Tag Archives: healthcare

Fact Sheet: Biden-Harris Administration Expands Health Coverage to DACA Recipients

President Biden announces final rule that will allow eligible DACA recipients to enroll in Affordable Care Act coverage. Some 100,000 DACA recipients are expected to take advantage of this opportunity. This fact sheet is provided by the White House:
 

During his State of the Union address, President Biden called for Congress to pass comprehensive Immigration Reform that includes a pathway to citizenship for Dreamers. Republicans blocked bipartisan reform legislation, but Biden is expanding eligibility for DACA recipients to enroll in the Affordable Care Act. © Karen Rubin/news-photos-features.com

The Biden-Harris Administration is expanding access to affordable, quality health care coverage to Deferred Action for Childhood Arrivals (DACA) recipients.  In 2012, President Obama and then Vice President Biden created the DACA policy to transform the lives of eligible Dreamers – young people who came to this country as children—allowing them to live and work lawfully in our country.  Over the last decade, DACA has brought stability, possibility, and progress to hundreds of thousands of Dreamers. 
 
While President Biden continues to call on Congress to provide a pathway to citizenship to Dreamers and others, he is committed to protecting and preserving DACA and providing Dreamers with the opportunities and support they need to succeed, including access to affordable, quality health care coverage.  Thanks to the Biden-Harris Administration’s actions, today’s final rule will remove the prohibition on DACA recipients’ eligibility for Affordable Care Act coverage for the first time, and is projected to help more than 100,000 young people gain health insurance.  Starting in November, DACA recipients can apply for coverage through HealthCare.gov and state-based marketplaces, where they may qualify for financial assistance to help them purchase quality health insurance. Four out of five consumers have found a plan for less than $10 a month, with millions saving an average of about $800 a year on their premiums.
 
President Biden and Vice President Harris believe that health care should be a right, not a privilege. Together, they promised to protect and strengthen the Affordable Care Act, lowering costs and expanding coverage so that every American has the peace of mind that health insurance brings.  Today’s final rule delivers on the President’s commitment by giving DACA recipients that same peace and opportunity.  
 
Today’s rule also reinforces the President’s enduring commitment to DACA recipients and Dreamers, who contribute daily to the strength and vitality of our communities and our country.  On day one of his Administration, President Biden committed to preserving and fortifying the DACA policy.  While only Congress can provide Dreamers permanent status and a pathway to citizenship, the Biden-Harris Administration has continued to vigorously defend DACA against ongoing legal challenges and strengthened DACA by codifying the 2012 policy in a final rule.  

Statement from President Joe Biden:

Today, my Administration is expanding affordable, quality health care coverage to Deferred Action for Childhood Arrivals (DACA) recipients. Dreamers are our loved ones, our nurses, teachers, and small business owners. And they deserve the promise of health care just like all of us.
 
Nearly twelve years ago, President Obama and I announced the DACA program to allow our young people to live and work in the only country they’ve called home. Since then, DACA has provided more than 800,000 Dreamers with the ability to work lawfully, pursue an education, and contribute their immense talents to make our communities better and stronger.
 
I’m proud of the contributions of Dreamers to our country and committed to providing Dreamers the support they need to succeed. That’s why I’ve previously directed the Department of Homeland Security to take all appropriate actions to “preserve and fortify” DACA. And that’s why today we are taking this historic step to ensure that DACA recipients have the same access to health care through the Affordable Care Act as their neighbors.
 
On Day One of my administration, I sent a comprehensive immigration reform plan to Congress to protect Dreamers and their families. Only Congress can provide Dreamers permanent status and a pathway to citizenship. Congress must act.

Statement from Vice President Kamala Harris:

Dreamers throughout this country are serving in our military, teaching in our classrooms, and leading our small businesses as entrepreneurs. They are our neighbors, classmates, and loved ones. Our nation is fortunate that America is their home.
 
Thanks to Deferred Action for Childhood Arrivals (DACA), more than 800,000 Dreamers have been able to live, study, and work in the only home they have ever known while making our nation a better place. It is why I fought to defend and protect DACA as Attorney General of California and a U.S. Senator from California.
 
Now as Vice President, I have worked alongside President Biden to take steps to preserve and fortify DACA. Today, we are building on this progress by ensuring DACA recipients also have access to affordable health care, which will improve the health of all communities. This announcement will bring relief to more than 100,000 people and help them thrive while working to achieve their aspirations.
 
President Biden and I will continue to do everything in our power to protect DACA, but it is only a temporary solution. Congress must act to ensure Dreamers have the permanent protections they deserve.

Contrast to Trump Position on DACA, ACA

In stark contrast to Biden’s support of DACA and ACA, Trump tried to dismantle the DACA program which had protected 700,000 young people who were brought to this country as children from deportation, eventually losing at the Supreme Court.

And Trump tried to repeal the Affordable Care Act – failed – and is vowing to try again if he wins in November. What this would mean for Americans:

  • More than 100 million Americans with preexisting conditions could be denied coverage or charged more
  • 40 million people’s health insurance coverage at risk
  • Health care costs would increase for the millions of Americans
  • Young adults up to age 26 could be kicked off their parent’s health care plan

Fact Sheet: Vice President Harris Announces Historic Advancements in Long-Term Care to Support the Care Economy

These advancements in long-term care to support the care economy are the latest the Biden-Harris Administration has taken to improve safety, provide support for care workers and family caregivers, and to expand access to affordable, high-quality care. This fact sheet is provided by the White House:

Vice President Harris is announcing two landmark final rules that fulfill the President’s commitment to safety in care, improving access to long-term care and the quality of caregiving jobs. © Karen Rubin/news-photos-features.com

Everyone deserves to be treated with dignity and respect and to have access to quality care. That’s why, today, Vice President Harris is announcing two landmark final rules that fulfill the President’s commitment to safety in care, improving access to long-term care and the quality of caregiving jobs. Ensuring that all Americans, including older Americans and people with disabilities, have access to care – including home-based care – that is safe, reliable, and of high quality is an important part of the President’s agenda and a part of the President’s broader commitment to care. Today’s announcements deliver on the President’s promise in the State of the Union to crack down on nursing homes that endanger resident safety as well as his historic Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers, which included the most comprehensive set of executive actions any President has taken to improve care for millions of seniors and people with disabilities while supporting care workers and family caregivers.


Cracking Down on Inadequate Nursing Home Care


Medicare and Medicaid pay billions of dollars per year to ensure that 1.2 million Americans that receive care in nursing homes are cared for, yet too many nursing homes chronically understaff their facilities, leading to sub-standard or unsafe care. When facilities are understaffed, residents may go without basic necessities like baths, trips to the bathroom, and meals – and it is less safe when residents have a medical emergency. Understaffing can also have a disproportionate impact on women and people of color who make up a large proportion of the nursing home workforce because, without sufficient support, these dedicated workers can’t provide the care they know the residents deserve. In his 2022 State of the Union address, President Biden pledged that he would “protect seniors’ lives and life savings by cracking down on nursing homes that commit fraud, endanger patient safety, or prescribe drugs they don’t need.”

The Nursing Home Minimum Staffing Rule finalized today will require all nursing homes that receive federal funding through Medicare and Medicaid to have 3.48 hours per resident per day of total staffing, including a defined number from both registered nurses (0.55 hours per resident per day) and nurse aides (2.45 per resident per day). This means a facility with 100 residents would need at least two or three RNs and at least ten or eleven nurse aides as well as two additional nurse staff (which could be registered nurses, licensed professional nurses, or nurse aides) per shift to meet the minimum staffing standards. Many facilities would need to staff at a higher level based on their residents’ needs. It will also require facilities to have a registered nurse onsite 24 hours a day, seven days a week, to provide skilled nursing care, which will further improve nursing home safety. Adequate staffing is proven to be one of the measures most strongly associated with safety and good care outcomes.

To make sure nursing homes have the time they need to hire necessary staff, the requirements of this rule will be introduced in phases, with longer timeframes for rural communities. Limited, temporary exemptions will be available for both the 24/7 registered nurse requirement and the underlying staffing standards for nursing homes in workforce shortage areas that demonstrate a good faith effort to hire.

