When Joe Biden served as Vice President under Barack Obama, he was instrumental in passing the Affordable Care Act, one of the largest healthcare overhauls in the history of the country. The confluence of his history with healthcare and the COVID-19 pandemic made healthcare changes a focal point of the 2020 election. Some of Biden’s major pledges included expanding access to healthcare, simplifying the system, and lowering prescription drug prices [1]. Given that Democrats now control all three branches of government, there is a strong chance that significant parts of Biden’s planned healthcare changes will be passed.
Within his first few days in office, Biden instituted changes to the United States’ vaccine infrastructure. The White House announced on January 27 that vaccine distribution would be increased to provide 200 million doses by the end of summer. Around the same time, Biden also indicated that he would expand the country’s testing infrastructure and authorize FEMA to create federally run community vaccination centers [2]. While the effects of these rapid changes to the country’s vaccine infrastructure will play out over the next few years, they will undoubtably result in several permanent changes, such as higher domestic production of vaccines, more attention to supply chain stability, and increased reliance on telemedicine [3].
Besides COVID-19, the Biden administration is facing considerable pressure from Democrats to expand insurance coverage. In February, two Democratic congressmen introduced the Medicare-X Choice Act, which would establish a public option for small businesses and individuals by 2025. The bill was first proposed in 2017 and allows the Health and Human Services secretary to negotiate drug prices for Medicare plans. It also expands subsidies and tax credits to many low- and middle-income Americans [4]. An analysis of the previous version of the bill by the American Hospital Association found that it would reduce healthcare spending by $1.2 trillion in the first decade after it goes into action. That would result in additional stresses to hospitals and other care facilities, half of which would likely see negative margins after the law goes into effect [5].
Regardless of whether Medicare-X passes, the Biden administration will likely take steps to reduce the cost of prescription drugs, which became a hot-button issue during the 2020 election. In 2019, prescription drugs cost Americans a collective $370 billion, a price which is expected to rise by 5% annually between 2021 and 2028 [6]. As a result, the issue has wide bipartisan support. The Biden administration’s approach will likely include allowing Medicare to negotiate drug prices and limit yearly increases on drug prices. Biden has pledged to do so by building on the ACA, a proposal that is likely to meet fierce opposition, both from Republican opponents who seek to dismantle the legislation and progressive Democrats who seek to institute a true public option [7].
While the Biden administration has indicated that healthcare reform is one of its top issues, the COVID-19 pandemic has taken the front seat. Additionally, while some healthcare legislation has been introduced, the Biden administration has remained focused on passing the $1.9 trillion economic stimulus package and a comprehensive immigration bill. As a result, the future and timeline of healthcare changes remains uncertain.
References
[1] Silberner, Joanne. “How Joe Biden Plans to Heal American Healthcare.” BMJ, 19 Jan. 2021, doi:10.1136/bmj.n142.
[2] Morse, Susan. “Biden Ramps up Vaccine Distribution to 200 Million Doses by the End of Summer.” Healthcare Finance News, HIMSS Media, 27 Jan. 2021, www.healthcarefinancenews.com/news/biden-ramps-vaccine-distribution-200-million-doses-end-summer.
[3] Galea, Sandro, et al. “Taking the Long View: COVID-19 Priorities for the Biden Administration.” Journal of Health Politics, Policy and Law, 2021, doi:10.1215/03616878-8970781.
[4] Pramuk, Jacob. “Senate Democrats Push for Public Option as Biden Weighs Health-Care Reform Plans.” CNBC, CNBC, 19 Feb. 2021, www.cnbc.com/2021/02/19/democrats-kaine-and-bennet-introduce-health-care-public-option-bill.html.
[5] Koenig, Lane. “The Impact of Medicare-X Choice on Coverage, Healthcare Use, and Hospitals: AHA.” American Hospital Association, 12 Mar. 2019, www.aha.org/position-paper/2019-04-30-impact-medicare-x-choice-coverage-healthcare-use-and-hospitals.
[6] Keehan, Sean P., et al. “National Health Expenditure Projections, 2019–28: Expected Rebound In Prices Drives Rising Spending Growth.” Health Affairs, vol. 39, no. 4, 2020, pp. 704–714., doi:10.1377/hlthaff.2020.00094.
[7] Gavulic, Kyle A., and Stacie B. Dusetzina. “Prescription Drug Priorities under the Biden Administration.” Journal of Health Politics, Policy and Law, 22 Jan. 2021, doi:10.1215/03616878-8970810.
