They are saying that well being care wasn’t on the poll this election. Political scientists will write dissertations about what People had been voting for (or towards) on the polls this yr, however by most accounts, well being care was not excessive on the checklist 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 can 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 at all times been, and can stay, to assist these efforts via balanced, evidence-based analysis, evaluation, and strategic recommendation.
Well being Entry, Fairness, and Affordability: Ending on a Excessive Be aware
The Biden administration will go away workplace with a report of unprecedented progress in well being protection and affordability. The numbers of people who find themselves uninsured is at an all-time low. Protection via the Reasonably priced Care Act (ACA) Marketplaces is at an all-time excessive, thanks largely to the improved premium tax credit (PTCs) enacted in 2021 and prolonged via 2025 within the Inflation Discount Act. The improved PTCs have dramatically improved protection affordability for thousands and thousands of individuals, saving the typical Market enrollee $700 per yr.
We’ve additionally seen important progress lowering historic inequities in well being protection entry for folks of colour. Below the Biden administration, the variety of Latino enrollees in the Marketplaces increased 185 percent, the variety of Black enrollees grew 204 %, and enrollment for American Indian/Alaska Native communities doubled. These features are attributable to the improved PTCs, but additionally 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 colour. In a current regulation, the Administration opened the doors 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 personal out-of-pocket costs in 2026 alone.
The Biden administration has additionally constantly defended the ACA’s protections for folks with pre-existing circumstances, 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 firms cowl, with out cost-sharing, advisable preventive companies and life-saving vaccines.
Lastly, the administration’s implementation of the No Surprises Act has protected thousands and thousands of People from sudden medical payments from out-of-network suppliers. They usually proceed efforts to make sure that the legislation’s dispute decision course of doesn’t end in larger total 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 Research Committee have known as for important cuts in funding for medical insurance protection and a roll again of the ACA’s pre-existing situation protections, in addition to the elimination of crucial protections for LGBTQ+ folks, pregnant people, and people who have had abortions or miscarriages. These proposals, if applied, would end in a significant loss of health care access and an increase in health care costs for thousands and thousands of People.
Over the approaching weeks and months we are going to study extra in regards to 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 stage and in the states. In acknowledgment of the uncertainty wrought by final night time’s election outcomes, and the great 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 probably 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.”