Strong transparency measures will ensure nursing home residents and their families are aware when a nursing home is using an exemption.

This rule will not only benefit residents and their families, it will also ensure that workers aren’t stretched too thin by having inadequate staff on site, which is currently a common reason for worker burnout and turnover. Workers who are on the frontlines interacting with residents and understanding their needs will also be given a voice in developing staffing plans for nursing homes. The Biden-Harris Administration also continues to invest in expanding the pipeline of nursing workers and other care workers, who are so essential to our economy, including through funding from the U.S. Department of Health and Human Services.


Improving Access to Home Care and the Quality of Home Care Jobs


Over seven million seniors and people with disabilities, alongside their families, rely on home and community-based services to provide for long-term care needs in their own homes and communities. This critical care is provided by a dedicated home care workforce, made up disproportionately by women of color, that often struggles to make ends meet due to low wages and few benefits. At the same time, home care is still very inaccessible for many Medicaid enrollees, with more than threequarters of home care providers not accepting new clients, leaving hundreds of thousands of older Americans and Americans with disabilities on waiting lists or struggling to afford the care they need.

The “Ensuring Access to Medicaid Services” final rule, finalized today, will help improve access to home care services as well as improve the quality caregiving jobs through its new provisions for home care. Specifically, the rule will ensure adequate compensation for home care workers by requiring that at least 80 percent of Medicaid payments for home care services go to workers’ wages. This policy would also allow states to take into account the unique experiences that small home care providers and providers in rural areas face while ensuring their employees receive their fair share of Medicaid payments and continued training as well as the delivery of quality care. Higher wages will likely reduce turnover, leading to higher quality of care for older adults and people with disabilities across the nation, as studies have shown. States will also be required to be more transparent in how much they pay for home care services and how they set those rates, increasing the accountability for home care providers. Finally, states will have to create a home care rate-setting advisory group made up of beneficiaries, home care workers and other key stakeholders to advise and consult on provider payment rates and direct compensation for direct care workers.


Strong Record on Improving Access to Care and Supporting Caregivers


Today’s new final rules are in addition to an already impressive track record on delivering on the President’s Executive Order on Care. Over the last year, the Biden-Harris Administration has:

  • Increased pay for care workers, including by proposing a rule to gradually increase pay for Head Start teachers by about $10,000, to reach parity with the salaries of public preschool teachers.
  • Cut child care costs for low-income families by finalizing a rule that will reduce or eliminate copayments for more than 100,000 working families, and lowering the cost of care for lower earning service members, thereby reducing the cost of child care for nearly two-thirds of children receiving care on military bases. Military families earning $45,000 would see a 34% decrease in the amount they pay for child care.

Supported family caregivers by making it easier for family caregivers to access Medicare beneficiary information and provide more support as they prepare for their loved ones to be discharged from the hospital. The Administration has also expanded access to mental health services for tens of thousands of family caregivers who are helping veterans

FACT SHEET: Biden-Harris Administration Highlights Substantial Progress on the President’s Care Agenda During Month of Action on Care

President Biden was laid out how he is building a Care Economy on transformational investments in child care, home care, paid family and medical leave, tax cuts for workers and families, and other priorities, which are fully paid for by making the wealthy and big corporations pay their fair share in taxes. © Karen Rubin/news-photos-features.com

This fact sheet on the progress the Biden-Harris Administration has made on the President’s Care Agenda during this proclaimed Month of Action on Care and the comparison to the Republican agenda is from the White House:

During Care Workers Recognition Month, the Biden-Harris Administration is marking the progress we have made to make care more affordable for American families, support family caregivers, boost compensation and job quality for care workers, and expand care options. President Biden was joined by care workers and unions as he laid out how he is building on that progress with transformational investments in child care, home care, paid family and medical leave, tax cuts for workers and families, and other priorities, which are fully paid for by making the wealthy and big corporations pay their fair share in taxes. That is in sharp contrast with congressional Republicans, who would make devastating cuts to funding for care, healthcare, Social Security, and Medicare to pay for massive tax cuts for billionaires and big corporations.
 
The Need to Improve Care
 
Too many families and individuals struggle to access the affordable, high-quality care they need. The cost of child care is up 26% in the last decade and more than 200% over the past 30 years. For older adults and people with disabilities, long-term care costs are up 40% over the past decade. As a result, the cost of care is out of reach for many Americans. At the same time, care workers—who are disproportionately women of color—struggle to make ends meet, even as they care for others. Due to the low pay and the demanding nature of care work, turnover rates are high. In addition, at least 53 million Americans serve as family caregivers—including over 5 million caring for service members or veterans—and many face challenges due to the lack of support, training, and respite.
 
The President’s Plan to Lower Costs for Families for Care
 
The President has made child care, long-term care, family caregiving, and paid leave a core part of his domestic and economic agendas. He has referenced these issues in each of his State of the Union Addresses, and proposed transformative investments in each budget. The President’s most recent budget proposes the following:
 
Affordable, High-Quality Child Care and Universal Preschool
 
High-quality early childhood education improves the lives of both children and their parents. The President’s child care plan provides a lifeline to the parents of more than 16 million children by guaranteeing affordable, high-quality child care from birth until kindergarten for low- and middle-income working families. Right now, the average price of child care is nearly $11,000 a year, with low-income families paying as much as a third of their income for child care. Under the President’s plan, most families would pay $10 per day, saving the average family over $600 per child, per month. The budget also invests in free, voluntary, universal preschool for all of the nation’s 4-year-olds and charts a path to expand preschool to 3-year-olds. Together, these investments will make early care and education programs affordable and available where families live and work in communities across the country, increase wages for early childhood education workers, and strengthen the economy.
 
Child Tax Credit
 
The President’s Budget would restore the expanded Child Tax Credit, lifting 3 million children out of poverty and cutting taxes by an average of $2,600 for 39 million low- and middle-income families that include 66 million children. This includes 18 million children in low-income families who would be newly eligible for the full credit, and 2 million children living with a caregiver who is at least 60 years old. It would also provide breathing room for day-to-day expenses by allowing families to receive their tax credit through monthly payments.
 
Long-term Care and Family Caregiving
 
The President is committed to protecting older adults’ and people with disabilities’ health and dignity. His plan would invest in expanding Medicaid home and community-based services to help a larger number of older adults and people with disabilities receive care in their home or community, and promote better opportunities for home care workers and family caregivers. There has been substantial growth amongst the younger population under 65 with disabilities living in nursing homes. The percentage of individuals younger than 65 living in residential nursing facilities grew from 10.6 in 2000 to 16.2 in 2017. The President’s investments will help ensure that they can receive care in their own homes and communities. The President has also proposed substantial investments for family caregivers serving our nation’s heroes, including stipends and support services for family caregivers of eligible veterans.
 
A National Paid Family and Medical Leave Program
 
Many workers with caregiving responsibilities are forced to leave the workforce intermittently or permanently to take care of their loved ones. As of March 2022, only 24% of private sector workers in the United States had access to paid family leave through their employer and only 43% had access to short-term disability insurance through their employer. The President proposes a national, comprehensive paid family and medical leave program, administered by the Social Security Administration (SSA) to ensure that all workers can take time off to care for and bond with a new child; care for a seriously ill loved one; heal from their own serious illness; address circumstances arising from a loved one’s military deployment; or find safety from domestic violence, sexual assault, or stalking; or grieve the death of a loved one.  The vast majority of America’s workers do not have access to employer-provided paid family leave, including 73 percent of private sector workers. Among the lowest-paid workers, who are disproportionately women and workers of color, 94 percent lack access to paid family leave through their employers. Some people’s caregiving responsibilities are so demanding that under the current system they have to give up paid work entirely or retire early to take care of their loved ones.
 
