BidenCare. What To Expect (Part 1)

With the election of Joe Biden as president, many are wondering what health care insurance will look like going forward.  Biden the candidate made several statements detailing what he would like to see happen concerning health insurance. With the newly elected congress controlled by the democrats, there is a real chance for Biden to put his stamp on health insurance in America.

So what health insurance changes can we expect from the Biden administration?  Below is a short, preliminary list of possibilities:

The Individual Mandate.

The individual mandate was established to stabilize and maintain ACA health plan affordability.  The idea was that by getting everyone to participate, healthy individuals generating very little in medical costs would offset the cost of those who are sick and generating substantial medical costs.

Through executive action, President Donald Trump removed the Affordable Care Act individual mandate when he signed the GOP tax bill into law in 2017.   At the time, the individual mandate was considered essential to the plan’s viability.  Many expected that without the individual mandate, far too many healthy Americans would opt out of ACA coverage. The result being a program over-burdened by an unsustainable percentage of policies generating costly medical bills.   Many expected this would lead to an inevitable unraveling of the Affordable Care Act.

To the surprise of many, this unraveling never materialized.  As it turned out, limiting the time when one could apply and qualify for an ACA plan, partially insolated the program from the spiraling health insurance plan adverse selection that was expected.

Several additional tactics were employed by the Trump administration to torpedo the ACA – including an attempt to get the ACA declared unconstitutional by the supreme court.  Regardless, the act managed to limp through to the end of the Trump presidency.

Under the Biden administration, the individual mandate will almost certainly become a re-established component of the Affordable Care Act.  Since the individual mandate currently is not federal law, we expect President Biden to employ a series of executive orders to re-establish the mandate.

COBRA subsidies.

President Biden is likely to back COBRA subsidies being added to ACA plans. To assist those who have been laid off due to the pandemic, it is expected that President Biden will recommend a 100% tax credit for health insurance premiums paid toward COBRA. (The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives employees who lose employee health insurance benefits, the right to choose to continue coverage under the group health plan that was provided by their employer.  depending on the type of qualifying event, COBRA may last for 18 months, 29 months or 36 months.  Circumstances the qualify for COBRA include voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102% of the cost to the plan.

COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage in certain instances where coverage under the plan would otherwise end.

COBRA outlines how employees and family members may elect continuation coverage. It also requires employers and plans to provide notice.)

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