One Diagram and Two Short Lists

The healthcare system is complicated. Explaining proposed improvements is a big challenge. Written material that digs in too deep, uses technical terms, and is many pages long doesn’t realistically give people the basic info they need. The goal here is to give you a brief, clear, and complete overview of Pres. Biden’s plan with one diagram and two short lists.

The primary goal of the president’s plan is to get people covered who are not currently enrolled in Medicaid, Medicare, an employer plan, or they’re working independently and just can’t afford to buy health insurance (even with the existing subsidies it’s still unaffordable to many). In addition to getting everyone covered, there are a series of proposed improvements that will increase the type and quality of coverage available.

This article will give you three sets of information:

1. A bullet point list of four actions President Biden took by signing an Executive Order on January 28, 2021. The Order reverses changes made in the last administration that caused 1.4 million Americans to lose their healthcare coverage;

2. A diagram that shows Biden’s plan to get coverage for everyone who needs it and to lower the costs for people who already have coverage and are struggling to pay for it; and

3. A bullet point list of the president’s additional plan to improve our healthcare system.

The Executive Order Signed on January 28, 2021

• The Order reversed actions of the prior administration that reduced healthcare coverage or made it more difficult to qualify for Medicaid or privately purchased policies under the Affordable Care Act/Obamacare (ACA).
• People who missed the annual deadline to sign up for coverage on HealthCare.gov can now get the critically important healthcare they need, during the pandemic.
• The Order reverses the prior administration’s actions that reduced affordability of coverage or provided less financial assistance, including for dependents.
• Coverage is once again available for comprehensive reproductive healthcare. The Executive Order restores women’s and girls’ sexual and reproductive healthcare rights in the United States.

Getting Everyone Covered

During the campaign, President Biden made clear that getting everyone covered would be accomplished by expanding the existing Obamacare/Affordable Care Act (ACA) and not through any version of “Medicare-For-All.” The Medicare-For-All proposals would require everyone in the country to be in a 100% government owned system. That plan was put forward by other Democratic candidates during the presidential primary season. But candidate Biden disagreed and made his own proposals, as described in this article.

Under the Biden plan, people will get healthcare coverage based upon the amount of money they earn per year.

Lower income people who can’t get Medicaid will get covered for free, in a new and much less expensive government plan (“Public Option”). The chart below shows how 4.5 million uninsured Americans will immediately get that coverage. That’s shown in the red column.

The green column shows how 28 million more Americans without healthcare coverage would get covered. First, they can choose the new Public Option. And second, the people in this middle-income group will also get more money from the government to help pay for that option or any other private insurance they choose.

The blue column shows how Americans in a higher income group will get more money to help pay for the coverage of their choice. They will also have an overall limit on how much they will pay for coverage.

Sources:

• National Center for Health Statistics: https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur202009-508.pdf
• US Department of Health and Human Services, Office of The Assistant Secretary For Planning and Evaluation: https://aspe.hhs.gov/prior-hhs-poverty-guidelines-and-federal-register-references
• Kaiser Family Foundation: https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/
• JoeBiden.com: https://joebiden.com/healthcare/
• CDC, Health Insurance Coverage: https://www.cdc.gov/nchs/fastats/health-insurance.htm
• IRS, Eligibility for Premium Tax Credit: https://www.irs.gov/affordable-care-act/individuals-and-families/eligibility-for-the-premium-tax-credit
• Whitehouse.gov: https://www.whitehouse.gov/briefing-room/statements-releases/2021/01/28/fact-sheet-president-biden-to-sign-executive-orders-strengthening-americans-access-to-quality-affordable-health-care

Additional Improvements to Our Healthcare System

· Stop “surprise billing.” Consumers trying to lower their health care spending often try to choose an in-network provider. But sometimes patients are unaware they are receiving care from an out-of-network provider and get a big, surprise bill. Pres. Biden’s plan eliminates this significant problem in our healthcare system.

· Lower Costs by Increasing Competition. A few big corporations are controlling the market for health insurance. Lack of competition is driving up prices for consumers. The Biden plan will aggressively use its existing antitrust authority to address this problem.

· Better Pay for healthcare Workers. The Biden plan will accelerate the testing and deployment of innovative solutions that improve quality of care and increase wages for low-wage health care workers, like home care workers.

· Lower Costs of Currently Approved Prescription Drugs. Drug manufacturers are not facing price competition for many drugs and therefore they charge whatever price they want. The plan will change the current system by allowing Medicare to use its significant leverage to negotiate lower prices for its beneficiaries.

· Dramatically Lower Costs for Newly Approved Prescription Drugs. Makers of newly approved drugs charge outrageously high prices. Under Biden’s plan, the government will have a panel of experts set a reasonable price that will be the rate that Medicare, the Public Option and private plans pay.

· Stop Abusive Price Increases for Drugs. As a condition of participation in the Medicare program and Public Option, all brand, biotech, and abusively priced generic drugs will be prohibited from increasing their prices more than the general inflation rate.

· Allow Consumers to Buy Prescription Drugs from Other Countries. To create more competition for U.S. drug companies, consumers will be able to price shop for drugs from outside the U.S. that have been found to be safe and effective.

· Stop Tax Breaks for Drug Company Advertising. Taxpayers should not have to foot the bill for the drug company’s ads. Biden will end the existing tax breaks for all prescription drug ads.

· Improving the Supply of Quality Generics. Generics help reduce health care spending, but brand drug companies have succeeded with strategies to delay the entrance of a generic into the market, even after the patent has expired. The Biden plan will accelerate the development of safe generics to achieve significant cost savings.

· End Discrimination in Our healthcare System. The plan will expand access to contraception and protect the constitutional right to an abortion. In addition, the Public Option will cover contraception and a woman’s constitutional right to choose. In addition, the plan will restore federal funding for Planned Parenthood.

· Reducing High Maternal Mortality Rate. The U.S. has the highest rate of deaths related to pregnancy and childbirth, and we are the only country experiencing an increase in this death rate. California came up with a strategy that halved the state’s maternal death rate. And the plan will take this strategy nationwide.

· Double Investment in Community Health Centers. Community health centers provide primary, prenatal, and other important care to underserved populations. Pres. Biden’s plan will double the federal investment in these centers, expanding access to high quality health care for the populations that need it most.

· Expand Access to Mental Healthcare. Pres. Biden will ensure enforcement of mental health laws that require the same amount of access to mental health services that exist for all other types of healthcare. The plan will also expand funding for mental health services.