The Biden-Harris Administration’s Historic Actions on Care
 
Since day one of the Administration, President Biden and Vice President Harris have been committed to improving the quality of and access to care while supporting care workers and family caregivers. The President’s American Rescue Plan (ARP) provided an historic $39 billion in child care relief funds to provide relief for child care providers and support for families to afford care. The ARP delivered $37 billion across all 50 states for activities and investments that enhance, expand, and strengthen home and community-based services and $145 million to help the National Family Caregiver Support Program deliver counseling, training, and short-term relief to family and other informal care providers. Moreover, over the past three years, the President has secured close to a 50% increase in federal child care assistance and a $1.5 billion increase in funding for Head Start. And in April 2023, President Biden signed an Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers (Care EO) surrounded by people with disabilities, family caregivers, long-term care workers, early educators, veterans, and aging advocates. The EO was celebrated by leaders from across the country. Over the past year, agencies have made substantial progress implementing the Care EO. For example:  
 

  • The Department of Health and Human Services (HHS), through the Administration for Children & Families (ACF), finalized a rule that will reduce the cost of child care for more than 100,000 low-income working families and make sure that more than 140,000 child care providers are paid more fairly and on-time. It also proposed a rule that would boost Head Start teacher wages by $10,000, on average.
    • For child care providers serving families benefiting from federal child care assistance, HHS, through ACF, adopted a pay floor that will increase child care payments for nearly 47,000 center- and home-based child care providers.
    • HHS, through the Centers for Medicare and Medicaid Services, proposed rules to ensure that home care workers get a bigger share of Medicaid payments; and establish minimum staffing standards in nursing homes receiving Medicare and Medicaid funding.
    • The Department of Defense reduced the amounts that lower-earning Service members pay out of pocket for child care, lowering child care costs for the families of more than 32,000 children aged 0-12 enrolled in installation Child Development Programs. Military Families earning $45,000 would see a 34% decrease in the amount they pay for child care. This also builds on the President’s Executive Order to advance the economic security of military spouses, veterans, caregivers and survivors.
    • The Department of Veterans Affairs launched a pilot program, known as the Virtual Psychotherapy Program for Caregivers, to provide mental health counseling services to family caregivers caring for our nation’s heroes. The program successfully completed its pilot phase and is now a permanent program. Since October 2023, the program has provided over 4,937 psychotherapy sessions to family caregivers.

 
In addition to these actions, federal agencies have taken dozens of others over the past year to improve family caregiving, long-term care, and child care. A full list can be found here.
 
Republican Officials Want to Provide Massive Taxes to the Rich while Making Devastating Cuts to Programs Working Families Count On
 
President Biden is building our economy from the middle out and bottom up—an economy where we invest in all Americans to make sure the middle class has a fair shot and no one gets left behind.
 
House Republicans have a very different economic vision. Under the RSC budget, care would be on the cutting block. Their budget proposal translates to 264,600 fewer child care slots and 253,500 fewer high-quality Head Start slots. These investments are critical to giving children a strong start and making sure that families have the help they need to thrive.
 
Along with damaging cuts to care funding, House Republicans would slash Social Security, Medicare, Medicaid, the Affordable Care Act, the Children’s Health Insurance Program, and other supports that working families count on. House Republicans would make these devastating cuts to pay for another $5.5 trillion in tax cuts skewed to the wealthy and big corporations. Their budget would deliver windfall tax cuts to billionaires and their heirs, eliminate the minimum tax on billion-dollar corporations President Biden signed into law, make it easier for the wealthy and corporations to cheat on their taxes, and preserve policies that encourage corporations to move jobs and profits offshore—all while making it more difficult for families to afford child care and education.
 

FACT SHEET: President Biden Takes New Steps to Lower Prescription Drug and Health Care Costs, Expand Access to Health Care, and Protect Consumers

Because of President Biden, Americans are now protected against receiving surprise medical bills for most emergency care and ambulance services as well as when consumers didn’t know they were getting care from an out-of-network provider – that has eliminated some 1 million “surprise” bills a month. © Karen Rubin/news-photos-features.com

The White House provided this fact sheet detailing actions President Biden has taken, and new actions he is taking to lower prescription drug and health care costs, expand access to health care and protect consumers, even as Republicans voted against giving Medicare the ability to negotiate drug prices and their presumed presidential nominee, Trump, is renewing calls to repeal the Affordable Care Act (Obamacare), which now has enabled a record 21 million to obtain health insurance, 9 million more than when Biden took office, and as he moves to negotiate for a $2000 cap on out-of-pocket prescription drug costs for all, not just Medicare recipients and expand the number of drug prices being negotiated from 10 to as many as 50 a year. –Karen Rubin, [email protected]

President Biden believes that health care is a right, not a privilege, and since day one, he has delivered health care to millions more Americans while also lowering health care costs. The President continues to build on, strengthen, and protect Medicare, Medicaid, and the Affordable Care Act, signing laws such as the American Rescue Plan Act and the Inflation Reduction Act to lower prescription drug costs and health insurance premiums. Thanks to the President’s efforts, more Americans have health insurance than under any other President, and are better protected against surprise medical bills and junk fees. Seniors are already seeing lower prescription drug prices with insulin capped at $35, free vaccines, and out-of-pocket costs for prescription drugs capped at $2,000 starting in 2025.  And the Administration is well on its way to lower the cost of range of drugs as Medicare negotiates over the prices of prescription drugs for the first time ever. The Biden-Harris Administration has also taken steps to make sure consumers aren’t scammed by junk insurance and have better access to mental health care.
 
However, the President is not just resting on these accomplishments.  He’s fighting to deliver even lower costs and better health care to Americans. That’s why the Biden-Harris Administration is acting to lower prescription drug costs, keep health insurance premiums low, expand access to health care, especially mental health care coverage, and continue to protect Americans from getting ripped off. 

Taking on Big Pharma to Deliver Lower Prescription Drug Costs for Seniors and Families

 After decades of opposition, President Biden enacted a law that finally takes on Big Pharma and gives Medicare the power to negotiate drug prices. President Biden’s Inflation Reduction Act will save millions of seniors money on some of the costliest prescription drugs on the market. Meanwhile, Big Pharma also executed over $135 billion in mergers and acquisitions in 2023 alone, while passing the cost to consumers. And eight of the 10 drugs selected for this year’s negotiation program raised their prices in 2024 – after all 10 drugs were already priced three to eight times higher in the United States than in other countries. President Biden knows how the Inflation Reduction Act is delivering for American families, and his Administration will continue the fight to lower health care costs for more Americans. 

  • Announcing that Manufacturers of 10 Drugs Remain at the Negotiating Table. Last month, for the first time in history, Medicare has made offers on the fair price for 10 of the most widely used and expensive drugs. Medicare is no longer taking whatever price for these drugs that the pharmaceutical companies demand. This week CMS announced that manufacturers for all 10 selected drugs are participating in drug price negotiation, with all manufacturers having submitted counteroffers and negotiations continuing.  Later this year, new, negotiated prices for the first 10 prescription drugs selected for the negotiation program will be announced.
     
  • Let Medicare Negotiate Drug Prices for at least 50 Drugs Every Year. Medicare should not be limited to negotiating just 20 drugs per year. Instead, the President is proposing that Medicare be able to negotiate prices for the major drugs that seniors rely on, like those used for treating heart disease, cancer, and diabetes. The Budget cuts federal spending by $200 billion increasing the number of drugs Medicare can select for negotiation and bringing more drugs into the negotiation process sooner, and other reforms.
     
  • Expand Cap on Out-of-Pocket Prescription Drug Costs. When the $2,000 out-of-pocket cap on prescription drugs applies in Medicare in 2025, nearly 19 million seniors and other beneficiaries are projected to save $400 per year on prescription drugs. The President is calling on Congress to expand the $2,000 out-of-pocket cap to all private insurance so that all Americans have the peace of mind that comes with knowing that they won’t have to choose between filling their prescription or putting food on the table.
     
  • Capping Medicare Cost-Sharing at $2 for Common Generic Drugs. Medicare will be launching a new model to limit Medicare Part D cost-sharing for certain generic drugs to $2. As Medicare prepares to launch the model, today HHS published a list of dozens of generic drugs for the model, including drugs like statins to treat high cholesterol, beta-blockers for high blood pressure, and platelet inhibitors to prevent blood clots. In his budget, the President is calling on Congress to limit Medicare cost-sharing to $2 for high-value generic drugs for all Medicare plans.
     
  • Access to Cell & Gene Therapies. In January, HHS announced that sickle cell disease will be the first focus of the Cell and Gene Therapy (CGT) Access Model. Under this model, CMS will negotiate with manufacturers on behalf of state Medicaid programs to increase affordable access to potentially lifesaving and life-changing treatment, and lower health care costs for some of the nation’s most vulnerable populations. Today, CMS is releasing the Request for Applications for drug manufacturers of cell and gene therapies to participate in the model.
     
