The executive order on strengthening Medicaid and the Affordable Care Act signed by new President Joe Biden a week ago has much more to it than just launching a three-month-long special enrollment drive under the ACA. The order stresses revisiting the policies enacted under his predecessor Donald Trump.
- The section of the order calls for “immediate review of agency actions”. Biden has asked the secretaries of Treasury, Labor, and Health and Human Services, and the heads of all other executive departments and agencies associated with Medicaid and the ACA to review all existing healthcare regulations, orders, guidance documents, and policies.
- The Trump-era decisions under scrutiny include policies or practices that may undermine protections for people with pre-existing conditions, including Covid-19 related complications, under the ACA; and demonstrations and waivers, and related policies that may reduce coverage under Medicaid or the ACA.
- Policies that may undermine the health insurance marketplace or the individual, that can present barriers to people attempting to access Medicaid or ACA coverage, and practices that may reduce the affordability of coverage or financial assistance for coverage, including for dependents, are also under the scanner.
- Besides review, the agencies have also been asked to consider whether to suspend, revise, or rescind those actions identified as inconsistent with the policy of protecting and strengthening Medicaid and the ACA.
The Biden administration is expected to scrap the 10-year waivers that HHS has approved. Block grants are also likely to come under scrutiny.
The three-month special enrollment drive has left payers in a fix given that they, as a common practice, resort to preventive services and chronic disease management strategies for the members for a year. This practice not just stops health conditions from deteriorating but also keeps treatment costs in check. But the special drive may not give payers enough time to prepare for this.