Biden’s Executive Order Reopens Health Care Enrollment

Joe Biden sits in the oval office signing a document

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Nearly 15 million Americans have a second chance to sign up for health insurance after President Joe Biden signed an executive order Thursday aimed at improving access to health care.

The most immediate result of Biden’s order is the establishment of a special enrollment period from Feb. 15 to May 15, where—the health insurance marketplace created by the Affordable Care Act (ACA)—will be reopened for new enrollees. The order applies to people in the 36 states that use The District of Columbia and the remaining 14 states have their own health insurance marketplaces and enrollment rules, and are not covered under the special enrollment period.

Biden, in his executive order, also directed federal agencies to reexamine policies that may limit access to health care under Medicaid and the ACA, as well as for those with pre-existing conditions.

“There’s nothing new that we’re doing here, other than restoring the Affordable Care Act and restoring the Medicaid to the way it was before Trump became president,” Biden said in a statement.

There are about 15 million uninsured people who could benefit from the special enrollment period. Sixty percent or 8.9 million of those would receive financial help if they signed up, according to a study by the Kaiser Family Foundation (KFF). Some 4 million people could get coverage for free.

Typically, Americans in states that use the federal health care marketplace can only sign up for coverage on once a year, during the open enrollment period in the fall. Under the Trump administration, open enrollment had been limited to just six weeks. For 2021 policies, it closed on Dec. 15, 2020.

Enrollment among new consumers decreased each year during Donald Trump’s presidency, something the KFF attributed to cuts made by Trump to funding for ACA marketing and outreach. The federal agency responsible for implementing the government’s health care marketplace, Centers for Medicare and Medicaid Services, now plans to spend $50 million on outreach efforts during the 12-week special enrollment period created by Biden’s order, it said in a statement Thursday.

The ACA has been subject to challenges, both in the legislature and in the courts. The Supreme Court heard arguments in November in a case surrounding whether a key part of the ACA—the individual mandate—is unconstitutional. The Trump administration and several states argued against the single payer mandate in the hopes the entire ACA would be removed. No date has been set for a decision.

In another action, Biden signed a presidential memorandum outlining his administration’s stance that there should be expanded access to women’s and reproductive health care. It also rescinded a rule referred to as the Mexico City Policy, which bars international nonprofits that provide abortion counseling or referrals from receiving federal funding.

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  1. The White House. “FACT SHEET: President Biden to Sign Executive Orders Strengthening Americans’ Access to Quality, Affordable Health Care.” Access Jan. 29, 2021.

  2. The White House. “Remarks by President Biden at Signing of Executive Orders Strengthening Americans’ Access to Quality, Affordable Healthcare.”

  3. Kaiser Family Foundation. “Marketplace Eligibility Among the Uninsured: Implications for a Broadened Enrollment Period and ACA Outreach.”

  4. Centers for Medicare & Medicaid Services. “2021 Special Enrollment Period in response to the COVID-19 Emergency.” Access Jan. 29, 2021.  

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