  • Expand the IRA’s Requirement that Drug Companies Pay Rebates When They Increase Prices Faster than Inflation. Thanks to the IRA, drug manufacturers must now pay rebates to Medicare if their price increases for certain drugs exceed inflation. The President is calling on Congress to require those rebates for commercial drug sales, as well as sales to Medicare. That will save the federal government billions of dollars, further curb prescription drug price inflation, and reduce health insurance premiums for people with private health insurance coverage.

 
Putting High-Quality Health Care Within Reach
 
Today, more Americans have health insurance than under any President. The President’s efforts to lower health insurance premiums have led to record-breaking enrollment in the Affordable Care Act’s Marketplaces, with over 21 million people signing up for coverage – 9 million more than when the President took office. The Biden-Harris Administration isn’t stopping there and is building on this incredible success by:
 

  • Keeping Health Insurance Premiums Low. Thanks to the President’s American Rescue Plan and Inflation Reduction Act, millions of Americans are saving on average $800 a year on premiums. The Biden-Harris Administration is committed to keeping health insurance premiums low, giving families more breathing room and the peace of mind that health insurance brings. To do that, the President is calling on Congress to make the expanded premium tax credits that the Inflation Reduction Act extended permanent. Without Congressional action, millions of Americans will see their health insurance premiums spike by hundreds or thousands of dollars starting in the fall of 2025.
     
  • Closing the Medicaid Coverage Gap. The President continues to call on Congress to provide Medicaid-like coverage to people in the 10 states that have not adopted Medicaid expansion as well as keeping Medicaid expansion enrollees covered.
     
  • Keeping Kids Covered. Investing in our nation’s children is a top priority for the President. Research shows that when children have health insurance, they thrive: they’re healthier, they do better in school, and are more likely to succeed in adulthood. Keeping children covered is the right thing to do, which is why the President wants to make sure that children can never lose coverage due to red tape from birth until they turn age 6, and that families only have to submit Medicaid paperwork once every three years.
     
  • Closing Research Gaps in Women’s Health Research. In November 2023, the President and the First Lady launched the first-ever White House Initiative on Women’s Health Research to fundamentally change how our nation approaches and funds women’s health research. Women make up more than half the population but have been understudied and underrepresented in health research for far too long. As part of the initiative, the President during the State of the Union will call on Congress to make bold, transformational investments in women’s health research. 
     
  • Making Home Care More Available. Thanks to the American Rescue Plan, President Biden delivered $37 billion to all states to expand access to home care and improve the quality of caregiving jobs. The Biden-Harris Administration is taking steps to improve the quality of Medicaid home care services and to make sure home care workers get a bigger share of Medicaid payments for these critical services.  The President remains committed to further improving and expanding Medicaid home care services, and is calling on Congress to do their part to allow the hundreds of thousands of older adults and individuals with disabilities on Medicaid home care waiting list to remain in their homes and stay active in their communities while continuing to improve the quality of jobs for caregivers.
     
  • Ensuring Access to Mental Health Care. Ensuring robust access to mental health care has been a bipartisan priority for almost 15 years, including the enactment of mental health parity requirements which require health plans to cover mental health care benefits at the same levels as physical health care benefits. Yet today, too many Americans still struggle to find and afford the care they need. The President is committed to tackling the mental health crisis in this country, which means making health plans do their part and providing agencies with the needed support to make sure they’re doing so. The Biden-Harris Administration is working to finalize the mental health parity rule, which would close existing loopholes as well as ensure health plans evaluate access to mental health care in their networks, and make changes if it’s found to be inadequate. In addition, the President is calling on Congress to further increase access to mental health care by expanding coverage in Medicare and private insurance, applying the mental health parity requirements to Medicare beneficiaries, and extending Medicare incentive programs to address mental health provider shortages.

Cracking Down on Junk Insurance, Surprise Bills and Fees, and Confusing Health Care Pricing

 
Nothing infuriates the President more than seeing Americans get ripped off. That’s why the Biden-Harris Administration has prioritized implementing surprise billing protections, preventing 1 million Americans from receiving surprise medical bills every single month. The President has also taken steps to prevent Americans from being ripped off by junk insurance that preys on vulnerable citizens by closing loopholes to ensure consumers know what they’re buying and can get the health coverage that best meets their needs. But more can be done to protect consumers, which is why the President intends to:
 

  • Prevent More Surprise Medical Bills. Today, Americans are protected from receiving medical bills for most emergency care and air ambulance services as well as when consumers didn’t know they were getting care from an out-of-network provider despite doing their homework and going to an in-network facility for treatment.  The President wants to further protect consumers by applying surprise billing protections to ground ambulance providers. The last thing people should worry about during an emergency is an unexpected bill for their ambulance ride.
     
  • Crack Down on Junk Insurance. Last year, the Biden-Harris Administration proposed a monumental rule to help millions of Americans access high-quality, affordable health insurance and protect consumers from being discriminated against because of pre-existing conditions. Making sure Americans aren’t scammed into low-quality coverage, and charged more or denied life-saving care is a key priority for the Administration, which is why we are working to finalize proposed rules that limit the availability of junk insurance.

Honoring America’s Commitment to Seniors

The President has always believed that Medicare and Social Security are a promise—a rock-solid guarantee generations of Americans have counted on to be able to retire with dignity and security. The President will reject any efforts to cut the Medicare or Social Security benefits that seniors and people with disabilities have earned and paid into their entire working lives. The Budget honors that ironclad commitment—not only by rejecting benefit cuts, but by embracing reforms and investments that will protect and strengthen both programs. The President is committed to working with Congress to ensure Medicare and Social Security remain strong for their beneficiaries, now and in the future. 

  • Securing Medicare. In his budget, the President is calling on Congress to ensure that high-income individuals contribute their fair share to Medicare and directs revenue from the Net Investment Income Tax into the HI trust fund as was originally intended. In addition, the President has proposed to direct savings from further lowering drug costs into the Medicare trust fund.  If Congress were to heed the President’s call and enact these reforms, it would substantially extend solvency for the Medicare HI Trust Fund, guaranteeing seniors the benefits they have been promised.
     
  • Protects Seniors’ Health and Dignity. As President Biden pledged to do two years ago in the State of the Union, the Biden-Harris Administration is “set[ting] higher standards for nursing homes and make sure your loved ones get the care they deserve and that they expect.” The nursing home industry receives billions of dollars of taxpayer funding each year, but for too long, many facilities have not had the staff required to give residents safe, high-quality care. That is changing. HHS has proposed a new rule establishing a federal floor for nursing home staffing, so that owners cannot cut staffing to unsafe levels simply to turn a profit. This includes a proposal for every facility to have a Registered Nurse on site 24/7, in addition to minimum number of registered nurses and nurse aides to assist with care. Earlier this year, HHS also finalized a rule to increase transparency in nursing home ownership, making it easier for residents and their loved ones to hold facilities accountable. The final rule was just submitted to the Office of Management and Budget for review

Strong Record on Expanding and Strengthening Health Care Nationwide

 The President’s new actions are all in addition to an already impressive track record on fighting for the health care of Americans across the nation. Over the last three years, the President has:

  • Expanded health insurance through the ACA Marketplaces to an additional nine million Americans and helped over one million people in Missouri, North Carolina, Oklahoma, and South Dakota gain Medicaid coverage.
  • Extended postpartum Medicaid coverage to nearly 700,000 women across 44 states and the District of Columbia.
  • Kept children covered continuously in Medicaid and CHIP for a full year.
  • Made it easier for people to enroll in the ACA Marketplaces and Medicaid, including for older adults that are covered by both Medicaid and Medicare.
  • Made critical vaccines free for all Medicare beneficiaries as well as adults enrolled in Medicaid, with seniors on Medicare saving on average $70 in out-of-pockets for vaccines.
  • Lowered maximum out of pocket costs for Americans with employer and ACA coverage by an average of $400.
  • Capped out-of-pocket costs at $35 for a month’s supply of insulin for seniors and people with disabilities on Medicare.

