Biden Plan to Order Review of Trump Health-Care Policies Likely to Face Speed Bumps
January 28 2021 - 05:59AM
Dow Jones News
By Stephanie Armour
President Biden is set to sign executive orders Thursday
directing the government to re-examine Trump-era health-care
policies, which could lead to the unraveling of initiatives like
Medicaid work requirements and short-term health plans.
But the process is likely to be long and met with legal
battles.
Many rules or waivers approved by former President Donald Trump
would require rule-making, public notice, or hearings before they
could be unraveled. Some policies are already enmeshed in legal
proceedings, which means the Biden administration in some cases
would need to move swiftly to take action before court decisions
are made.
States are likely to fight to preserve other Trump
administration changes, such as a first-ever block grant in
Tennessee that would cap federal funding for the state's Medicaid
program.
Mr. Biden is likely to stop short in the executive orders of
calling for the policies and waivers to be gutted. The orders are
expected to call for federal agencies to re-examine rules and
policies that limit access to health care, including demonstrations
and waivers under Medicaid and the Affordable Care Act. Agencies
will then consider whether to take additional action.
The orders will also temporarily reopen enrollment under the ACA
from Feb. 15 through May 15 and Mr. Biden will rescind a rule that
bars international nonprofit groups from getting federal funding if
they provide abortion counseling or referrals. He will also direct
the Department of Health and Human Services to consider whether to
rescind regulations that barred family planning groups from getting
federal funds if they refer patients for abortion.
But his sweeping call to review decisions that could limit
access to health care marks the start of a tougher battle that is
likely to spur political conflict between the Biden administration
and Republicans.
Medicaid work requirements were a long-held goal of
conservatives, but the mandates had never been approved until the
Trump administration. The Supreme Court is slated to hear arguments
over the legality of federal approvals for work requirements that
were adopted in Arkansas and New Hampshire. The decision could help
determine how much authority HHS has in crafting waivers in
Medicaid.
The Biden administration could try to move quickly to end work
requirements that were granted in Medicaid, a federal-state program
for low-income and disabled people. Fast action could potentially
make the Supreme Court case moot.
But 12 states have already had their requirements approved and
could challenge any effort to take them away. The new
administration in some cases has to follow certain
procedures--including hearings--which could take time, and there
are legal questions as to how quickly the Biden administration
could move to make any changes.
The Trump administration also allowed the proliferation of
short-term health plans and association health plans, which provide
insurance that doesn't comply with the ACA consumer protections.
Both are entangled in lawsuits and the D.C. Circuit Court of
Appeals has upheld the expansion of short-term health plans.
The Biden administration can still move to weaken or reverse the
regulations that gave rise to the plans. But the action could be
tough politically, since the short-term plans have become more
widespread because they are generally inexpensive compared with
ACA-compliant plans. Trying to take away plans that millions of
consumers now have could prompt a backlash, so it is possible the
Biden administration could opt instead to limit future enrollments,
according to legal and health policy analysts.
The review means a host of policies will be up for grabs,
pitting Democrats who believe the federal government should do more
to provide health coverage and access against Republicans who say
the initiatives often amount to federal overreach, hinder state
authority and spur overspending of taxpayer dollars.
Mr. Biden has designed his health policy agenda on expanding
health coverage during a pandemic that has had a disproportionate
impact on people who have lower incomes and in communities of
color.
Health-insurance coverage rates increased for all racial and
ethnic groups between 2010 and 2016, with the largest increases
occurring after implementation of the ACA, but the coverage gains
began stalling and reversing for some groups starting in 2017 and
2018, according to the Kaiser Family Foundation.
Write to Stephanie Armour at stephanie.armour@wsj.com
(END) Dow Jones Newswires
January 28, 2021 05:44 ET (10:44 GMT)
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