The Future of American Health Care

With President-elect Joe Biden taking office in January, what will the future of American health care look like?

On November 6, AP called the election for Joe Biden, after passing the 270 electoral votes needed, with a win in Pennsylvania. What will the future of American health care look like under the Biden administration? 

Even under Biden’s administration, the Senate is so divided that it is unlikely that anything significant will change in the American health care system for at least two years. The debates over Medicare for All, public insurance, and federal control of drug prices, will likely lead to a standstill in the near future. Biden endorsed lowering the Medicare eligibility age and expanding Affordable Care Act grants, which is projected as unlikely to pass in the Republican-controlled Senate. 

Nonetheless, the Biden administration is planning ambitious actions to improve the future of American health care. Beyond expanding the ACA, Biden plans to help public health agencies as they deal with the continuous spread of COVID-19 and pass a stimulus bill to help support hospitals, doctors, and nursing homes. 

The most significant facet of Biden’s policy is the public option he intends to implement. This will be sold on Obamacare’s marketplaces—where nearly 12 million Americans buy their insurance—adding more competition in places where only a limited number of health care plans are available. The public option will also cover low-income Americans that cannot get insurance because their states are opposed to Obamacare. Biden’s plan will immediately enroll nearly 4 million citizens that have not been able to get health insurance because their states will not expand Medicaid. However, this plan may be too controversial to pass through Congress without a Democrat majority. 

For the majority of the 150 million people with employer-sponsored coverage, it may not make sense to join the program. They will not be able to use the money their employer pays for insurance premiums, nor can their employers choose to put their employees on the government plan. This will most likely make most people—from both large group coverage and the public option—still reliant on their job for health insurance benefits. Health insurance today is very unaffordable for middle-income citizens. However, under Biden’s plan, a family making $150,000 would pay no more than $12,750 in annual premiums. 

Biden will likely implement regulations to combat COVID-19. He rolled out his COVID-19 task force on November 19. The task force members include David Kessler, former Food and Drug Administration commissioner; Vivek Murthy, the former surgeon general; and Yale physician-researcher Marcella Nunez-Smith. Biden has said he wishes to implement a national mask mandate, but this will need to go through the local government. Aside from mask mandates Biden plans to work with Congress to implement several more components in his coronavirus action plan. Such as, providing free testing for all Americans, getting rid of out-of-pocket expenses for coronavirus treatment, and getting personal protective equipment (PPE) for essential workers. 

It is likely that Biden’s administration will review the regulations put forward by Trump to prevent birth control. Biden can reverse the Trump administration’s changes to the Title X program that institutes access to birth control and other reproductive health care. 

Politically, there are going to be many hoops the Biden administration will need to jump through to secure his plan for the future of American health care. The ACA—that narrowly passed eight years ago—will be brought back to court with Republicans looking to dismember it. This could mean that millions may lose their health insurance, including millions more with preexisting conditions. If the Supreme Court strikes down the ACA, Biden will put his “Bidencare” plan forward. This policy is estimated to provide health insurance to every person that resides in the U.S. legally. It will also, however, leave nearly 6.5 million undocumented immigrants without health insurance.

Yet, if Biden’s plan is put forward it would mean that much of the current health care system will remain in place. Workers will be able to get their health insurance through their employers, but also Medicare and Medicaid will remain. In order to do this, Democrats will need to win two Georgia Senate seats in a January runoff to reach a 50-50 tie in the Senate. Also Vice President-elect, Kamala Harris, will give the chamber to the Democrats as the president of the Senate. 

On January 20, the Biden administration is set to take office at the White House. Thus, marking a new presidency and beginning the new future of American health care.