Lowered coinsurance for seniors that took the 47 drugs covered by Medicare Part B that hiked prices faster than inflation in 2023, with some enrollees saving as much as $618 per dose.

FACT SHEET: Dozens of Pharma Companies Raised Prices Faster than Inflation, Triggering Medicare Rebates, While Republicans Work to Insure Giveaways to Big Pharma, Higher Costs for Seniors, Families

President Biden’s Inflation Reduction Act cracks down on Big Pharma price gouging, saving some seniors thousands of dollars per dose of medication. Meanwhile, Congressional Republicans push for giveaways to drug industry

President Biden’s Inflation Reduction Act cracks down on Big Pharma price gouging, saving some seniors thousands of dollars per dose of medication. Meanwhile, Congressional Republicans push for giveaways to drug industry © Karen Rubin/news-photos-features.com

President Biden visited the National Institutes of Health Clinical Center in Washington, D.C. to announce that dozens of pharmaceutical companies will be required to pay rebates to Medicare for outrageous price hikes on prescription drugs that over 750,000 seniors take per year. For the last quarter of 2023, 48 Medicare Part B drugs raised their prices faster than inflation, and some drug companies raised prices of certain medications faster than inflation for every quarter over the last year. President Biden’s Inflation Reduction Act cracks down on this exorbitant price gouging, requiring these companies to pay rebates back to Medicare, saving seniors who take these drugs between $1 and $2,786 per dose on their medication.

President Biden vowed to lower prescription drug costs for seniors and families – and he is delivering on that promise. His Inflation Reduction Act finally allows Medicare to directly negotiate lower prescription drug prices, capped the cost of insulin for Medicare beneficiaries at $35, made recommended adult vaccines free, requires drug companies to pay rebates if they raise prices faster than the rate of inflation, and locked in savings of $800 per year on health insurance for nearly 15 million Americans. While Republicans in Congress fight tooth and nail to repeal the Inflation Reduction Act and put money back in the pockets of Big Pharma, President Biden won’t back down from the fight to lower costs for hardworking Americans and make sure every family has access to affordable health care.

The Biden-Harris Administration announced:

  • The Department of Health and Human Services (HHS) announced a new list of 48 Medicare Part B drugs that raised their prices faster than inflation, and may be subject to inflation rebates in the first quarter of 2024 as a result of the Inflation Reduction Act. President Biden’s prescription drug law cracks down on price gouging from Big Pharma, requiring companies to pay back Medicare if they raise prices on seniors at a higher rate than inflation. Starting in January, some Medicare beneficiaries who take these 48 prescription drugs – including drugs used to treat cancer and fight infections – will have lower coinsurance than what they would have paid otherwise, and their out-of-pocket costs may decrease by $1 to as much as $2,786 per average dose.

Over the last four quarters, 64 drugs in total had prices that increased faster than inflation and may be subject to inflation rebates because of the Inflation Reduction Act. Some drugs, such as Signifor, used to treat an endocrine disorder, raised prices faster than inflation every quarter since the Inflation Reduction Act’s inflation rebate provision went into effect. Some Medicare beneficiaries who take Signifor could save $311 per monthly dose starting January because of the law.
 
The Administration is focused on making sure medications developed with taxpayer funds are available to Americans at reasonable prices. On average, Americans pay 2 to 3 times more than consumers in other developed countries for prescription drugs. Last week, the Administration announced a proposal to put drug companies on notice if products developed using federal funds are not made available to the public on reasonable terms, including based on price. The proposal would promote the federal government’s ability to license a patent — such as those used to create life-saving drugs — to a competitor with the goal of increasing competition and bringing costs down for families.
 
Building off last week’s announcement, today HHS announced that the Administration for Strategic Preparedness and Response (ASPR) is making fair pricing a standard part of contract negotiations for medical products developed or purchased as part of its commitment to obtain best value for the US taxpayer. In September 2023, ASPR finalized a Project NextGen contract agreement for a potentially life-saving COVID-19 treatment being developed by Regeneron stating if the product is commercialized, its list price in the United States will be equal to or less than its retail price in comparable global markets. Since then, ASPR has also included similar language in recent agreements with CastleVax, Codagenix and Gritstone Bio, developers of the first three vaccines selected for development within Project NextGen. These clauses will be in effect if and when a company’s candidate vaccine is selected to move into ASPR-supported Phase 2b trials to evaluate clinical safety and efficacy.These actions are the result of a successful and collaborative approach by ASPR and its industry partners and show HHS’s commitment to keep Americans from paying unfair prices for the care they need.

  • HHS is releasing new data on the ten drugs selected for Medicare Drug Price Negotiation. For Medicare enrollees who take these drugs, their out-of-pocket spending on the 10 drugs selected for negotiation represents, on average, over half of their total Part D out-of-pocket spending. The report shows that total Medicare spending on the 10 drugs more than doubled from 2018 to 2022 – a rate that was 3 times faster than all Part D drugs over the same period. The report also shows that 7 of the 10 drugs selected received direct at least one form of federal support towards their drug development or utilized a federal-funded invention for their development.

After decades and hundreds of billions of dollars spent by Big Pharma to block Medicare from directly negotiating lower prescription drug prices for people with Medicare, President Biden’s Inflation Reduction Act finally got it done. In total in 2022, Medicare Part D beneficiaries paid $3.4 billion in out of pocket costs for the 10 drugs selected for negotiation, and some paid over $6,000 per year for just one of the drugs on the list. Negotiated prices will go into effect for seniors in 2026.
Today’s announcements build off the actions the Administration has already taken to lower prescription drug costs for millions of seniors and families because of President Biden’s Inflation Reduction Act. In 2023 alone:

  • The Inflation Reduction Act saved nearly 15 million Americans an average of $800 in 2023 because of health insurance savings the law locked in.
    • The Inflation Reduction Act capped the cost of insulin at $35 per covered insulin product for Medicare beneficiaries, saving an estimated 1.5 million seniors on Medicare $500 on average in 2023 on insulin costs. 
       
    • The Inflation Reduction Act made recommended vaccines – like the shingles vaccine – free for the 50.5 million seniors with Medicare Part D, and made recommended, approved adult vaccines free for all adults in the Children’s Health Insurance Program, and nearly all full-benefit adults enrolled in traditional Medicaid. Seniors on Medicare who received a Part D vaccine saved an average of $70 on vaccines in 2023.
       
    • The Inflation Reduction Act saved many seniors on Medicare as much as $618 per average dose on 47 prescription drugs in 2023 because of the law’s provision requiring drug companies to pay rebates on certain drugs if they raise prices for those drugs faster than the rate of inflation. Starting in 2024, some seniors who take 48 prescription drugs could see savings of as much as $2,786 per average dose because those 48 drugs raised their prices faster than inflation in the last quarter of 2023.

In the coming months and years, the Inflation Reduction Act will continue to deliver cost-savings to millions of Americans, including:

  • In 2024, Part D enrollees will no longer pay 5% co-insurance when they reach the catastrophic phase of their benefit – meaning that some beneficiaries’ prescription drug costs will be capped at about $3,500 next year.
    • When the $2,000 out-of-pocket cap on prescription drugs applies in 2025, nearly 19 million seniors and other beneficiaries are projected to save $400 per year on prescription drugs. 1.9 million enrollees with the highest drug costs will save an average of $2,500 per year because of this provision of the Inflation Reduction Act.
       

Millions of seniors could save money when negotiated prices of the first group of drugs selected for the Inflation Reduction Act’s Medicare Price Negotiation program are scheduled to go into effect in 2026. In 2022, seniors spent $3.4 billion in out-of-pocket costs on the first ten drugs selected for negotiation – used to treat common conditions like diabetes, Crohn’s disease, arthritis, blood clots and more. A report released last week shows that had the Medicare price negotiation program been in effect in 2021, Part D out of pocket costs would have declined 23% for people taking the ten costliest drugs at the time.

The Congressional Republican Agenda on Prescription Drugs: Giveaways to Big Pharma and Higher Costs for Seniors and Families


While President Biden has taken historic action to reduce prescription drug costs for seniors and for working-age people who get health insurance through their jobs, Congressional Republicans are actively fighting to roll back the reforms the President signed into law and to keep Big Pharma’s taxes low.
 
