Biden to sign orders to establish 3-month ACA sign-up period, roll back Trump's Medicaid priorities

President Joe Biden will sign an executive order to hold a three-month special open enrollment period for the Affordable Care Act exchanges starting Feb. 15. (Getty/kroach)

President Joe Biden is expected to sign an executive order Thursday that sets up a special enrollment period for the Affordable Care Act’s (ACA's) insurance exchanges to run from Feb. 15 to May 15.

Biden is also expected to sign orders that will reexamine waivers surrounding Medicaid and the marketplace that could make it more difficult for people to gain access to care, including Medicaid’s work requirements.

“This executive order takes critical steps to reverse attacks on and strengthen Medicaid and the Affordable Care Act, so they can continue to provide access to life-saving care for millions of Americans,” a fact sheet from the White House said.

The White House said the special enrollment period for the 2021 coverage year will give Americans who need coverage during the pandemic the chance to sign up.

The order represents a departure from the Trump administration, which cut the enrollment period in half. The open enrollment for 2021 last six weeks and ended Dec. 15.

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More Americans could choose to sign up for ACA coverage because of job losses stemming from the pandemic. A July analysis from Avalere predicted the exchanges could add more than 1 million new enrollees because of the pandemic. But the sign-ups on HealthCare.gov after open enrollment were more than 8.2 million, about roughly the same as the 8.3 million that signed up for 2020 coverage.

The executive orders also lay out sharp departures on other areas of health policy from Biden’s predecessor.

Another order directs federal agencies to reexamine any demonstrations or waivers under Medicaid and the ACA that may reduce coverage and chiefly mentions work requirements for Medicaid.

The work requirement waivers touted by the Trump administration have been struck down by multiple courts. The Supreme Court is expected to hear an appeal from Arkansas and New Hampshire to reinstall the programs struck down by lower courts.

The Trump administration also gave a waiver last year to Georgia to rely on the private sector to get ACA signups instead of HealthCare.gov. Some experts have questioned whether the waiver will make it harder for people to buy insurance, not easier.

Biden also issued two separate orders on abortion policy, including rescinding a global gag rule that bars international nonprofits that offer abortion counseling or referrals from getting federal funding. He also wants the Department of Health and Human Services to rescind regulations that could cut Title X funding to groups such as Planned Parenthood that perform abortions.