Presumed President-Elect Biden has opportunity to reverse decisions that have harmed American health care
Nov. 20, 2020 (ACP) – The American College of Physicians is preparing to offer guidance to the incoming Biden administration for restoring the medical system to good health.
“With a change in administrations, ACP sees an opportunity for the Biden administration to reverse decisions that have hurt American health care, while continuing other Trump administration policies, like reducing paperwork for physicians, that we strongly support,” said Bob Doherty, ACP senior vice president for governmental affairs and public policy. “We're happy to play an important role in the process. In a matter of weeks, we'll be sending the new administration very specific recommendations about what needs to be done in terms of executive orders and new regulations.”
As it lays out its priorities moving forward, ACP will rely on its Vision for a Better U.S. Health Care System, which was released in January. “This document is our lodestar,” Doherty said, “and the coronavirus pandemic has shown us that the deficiencies we identified are very much present. In fact, they have contributed to the high infection and death rates that are plaguing our nation.”
Doherty identified these areas as top priorities for ACP as it develops the guidance it will present to the Biden administration:
- Improve insurance coverage: “The Biden administration can do a lot in terms of reversing policies under the Trump administration that have undermined the Affordable Care Act (ACA), such as allowing the selling of short-term insurance plans, failing to expand outreach and allowing states to impose Medicaid work requirements,” Doherty said.
ACP hopes Biden will reverse Trump administration rules that allow the sale of plans that do not cover the 10 categories of essential benefits required of other ACA-compliant plans. And it will urge the White House to increase funding and support for ACA outreach and enrollment.
However, this won't be a quick process. Although the Biden White House will be able to make administrative changes, they must go through a process that takes time, Doherty said.
“Rolling back regulations that have been finalized by the previous administration won't happen overnight, since by law they have to go through an entirely new round of agency rulemaking with public comment. Many could remain in effect in the meantime,” Doherty cautioned. “Still, the Biden team will be exploring ways to quickly halt, delay or modify implementation of rules it seeks to reverse or modify. Executive orders that have not been finalized as regulations can be reversed with the stroke of a pen by the new president, and new policy directions for federal agencies can be created by new Biden executive orders.”
- Eliminate Trump-era limits on immigration: “The Trump administration changed immigration policy in very dramatic ways without having to go through votes in Congress. We'd like to see the new Biden administration begin to roll back those policies,” Doherty said.
Biden has promised that on the first day of his administration, he will terminate the Trump administration's ban on travel from seven majority-Muslim countries, restore the Deferred Action for Childhood Arrivals program to protect “Dreamers” from deportation and appoint a federal task force to reunite immigrant children who were separated from their parents at the border. ACP supports all these actions and notes that the American medical system will benefit from changes in immigration policies that are denying the United States the talents of physicians from countries have been subject to restrictions
“It's important for international medical graduate students to be able to come to the United States,” Doherty said. “We must not be denied the extraordinary medical talent that comes from other countries.”
ACP also believes the new administration should begin the process of reversing the public charge rule, which denies residency to legal immigrants if they are likely to use public programs like Medicaid. This policy, as ACP has noted, is a major barrier to legal immigrants getting the health care they need.
- Take action against climate change: “We'd like to see a science-based approach to climate change,” said Doherty. ACP has highlighted how climate change is a public health emergency.
In line with ACP priorities, Biden has promised to rejoin the Paris Accord on the first day of his administration, recommitting the United States to specified targets for reducing carbon emissions. ACP hopes he will begin the process of reversing Trump administration regulations that eased restrictions on carbon emissions and opened up more federal lands to drilling for oil.
- Support women's and LGBTQ health: The Biden administration is expected to begin to reverse restrictions on federal funding for Planned Parenthood and on physicians who counsel women on abortion or provide abortion services themselves. It may seek to expand the ACA's essential benefit requirements to ensure coverage for the full range of women's health and roll back so-called employer-conscience exemptions that allow workplaces to exclude contraception from coverage. ACP supports these moves.
Also in line with ACP recommendations, the new administration is expected to reverse federal regulations and executive actions that weaken health care for LGBTQ persons.
ACP will also urge the Biden administration to continue or even expand certain beneficial Trump-era reforms such as implementing higher Medicare payments for office visits, putting patients over paperwork, easing documentation and reporting requirements, and expanding coverage and payment for telehealth visits and phone calls.
“Joe Biden now has the opportunity to advance polices to make health care better,” Doherty said. “ACP stands ready to assist him.”