Congressional Republicans’ agenda for Big Pharma giveaways includes:
 
Repealing prescription drug inflation rebates. The Inflation Reduction Act (IRA) cuts costs for Medicare and seniors by requiring pharmaceutical companies to pay a rebate to Medicare if they increase prices faster than inflation. Dozens of Republicans have signed onto legislation that would revoke the rebate requirement.
 
By 2031, repealing this provision would:

  • Cost seniors $5 billion per year.
  • Increase federal deficits by $7 billion per year.
  • Give away over $10 billion per year to pharmaceutical companies.

Taking away Medicare’s ability to negotiate prescription drug prices. The IRA finally gave Medicare the authority to directly negotiate with drug companies on the high prices they charge for prescription drugs. Republican Chairs and Ranking Members of the committees with jurisdiction over Medicare have publicly committed to repealing this authority, which would allow Big Pharma to go back to charging seniors exorbitant prices for life-saving drugs.
 
By 2031, repealing this provision would:

  • Cost seniors $7 billion per year.
  • Increase federal deficits by $14 billion per year.
  • Give away over $20 billion to pharmaceutical companies per year.

Opposing caps on insulin prices. Monthly insulin costs for Medicare beneficiaries are now capped at $35—providing certainty and critical cost savings for seniors who in some cases were paying as much as $400 for a month’s supply of insulin. The Republican Study Committee budget, as well as the House Budget Committee-passed budget plan, propose to repeal this and other IRA drug price reforms.  
 
Repealing this provision would mean the 1.5 million Medicare beneficiaries who use insulin could see their annual costs rise by an average of $500.
 
Protecting Big Pharma’s ability to avoid paying taxes. President Biden negotiated a historic agreement with over 130 countries that would enable the U.S. and its partners to ensure Big Pharma and other multinationals pay at least a minimum tax rate and has proposed that the U.S. implement that agreement with a 21% minimum tax rate on multinationals. Congressional Republicans are not only blocking the U.S. from implementing the global minimum tax agreement and vowing to never raise taxes on Big Pharma and other multinationals by implementing it, they also traveled to Europe this summer to try to persuade other countries to withdraw from the global agreement and keep taxes low for Big Pharma and other multinationals.
 
Blocking implementation of the President’s international tax reform proposals means:

  • Protecting a system in which Big Pharma can lower its taxes to under 12% by shifting profits offshore.

The U.S. would lose out on hundreds of billions in savings from adopting the President’s proposals to implement the international agreement. Based on a PhRMA-funded analysis, nearly $100 billion of the savings – or almost one-fifth of the total revenue – from implementing the President’s 21% minimum tax proposal would come from cracking down on pharmaceutical industry tax avoidance

FACT SHEET: Biden Administration Launches Office of Pandemic Preparedness and Response Policy

More than one million Americans died of COVID, millions more are suffering long-COVID; it is estimated that 70 percent died needlessly, avoidably, while Biden’s swift actions to set up a comprehensive vaccination-delivery program (free tests, free masks, free vaccinations), saved 2 million lives. As part of President Biden’s commitment to ensure that our country is more prepared for a pandemic than we were when he took office, the Administration is standing up the Office of Pandemic Preparedness and Response Policy (OPPR). This will be a permanent office in the Executive Office of the President (EOP) charged with leading, coordinating, and implementing actions related to preparedness for, and response to, known and unknown biological threats or pathogens that could lead to a pandemic or to significant public health-related disruptions in the United States. © Karen Rubin/news-photos-features.com

A valid concern Americans should hold is that public health has been so politicized, so weaponized that leaders on all levels of government – federal, state, and local  – who are responsible for the welfare of their constituents, along with the weakening of their ability to take action to protect public health by the radical rightwing extremist judiciary put into place by McConnell and Trump, that we will not be informed when there is a new threat, that they will take action to quarantine, mandate masks and vaccinations to prevent hospital systems from being overwhelmed, and certainly, that concern that there won’t be the resources, the expertise, the means, infrastructure or the fortitude to protect us from the next pandemic. And the next pandemic is certain to take place, not in 100 years, but pushed forward by the changes to the ecosystem because of human-caused climate change.

More than one million died of COVID, millions more are suffering long-COVID; it is estimated that 70 percent died needlessly, avoidably, while Biden’s swift actions to set up a comprehensive vaccination-delivery program (free tests, free masks, free vaccinations), saved 2 million lives. With this in mind, the Biden-Harris Administration is taking steps, setting up the mechanisms to obtain vaccines, treatments and tests – while Florida Governor and presidential wannabe Ron DeSantis has actually made it illegal for Floridians to have a public response to a pandemic and Congressional Republicans show no interest whatsoever in allocating the funds to save lives. (Trump had dismantled the pandemic response infrastructure set up by the Obama Administration. Here is a fact sheet form the White House on its launch of Office of Pandemic Preparedness and Response Policy: –Karen Rubin/news-photos-features.com

The Biden-Harris Administration has made historic progress on our nation’s ability to manage COVID-19 so that it no longer meaningfully disrupts the way we live our lives. Under President Biden’s leadership, the Administration has taken significant steps to ensure all individuals have continued access to lifesaving protections such as vaccines, treatments, and tests, and that the nation is well prepared to manage the risks of COVID-19 or other causes of potential pandemics in the future.
 
As part of the President’s commitment to ensure that our country is more prepared for a pandemic than we were when he took office, the Administration is standing up the Office of Pandemic Preparedness and Response Policy (OPPR). This will be a permanent office in the Executive Office of the President (EOP) charged with leading, coordinating, and implementing actions related to preparedness for, and response to, known and unknown biological threats or pathogens that could lead to a pandemic or to significant public health-related disruptions in the United States. OPPR will take over the duties of the current COVID-19 Response Team and Mpox Team at the White House and will continue to coordinate and develop policies and priorities related to pandemic preparedness and response.
 
To lead this work, the President announced that Major General (ret) Paul Friedrichs will serve as the inaugural Director of OPPR and Principal Advisor on Pandemic Preparedness and Response as of August 7, 2023.  Maj. Gen. (ret) Friedrichs’ unparalleled experience makes him the right person to lead this office. He is currently Special Assistant to the President and Senior Director for Global Health Security and Biodefense at the National Security Council (NSC). Maj. Gen. (ret) Friedrichs previously served as Joint Staff Surgeon at the Pentagon, where he coordinated all issues related to health services, provided medical advice to the Chairman of the Joint Chiefs of Staff and served as medical adviser to the Department of Defense (DoD) Covid-19 Task Force. 
 
The Office of Pandemic Preparedness and Response Policy will:
 
Coordinate the Administration’s domestic response to public health threats that have pandemic potential, or may cause significant disruption, and strengthen domestic pandemic preparedness. This includes ongoing work to address potential public health outbreaks and threats from COVID-19, Mpox, polio, avian and human influenza, and RSV.
 
Drive and coordinate federal science and technology efforts related to pandemic preparedness. Specifically, OPPR will oversee efforts to develop, manufacture, and procure the next generation of medical countermeasures, including leveraging emerging technologies and working with HHS on next generation vaccines and treatments for COVID-19 and other public health threats. During the height of the pandemic, the Biden-Harris Administration made historic investments in COVID-19 vaccines, tests, and treatments that were made widely available. OPPR will continue to leverage these investments as it drives future progress in combatting COVID-19 and other public health threats.
 
Develop and provide periodic reports to Congress. As required by statute, OPPR will develop and provide to Congress a biennial Preparedness Review and Report and Preparedness Outlook Report every five years.
 
