On July 15th, highest-polling 2020 Democrat Joe Biden unveiled “The Biden Plan to Protect & Build on the Affordable Care Act.”
The Affordable Care Act (ACA) was President Obama’s key piece of legislation on which his former Vice President Biden has done well to capitalize to propel his own campaign. While other 2020 hopefuls are advocating for “Medicare for All” proposals to replace the ACA, many of which would involve the eradication of private insurance, Biden is sticking with Obamacare and “opposes every effort to get rid of this historic law – those by Republicans and those by Democrats.”
Improving Access
Notably, Biden said that, as president, he would give Americans “a new choice, a public health insurance option like Medicare,” which he is dubbing “the Biden public option.” He argues this option will make healthcare more affordable, more coordinated, and more small-business friendly.
Additionally, Biden promised to reduce the share of income that low and middle-income families must pay to purchase insurance on the individual healthcare market through “eliminating the 400% income cap on tax credit eligibility and lowering the limit on the cost of coverage from 9.86% of income to 8.5%.”
Given the reality that 14 states continue to refuse to expand Medicaid, which has meant that 4.9 million otherwise eligible adult Americans lack coverage, Biden’s plan “will ensure these individuals get covered by offering premium-free access to the public option…and making sure their public option covers the full scope of Medicaid benefits.” Those states that did choose to expand Medicaid will also be allowed to cover those individuals through the public option “as long as the states continue to pay their current share of the cost of covering those individuals.”
Finally, all individuals earning below 138% of the federal poverty line would be automatically enrolled in the healthcare plan for which they are eligible when they interact with certain public institutions or public programs to make the complex care system easier to navigate.
Prescription Drug Companies
Under the Biden Plan, the “outrageous exception allowing drug corporations to avoid negotiating with Medicare over drug prices” would be repealed, which would allow Medicare to better negotiate with drug manufacturers and achieve lower prices for those covered under the plan (similar to how Medicare currently negotiates with healthcare providers).
Healthcare as a Human Right
Acknowledging the bias of the healthcare system, rooted in “racism, sexism, homophobia, transphobia, and other forms of discrimination,” the Biden Plan also includes a section on ensuring that healthcare is equally available to people of all identities.
In the plan, Biden pledges to repeal the Hyde Amendment, which prohibits the use of public funding (i.e. Medicaid) to procure an abortion; reproductive justice advocates argue that the amendment creates an insurmountable barrier for many women who are low-income to access safe abortions.
Biden has previously come under fire for his views on abortion; as a senator, he criticized Roe v. Wade for going “too far,” and then revised his stance to argue that, while Roe should remain the law, federal money should not be given to women to access abortions. Up until June 5 of this year, Biden maintained his support of the Hyde Amendment; after facing criticism, he eventually reversed his opinion abruptly, saying in a speech: “If I believe healthcare is a right, as I do, I can no longer support an amendment that makes that right dependent on someone’s ZIP code.”
Also relating to reproductive rights, Biden’s plan calls for the codification of Roe, the restoration of Medicaid funding for Planned Parenthood, and the reversal of state policies that create barriers to women receiving abortions. Regarding “our unacceptably high maternal mortality rate, which especially impacts people of color,” the Biden Plan argues that the U.S. should adopt California’s strategy, which reduced the state’s maternal death rate by over 55%.
Biden also pledged to double federal investment in community health centers, which “provide primary, prenatal, and other important care to underserved populations,” as well as achieve mental health parity and improve access to mental health care.
While more progressive candidates and potential-voters alike have argued that we need a more radical change to our healthcare system than simply revising existing policies, regulations, and institutions, a spokesperson told POLITICO in an email: “We can’t afford the years it will take in order to write and maybe pass Medicare for All. A stop in progress is unacceptable. That’s why the Biden Plan builds on Obamacare and works toward achieving universal coverage as soon as possible.”
As with many aspects of the Biden campaign, it remains to be seen whether his moderate, incrementalist approach will pay off at the voting booths come 2020.