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On Health Care, Biden Administration Must Reverse Trump’s Sabotage

President Trump sought to repeal the Affordable Care Act and, short of achieving full repeal, his Administration took many steps to undermine coverage and limit access to care — as we outline in a new brief (summarizing our comprehensive Sabotage Watch tracker). The Biden Administration will need to reverse these policies to achieve its goals of expanding health coverage and improving health equity.

President-elect Biden and Congress have important opportunities to expand and improve health coverage, particularly for underserved communities, and the Administration also can make important improvements administratively. But all of these proposed improvements must rest on the foundation of a strong Medicaid program and robust access to marketplace coverage — so repairing the damage of the last four years will be important to their success.

The new Administration will need to:

  • Restore access to Medicaid and marketplace coverage. President Trump slashed consumer outreach and enrollment assistance, discouraged immigrants and their family members from enrolling in coverage, and encouraged states to require unnecessary and burdensome paperwork from people trying to enroll or maintain their coverage.
  • End state policies that take away people’s coverage. The Trump Administration allowed and encouraged states to take Medicaid coverage away from people who don't meet work requirements or pay premiums, with deeply harmful effects. Where implemented, these policies ended or threatened health coverage for 20 to 40 percent of those subject to them. In Arkansas, studies also found its policy increased uninsured rates, worsened access to care, and did not increase employment.
  • Reverse cuts to financial assistance. The Trump Administration took regulatory action that resulted in cuts to financial assistance for millions of people buying coverage on the marketplace.
  • Restore consumer protections. The Trump Administration encouraged the sale of sub-par individual market health plans and weakened standards for access to care in Medicaid. It also restricted access to qualified family planning providers and gutted anti-discrimination protections for women, LGBTQ+ people, people with disabilities, and those with limited English proficiency.

The Trump Administration’s actions to significantly weaken health coverage and access have left many people without the care they need. The Biden Administration has ambitious plans to expand and improve coverage, but, for these new policies to succeed, it will also need to repair the many tears in the health care safety net.