Major General (ret) Paul Friedrichs, Inaugural Director of OPPR and Principal Advisor on Pandemic Preparedness and Response
 
Major General Friedrichs is currently Special Assistant to the President and Senior Director for Global Health Security and Biodefense at the National Security Council (NSC). Prior to joining the NSC, Dr. Friedrichs most recently served as the Joint Staff Surgeon and the medical advisor to the Department of Defense (DoD) COVID-19 Task Force. Throughout his career he has worked closely with Federal, State, Tribal, local, and territorial government partners, as well as industry and academic counterparts and has been active in multiple professional medical societies. Dr. Friedrichs has also overseen the DoD global patient evacuation system, supporting global medical care and numerous interagency domestic and global disaster responses. He led the DoD Task Force which developed plans to implement high reliability medical principles across DoD and stood up the Air Force’s first medical analytics capabilities. Over the course of his 37-year career, he has led military hospitals and regional and global health care systems, published multiple medical papers, and consistently sought opportunities to partner with colleagues to improve health care delivery and preparedness. As the United States’ representative to the North Atlantic Treaty Organization Committee of Military Medical Chiefs, he worked closely with many of America’s closest allies and partners throughout the pandemic and in developing medical support to the Ukrainian military.
 
Dr. Friedrichs is a board-certified physician who has cared for hundreds of patients in combat and managed broad domestic and global public health threats. He has spent all of his career in public service, having first received his commission through Reserve Officer Training Corps in 1986 and rising to Major General in 2023.

FACT SHEET: Biden Announces Plan to Expand Health Coverage, Support to DACA Recipients

This fact sheet on President Biden’s plan to expand health coverage and other support to DACA recipients was provided by the White House:

In 2012, President Obama and then Vice President Biden announced the Deferred Action for Childhood Arrivals (DACA) program to allow young people to live and work in the only country they know as home.  Over the last decade, DACA has brought stability, possibility, and progress to more than 800,000 Dreamers. 
 
President Biden believes that DACA recipients strengthen our economy and enrich our workplaces, our schools and communities, and our country as a whole. That’s why on his first day in office, he called on Congress to give Dreamers a pathway to citizenship and he has repeated that call every State of the Union address since. While Congress has failed to act, the Biden-Harris Administration has taken significant measures to protect Dreamers. This includes, issuing regulations by the Department of Homeland Security to “preserve and fortify” DACA and fighting political opponents in court as they attempt to strip them of the only home they have ever known.
 
The Biden-Harris Administration is committed to providing Dreamers the opportunities and support they need succeed. President Biden is announcing  a plan to expand health coverage for DACA recipients. The Department of Health and Human Services will shortly propose a rule amending the definition of “lawful presence,” for purposes of Medicaid and Affordable Care Act coverage, to include DACA recipients. We recognize that every day counts, and we expect to get this done by the end of the month. If finalized, the rule will make DACA recipients eligible for these programs for the first time.  Under the proposed rule, DACA recipients will be able to apply for coverage through the Health Insurance Marketplace, where they may qualify for financial assistance based on income, and through their state Medicaid agency.  Like all other enrollees, eligibility information will be verified electronically when individuals apply for coverage.
 
President Biden and Vice President Harris believe that health care should be a right, not a privilege. Together, they promised to protect and strengthen the ACA and Medicaid, lowering costs and expanding coverage so that every American has the peace of mind that health insurance brings.  The President’s announcement gives DACA recipients that same opportunity, as the Administration continues to urge Congress to provide a pathway to citizenship to Dreamers, providing them the ultimate peace of mind they need and deserve.  
 
While we wait for Congress to act, and although there are some restrictions on the availability of benefits for DACA recipients, DACA recipients should take note of the numerous Federal programs, opportunities, and resources that have been and continue to be available to them:

Experiential Learning, National Service, and Employment Opportunities:

  • AmeriCorps VISTA Program. DACA recipients are eligible to serve in the AmeriCorps VISTA program, which provides participants with an opportunity to assist local organizations in alleviating poverty. Participants serve in a full-time position for one year and earn related benefits such as a living allowance, professional development and training, and a cash stipend.[1] Find a VISTA service opportunity here.
     
  • Outdoor Programs. DACA recipients have access to a range of outdoor programming, environmental education, and volunteer service programs in their communities and across the country. These include Every Kid Outdoors, the Scout Ranger Program, and the Healthy Parks, Healthy People program as well as the YMCA-National Parks Service partnership, including the Bringing Youth Outdoors Together Summer Camp Program.
     
  • American Job Centers. DACA recipients with work authorization can access many programs within American Job Centers, which help job seekers obtain employment and training to further their careers. American Job Centers provide counseling, skill and ability assessments, and advice on in-demand jobs and potential training opportunities. Locate an American Job Center here.
     
  • Job Corps. DACA recipients with work authorization may qualify for Job Corps, a no-cost education and vocational training program administered by the U.S. Department of Labor, which helps individuals ages 16-24 improve the quality of their lives by empowering them to secure good jobs and become independent. Job Corps students have access to room and board while they learn skills in specific training areas. Learn more about Job Corps here.
     
  • YouthBuild. DACA recipients with work authorization may qualify for YouthBuild, a pre-apprenticeship program for certain individuals ages 16-24. At YouthBuild’s 275 locations across the country, participants learn vocational skills in construction and other in-demand industries—including health care, information technology, and hospitality—while also earning their high school or equivalent degree, preparing them for opportunities such as college, Registered Apprenticeships, and employment. Information on YouthBuild is here.
     
  • National Farmworker Jobs Program. DACA recipients with work authorization who are engaged in agricultural work may benefit from the National Farmworker Jobs Program (NFJP), which offers services for migrant and seasonal farmworkers and certain family members within the network of American Job Centers. Career Services and Training grants can help farmworkers gain skills, advance in agricultural jobs, or find employment in new industries. Housing grants assist farmworkers in finding safe and sanitary permanent or temporary housing. Access NFJP resources here.
     
  • ARP Good Jobs Challenge. The Economic Development Administration’s American Rescue Plan: Good Jobs Challenge within the U.S. Department of Commerce is an investment in high-quality, locally led workforce systems to expand career opportunities and good-paying jobs for American workers, including DACA recipients, to achieve economic mobility and security. Awards under the Good Jobs Challenge have been granted to diverse worker-centered training partnerships and systems across the country spanning 31 states and Puerto Rico. The program also focuses on removing systemic barriers to employment through support services such as childcare, transportation, and paid on-the-job training opportunities. Access Good Job Challenge resources here.
     
  • Dept. of Education Resources. The Department of Education has a Resource Guide for schools, colleges, and teachers to support the to support the educational and career success of DACA recipients in secondary and postsecondary education, as well as comprehensive educational resources for DACA students available here.

Assistance with Renting or Purchasing a Home:

  • FHA Financing. DACA recipients are eligible to apply for Federal Housing Administration (FHA) insured financing for FHA Title II Single Family forward mortgage programs. FHA programs insure private loans made by FHA-approved lenders and FHA-backed loans can help reduce down payments for a home or condominium.
     
  • Housing, Rental, and Credit Counseling Services. DACA recipients can receive free or low-cost advice on buying a home, renting, preventing default, avoiding mortgage default and foreclosure, transitioning from homelessness, budgeting or through HUD-approved housing counseling agencies. Locate a HUD-approved housing counseling agency here or by calling 800-569-4287. Services are available in many languages, including Spanish, Korean, Portuguese, and Mandarin Chinese.

Tax Credits, Financial Education and Consumer Protection:

  • Tax Credits. DACA recipients may be eligible for tax credits, including the Child Tax CreditEarned Income Tax Credit, and other child care, and education tax credits. The Internal Revenue Service (IRS) also provides in-depth tax information for immigrants including an immigrant tax guide, and a residency and tax law overview.
     
  • CFPB Resources. The Consumer Financial Protection Bureau (CFPB) provides detailed, targeted consumer tools, financial education resources in ArabicChineseKoreanRussianSpanishTagalog,  Vietnamese, and plain language publications to assist all individuals, including DACA recipients, in making informed financial decisions. CFPB can help answer hundreds of financial questions including questions on loans, credit, bank accounts, debt collection, and more.
     
  • Consumer Complaints. Consumers, regardless of immigration status, may submit a complaint through CFPB about financial products and services offered by companies, including checking and savings accounts, credit cards, debt collection and settlement, money transfers, virtual currency and more. Most companies respond within 15 days. Complaints can be submitted online or by phone and interpreting services are available by phone in 180 languages.
     
  • CFPB Immigrant Initiative. CFPB recently-launched an engagement and policy initiative aimed at using the Bureau’s tools and authorities to support immigrant families in accessing opportunities to build wealth and contribute to their communities. If you or your family have an experience to share about financial barriers faced by immigrants, please share your story.
  • FTC Consumer Alerts. All individuals can monitor current and past consumer scams through the Federal Trade Commission’s Consumer Alerts system. Sign up here to receive alerts about the latest scams FTC has identified.

