Possible Health Care Changes in 2021
Even before taking office on January 20, Biden administration shared plans for a new direction in combatting the COVID-19 pandemic. The Biden-Harris transition team seven-point plan to combat the coronavirus includes:
1. Access to regular, reliable, and free testing
2. Increases in the supply of Personal Protective Equipment (PPE)
3. Evidence-based guidance of how communities can navigate the pandemic
4. Equitable distribution of treatments and vaccines
5. Increased protections for older and higher-risk individuals
6. New defenses for predicting, preventing, and mitigating pandemic threats
7. Mask mandates nationwide
On January 14, the soon-to-be president announced his plans to pursue a $1.9 trillion COVID-19 relief package with Congress. It includes funding investments in supplies for financially strapped medical facilities, increased vaccine production and testing, expedited vaccine distribution (and administration of 100 million vaccines by the 100th day in office), and expanded domestic PPE manufacturing. Now comes the hard part, negotiating with Congress on approval.
Already, several members of the U.S. Senate have said the proposal is dead on arrival in their chamber.
On January 28, the White House announced plans to take executive action to reopen the Affordable Care Act (ACA) federally facilitated marketplace (FFM), HealthCare.gov. The goal is to help Americans who have lost health coverage during the COVID-19 pandemic. Ordinarily, enrollment in the public health exchanges is limited to an annual six-week period (slightly longer in some states) that starts in the fourth quarter. President Biden is also advocating reducing barriers for individuals to join Medicaid.
Another action health experts anticipate is a change in ACA subsidy eligibility, which would allow more people to qualify for tax credits to reduce their premium cost. Funds for marketing the federal and state exchanges could return as well, after a 90% reduction in the past several years. Funding of ACA navigators who assist with enrollments may return, too.
Under former Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, several changes governing public health insurance exchanges were announced in late 2020 and early 2021. While the Biden team may embrace some of these CMS modifications – such as reduced user fees – it may roll back others. That includes state waivers and requests to transition from the FFM to a state access model, which relies more on private web brokers or purchasing coverage directly through insurers.
With support from Congress, the Individual Mandate penalty could return, although there is no forecast on what amount might be imposed. The mandate was eliminated as part of a GOP tax bill in 2017, which reduced the penalty for not having ACA-compliant health coverage to zero. That helped set up a court challenge to the ACA, which is now under review by the U.S. Supreme Court.
Open enrollment for 2021 health plans in California ended January 31, 2021. But in response to the ongoing COVID pandemic and the Biden administration’s decision to open a special enrollment period on HealthCare.gov, Covered California announced a COVID-related special enrollment period for uninsured residents. It runs from February 1, 2021 to May 15, 2021, and gives the state’s 2.7 million uninsured residents another opportunity to sign up for coverage, even if they don’t experience a qualifying event.
The state estimates that 1.2 million of those uninsured residents are eligible for premium subsidies through Covered California or Medi-Cal, and Covered California plans to spend $6 million on marketing and outreach to make sure people are aware of the additional opportunity to enroll in health coverage for 2021.
California residents are required to have health coverage or pay a penalty on their state tax return (unless they qualify for an exemption from the penalty).
Covered California has announced a new Special Enrollment Period
Covered California has announced a new Special Enrollment Period (SEP) that will extend the opportunity to enroll in on-exchange Individual plans through December 31, 2021. 加州全保/加州健保宣布了一個新的特殊註冊期（SEP)，將註冊健保個人計畫的時間延長到2021年12月31日。
This longer enrollment period ensures that all eligible Californians are informed of the opportunities to get health coverage. This includes: 這次較長的註冊期可以確保所有符合條件的加州人都能有機會獲得健康保險。這包括：
- New subsidies that will help the uninsured get coverage 新的補貼將幫助沒有保險的人獲得保險 - New savings opportunities to those who currently have coverage without subsidies 為那些有保險而沒有補貼的人提供新的省錢機會 - Increased subsidies to provide financial help to those currently enrolled which will help them continue to stay covered 增加的補貼可以給那些已經註冊的人提供經濟幫助，也有助於他們持續獲得保險的保障