They are saying that well being care wasn’t on the poll this election. Political scientists will write dissertations about what Individuals had been voting for (or in opposition to) on the polls this 12 months, however by most accounts, well being care was not excessive on the record of priorities. And but, in relation to well being care entry, fairness, and affordability, there may be a lot to lose. In gentle of the election outcomes, it’s going to require concerted and aggressive efforts amongst policymakers and advocates to protect features in insurance coverage protection, enhancements in well being fairness, and enhanced well being care affordability. At CHIR, our mission has all the time been, and can stay, to help these efforts by means of balanced, evidence-based analysis, evaluation, and strategic recommendation.
Well being Entry, Fairness, and Affordability: Ending on a Excessive Notice
The Biden administration will go away workplace with a document of unprecedented progress in well being protection and affordability. The numbers of people who find themselves uninsured is at an all-time low. Protection by means of the Inexpensive Care Act (ACA) Marketplaces is at an all-time excessive, thanks largely to the improved premium tax credit (PTCs) enacted in 2021 and prolonged by means of 2025 within the Inflation Discount Act. The improved PTCs have dramatically improved protection affordability for hundreds of thousands of individuals, saving the common Market enrollee $700 per 12 months.
We’ve additionally seen vital progress decreasing historic inequities in well being protection entry for folks of coloration. Below the Biden administration, the variety of Latino enrollees within the Marketplaces elevated 185 p.c, the variety of Black enrollees grew 204 p.c, and enrollment for American Indian/Alaska Native communities doubled. These features are attributable to the improved PTCs, but in addition to the numerous investments the Biden administration has made in Market outreach and help, in addition to reductions in paperwork burdens that disproportionately hinder enrollment amongst folks of coloration. In a current regulation, the Administration opened the doorways for “Dreamers” – Deferred Motion for Childhood Arrivals (DACA) recipients – to acquire inexpensive Market protection.
This administration ushered in dramatic enhancements in affordability for Medicare enrollees, together with an annual cap on prescription drug prices, entry to vaccines with out cost-sharing, and a $35 restrict on month-to-month insulin prescriptions. The Inflation Discount Act additionally gave Medicare new powers to barter costs with pharmaceutical producers, which is projected to avoid wasting enrollees $1.5 billion in private out-of-pocket prices in 2026 alone.
The Biden administration has additionally constantly defended the ACA’s protections for folks with pre-existing situations, cracking down on “junk plans” that gained’t cowl folks in less-than-perfect well being. The present U.S. Division of Justice can also be defending in courtroom the ACA’s requirement that insurance coverage corporations cowl, with out cost-sharing, really helpful preventive providers and life-saving vaccines.
Lastly, the administration’s implementation of the No Surprises Act has protected hundreds of thousands of Individuals from sudden medical payments from out-of-network suppliers. And so they proceed efforts to make sure that the legislation’s dispute decision course of doesn’t lead to larger general premiums for customers, regardless of authorized challenges.
The Work to Come: Navigating Uncertainty, Defending the Progress Made
The precise well being care agenda of the incoming Trump administration is unclear, however coverage proposals from the Heritage Basis’s “Venture 2025” and the Republican Examine Committee have referred to as for vital cuts in funding for medical health insurance protection and a roll again of the ACA’s pre-existing situation protections, in addition to the elimination of vital protections for LGBTQ+ folks, pregnant people, and those that have had abortions or miscarriages. These proposals, if carried out, would lead to a vital lack of well being care entry and a rise in well being care prices for hundreds of thousands of Individuals.
Over the approaching weeks and months we’ll be taught extra concerning the new administration’s well being care agenda. For CHIR, we stand able to work with policymakers and advocates of all political persuasions to protect the historic features made up to now 4 years and construct on that progress, at each the federal degree and within the states. In acknowledgment of the uncertainty wrought by final night time’s election outcomes, and the large quantity of labor forward, we share beneath a quote from the late Senator Edward Kennedy. The Senator was a key architect of the ACA and essentially the most tireless advocate for common, equitable well being protection in our lifetimes:
“For all these whose cares have been our concern, the work goes on, the trigger endures, the hope nonetheless lives, and the dream shall by no means die.”
