President Biden has issued an avalanche of executive orders since taking office last week with many designed to undo Trump administration actions. This is no way to govern, as The New York Times pointed out in an editorial, “Ease up on the Executive Actions, Joe.”
But here we are, and yesterday was Biden’s health reform action day with orders to “rebuild” Obamacare after a decade of Republican “attacks” and “sabotage.”
This is nonsense. The Trump administration actually repaired the Obamacare market after premiums doubled during the Obama years and insurers left the market in droves. Because of actions the Trump administration took to stabilize the market, average premiums for the benchmark plan on healthcare.gov dropped this year for the third consecutive year, and insurer participation grew, expanding choices of plans.
Biden has ordered HHS to create a special enrollment period for ACA coverage, increase spending on “navigators” and reexamine Medicaid work requirements. The order also sets in motion a process to try to undo other Trump administration rules, all designed to provide more options of more affordable coverage through short-term plans, association health plans, and Health Reimbursement Arrangements, for example.
Galen Senior Fellow Brian Blase led these initiatives at the White House and was quoted by the Associated Press as cautioning the Biden administration against throwing out policies intended to help people, including those who don’t qualify for financial assistance under the ACA.
“Obamacare plans are generally only attractive to people who receive large subsidies to buy them,” he said. People need more options, and the Trump administration acted through the administrative rule-making process to offer them.
President Biden has promised, precariously, that “…If you have private insurance, you can keep it.” He will have to be careful not to undo Trump actions that created new options for millions of people.
Biden appointees should carefully review the impact of these consumer-friendly, market-based policies before trying to spend trillions of dollars more on Obamacare and new programs, such as a “public option,” a path to a government-run health system. The Biden actions are purportedly to help the “millions” or “tens of millions” of people who lost coverage during the pandemic.
But that didn’t happen. The Kaiser Family Foundation wrote in December, “While much is unknown, a review of administrative data suggest that the uninsured rate may not have changed much during the pandemic to date.” Doug Badger explains that 99% of Americans lawfully present in the United States have access to affordable health coverage, regardless of their income or medical condition.
First, do no harm.
(Watch this space for a forthcoming paper by Brian Blase with more evidence that administration actions he led actually helped the private market for health insurance.)