Potential Biden Administration Health Care Changes Without Congressional Approval

By ROGER STARK  | 
Nov 9, 2020
BLOG

Assuming that one or both races in the U.S. Senate runoffs in Georgia will be won by Republicans, the upper house will be controlled by Republicans. This will give the Biden Administration limited power to make major health care reforms. On the other hand, the Trump Administration used Executive Orders fairly liberally and it is anticipated that a Biden Administration would do the same. (here)

A Republican Senate would not allow any significant legislation that would extend socialized medicine in the U.S. This would take “Medicare for All” and a national public option off the table. Dropping the age for Medicare eligibility to 60 years of age and providing more generous premium subsidies for people purchasing individual health insurance plans in the Obamacare exchanges would, in all likelihood, require Congressional action as well.

Prescription drug price controls have been supported by members of both political parties. It would require a substantial political lift for the new president to force price controls on the pharmaceutical industry with only an Executive Order.

Presidential Executive Orders could be used for a number of smaller changes, however. A Biden Administration could give states more Medicaid dollars, especially with the increase in enrollment caused by the coronavirus and the resulting job losses. The work requirement for able-bodied Medicaid recipients that some states have instituted could also be rescinded.

The Trump Administration expanded the use and time-frame of short-term, limited-duration health insurance plans. These have long been opposed by the political left. (here) These could be abolished or significantly shortened by an Executive Order.

Biden has stated that rejoining the World Health Organization is a priority. This would not require Congressional action.

Of interest to Washington state taxpayers is the potential for federal funding of the state's new public option. (here) It is potentially possible to use federal taxpayer dollars to subsidize the WA state public option through the use of an Obamacare 1332 waiver. (here) The language of the Affordable Care Act, however, makes it clear that a 1332 waiver can not increase the federal deficit. Without new federal taxes, which will be impossible with a Repubican Senate, a Washington state 1332 waiver may very well not be accepted by the new administration.

Small changes to the U.S. health care delivery system can be made by the use of Executive Orders. Major changes will require a new Congress or new rulings by the U.S. Supreme Court.