This week, our In Focus section reviews Democratic Nominee Joe Biden’s healthcare plan to protect and build on the Affordable Care Act (ACA). On August 18, 2020, Biden was officially nominated as the presidential candidate. Biden vowed at the 2020 Democratic National Convention (DNC) that if elected, he would strengthen the ACA and provide a Medicare-like public option. HMA summarizes Biden’s official plan below.
Plan to Protect and Build on the ACA
If elected president, Biden is seeking to give Americans “more choice, reduce health care costs, and make the health care system less complex to navigate.” He breaks down his plan into four of the following goals.
- “Give every American access to affordable health insurance”
Biden hopes to insure approximately 97 percent of Americans by creating a public health insurance option like Medicare. The public option, referred to as the Biden Plan, would negotiate lower prices from hospitals and providers to reduce costs for patients. There would be no co-payments for primary care. The public option would be available for purchase through the individual health insurance marketplace. In non-expansion states, the 4.9 million individuals who would have gained Medicaid through expansion, would be offered premium-free access to the public option.
The public option would build upon the ACA and would not eliminate private insurance. The Biden Plan would increase tax credits to purchase coverage through the individual marketplaces by calculating them based on the cost of a gold plan, rather than a silver plan. The cost of coverage for everyone would be limited to 8.5 percent of income, compared to the current 9.86 percent for low income families. The income cap for tax credits would also be eliminated, so families making more than 400 percent of the federal poverty level would be eligible for tax credits. Families that receive insurance from their employers, would be able to switch to a plan on the individual marketplace.
- “Provide the peace of mind of affordable, quality health care and a less complex health care system”
In addition to increasing tax credits and removing the income cap to make healthcare more affordable, the Biden Plan would stop “surprise billing” by barring health care providers from charging patients out-of-network rates when the patient does not have control over which provider they see in an in-network hospital. Biden would also use existing antitrust authority to address the lack of competition in the market to lower prices and increase wages for low-wage health care workers such as home care workers.
- “Stand up to abuse of power by prescription drug corporations”
The Biden Plan would repeal the exception that allows drug manufacturers to avoid negotiating with Medicare over drug prices and would limit launch prices for drugs that face no competition through external reference pricing or by an evaluation by independent board members for Medicare and public option plans. All brand, biotech, and generic drugs will be prohibited from increasing their prices more than the general inflation rate. A tax penalty will be imposed on manufacturers that increase the price higher than the inflation rate.
Consumers would also be allowed to purchase prescription drugs from other countries if the Department of Health and Human Services deems them safe. The tax deduction for all prescription drug advertisements would be eliminated. Finally, Biden supports a proposal from Senator Patrick Leahy (D-VT) to allow generic manufacturers to obtain samples of the branded products which are necessary to develop more affordable alternatives and provide equivalence to the brand product which is required for FDA approval.
- “Ensure health care is a right for all, not a privilege for just a few”
Biden seeks to expand access to contraception and protect the right to an abortion by repealing the Hyde Amendment, which bars the use of federal funds to pay for an abortion, and restore federal funding to Planned Parenthood. Furthermore, Biden would codify Roe v. Wade and stop state laws that violate the constitutional right to an abortion, such as TRAP laws, parental notification requirements, mandatory waiting periods, and ultrasound requirements.
The Biden Plan would work to reduce high maternal mortality rate, especially for black women, defend health care protections for all, regardless of gender, gender identity, or sexual orientation, and expand access to mental health care. The Plan will also double the federal investment to community health centers.
Biden strongly opposes the efforts by current President Trump and Congressional Republicans to dismantle and repeal the Affordable Care Act (ACA). He believes that “every American has a right to the peace of mind that comes with knowing they have access to affordable, quality health care.” Biden will continue to build on his plan by rolling out proposals to tackle public health challenges.