Health and Well-Being:

  • HRSA Health Centers. DACA recipients can access health care through Health Resources & Services Administration (HRSA) Health Centers, which provide affordable, accessible, quality primary health care to patients regardless of ability to pay, insurance status, or immigration status. HRSA Health Centers are located in every state, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and the Pacific Basin. Locate a Health Center here.
     
  • Emergency Medicaid. DACA recipients may be eligible for emergency Medicaid. Emergency Medicaid pays for emergency medical treatment for people who meet Medicaid eligibility requirements in their state, but do not meet Medicaid’s citizenship and immigration status requirements
     
  • Public Health Programs. DACA recipients can also access public health programs that provide certain immunizations or treatment of communicable diseases.
     
  • Pregnancy and Breastfeeding SupportMotherToBaby, a program funded by HRSA, provides expert, confidential, and no-cost information about the impact of medications, drugs, or other exposures during pregnancy and breastfeeding. DACA recipients and their families can access these services, which are provided in English and Spanish, through the organization’s website, by calling 866-626-6847, or texting 855-999-3525.
     
  • Maternal Mental Health Support. The National Maternal Mental Health Hotline (1-833-943-5746) provides free, confidential, 24/7 emotional support, resources, and counseling referrals to pregnant and postpartum individuals facing mental health challenges, and their loved ones. Support is available over the phone and text in English and Spanish. Interpreter services are available in 60 additional languages and a relay service is available for people who are deaf or hard-of-hearing.
     
  • Special Health NeedsFamily-to-Family Health Information Centers (F2F HICs) are located in all 50 States and U.S. territories and provide support, information, resources, and training for families of children and youth with special health care needs, including on specific health issues, family-centered care, and shared decision making (SDM). Find an F2F center in your area here.
     
  • Nutrition Assistance. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides pregnant, postpartum and breastfeeding individuals, as well as infants and children under 5, with food, nutrition and breastfeeding education, and referrals to health and social services. Eligibility is determined by categorical, residential, income, and nutrition risk requirements. Learn how to apply for WIC here or by calling a state, toll-free number found here.

Military Veterans and Active-Duty Servicemember Resources:

  • Veterans Benefits.  The Department of Veterans Affairs provides benefits and other assistance to all eligible Veterans regardless of their immigration status. More information for Veterans, their families, caregivers, and survivors is available here or can be accessed by calling 1-800-MyVA411 (1800-698-2411) which is available 24 hours a day, 365 days a year.
  • Free Legal Assistance. All active-duty military personnel and their dependents, as well as certain Reserve and National Guard Soldiers and retirees, are eligible for free legal assistance, including immigration and naturalization legal services. More information on Air Force Legal Assistance is available here, Army Legal Assistance here, Navy and Marine Legal Services here, and Coast Guard Legal Services here.

FACT SHEET: New Data Show 8.2 Million Fewer Americans Struggling with Medical Debt Under Biden Administration

The Consumer Financial Protection Bureau (CFPB) released a new report that shows that the number of Americans with medical debt on their credit reports fell by 8.2 million from the first quarter of 2020 to the first quarter of 2022 © Karen Rubin/news-photos-features.com

The Administration’s work to strengthen the Affordable Care Act along with new consumer protections lead to continued progress reducing the burden of medical debt.. This fact sheet is provided by the White House:

The Consumer Financial Protection Bureau (CFPB) released a new report that shows that the number of Americans with medical debt on their credit reports fell by 8.2 million from the first quarter of 2020 to the first quarter of 2022. Today’s report is consistent with a recent report from the Centers for Disease Control and Prevention (CDC) that found that the number of Americans who are part of families having trouble paying their medical bills declined by 5.5 million between 2020 and 2021. One driver of these declines is the significant increase in the number of insured Americans over this period, a result of the President’s strategy of protecting and strengthening the Affordable Care Act (ACA) and lowering health care costs. The decline also reflects continued actions by the CFPB to highlight problems with inaccurate reporting of debt in collections and put the industry on notice to correct their behavior.

The new data also underscore the importance of the Biden-Harris Administration’s government-wide initiative to reduce the burden of medical debt. Following the Vice President’s April 2022 announcement, medical debt was directly relieved for many low-income Americans. And, informed by research showing that medical debt is not a reliable predictor of financial health, federal agencies are working to eliminate the use of medical debt to assess creditworthiness for participation in government lending programs. Specifically:  

  • The Department of Veterans Affairs (VA) implemented a streamlined process to make it easier and faster for lower-income veterans to get their VA medical debt forgiven. The new process – establishing simple criteria to qualify for debt relief and launching a new online debt relief portal – has already provided relief to over 10,000 veterans and saved them more than $10 million in copay debt.
  • Communities across the country – from Cook County, Illinois, to Toledo, Ohio, to New Orleans, Louisiana, to Pittsburgh, Pennsylvania – are using or have passed legislation to use about $16 million American Rescue Plan (ARP) funding to purchase medical debt from hospitals and other sources and forgive it, wiping out nearly $1.5 billion in medical debt, a ratio of nearly 100-to-1. Other localities and states have proposed to make similar purchases using ARP funding.
  • The Federal Housing Finance Agency (FHFA) validated and approved the use of VantageScore 4.0, along with FICO 10T, for the underwriting of mortgages by Fannie Mae and Freddie Mac. The addition of VantageScore 4.0, which excludes medical debt entirely, marks the first time that a credit score that excludes medical debt has been approved for mortgage underwriting of Enterprise loans.
  • The Small Business Administration (SBA) will take a number of steps to reduce the role of medical debt in the underwriting of loans for its 7(a) guaranteed loan program, including revising its lender Standard Operating Procedures to discourage consideration of medical debt and making technology investments in Lender Match to help borrowers find lenders that exclude medical debt in their credit decisions.

These reductions in medical debt will provide real benefits to many Americans. Reducing medical debt directly impacts household finances by improving credit scores and access to credit. And research shows that households that have their medical debt relieved see improvements in access to medical care, and in physical and mental health outcomes. Since medical debt is disproportionally held among low-income communities, reductions in the burden of medical debt helps advance financial and health equity.
 
The CFPB report also shows that medical debt still accounts for more than 50% of debt in collections tradelines, exceeding the number of debt in collections tradelines from all other sources combined, including credit cards, personal loans, utilities, and phone bills. Getting sick or taking care of loved ones should not mean financial hardship for American families. That is why the Administration has—and will continue—to take action to ease the burden of medical debt and protect consumers from predatory collection practices.
 
Supporting Veterans in Financial Hardship
 
In Spring 2022, VA committed to make it easier and faster for lower-income veterans to get their VA medical debt forgiven. Previously, veterans in financial hardship who needed medical debt relief for VA copayments had to fill out a complex, paper form and navigate complicated eligibility requirements. The application process was confusing, and time-consuming, and as a result, veterans may have been deterred from applying for much needed relief.
 
Since the spring 2022 announcement:

  • VA streamlined the application process, including establishing a simple, standardized criteria to qualify for debt relief and launching a new online debt relief portal to make it easier and faster to apply.
  • Since introducing the new criteria, VA has approved over 93% of debt relief requests, and 42% of relief requests are now submitted via the online portal.  
  • To date, the new streamlined system has provided relief to over 10,000 veterans and saved them more than $10 million combined in unpayable copay debt.

Helping Communities Wipe Out Medical Debt
 
To help relieve the burden of medical debt on their residents as part of the recovery from the COVD-19 pandemic, communities across the country are using American Rescue Plan (ARP) funding to support efforts to buy and forgive medical debt. These communities work with partners to purchase medical debt portfolios from hospitals, health systems, and debt collection agencies and forgive the debt. Because medical debts are often available for purchase at pennies on the dollar, these efforts can translate into massive reductions in medical debt.
 
In the programs implemented to date, individuals qualify if they are residents of the given locality and have incomes below a certain threshold or have medical debt in excess of 5% of their annual household income. Individuals whose debt is cancelled are notified by mail and do not need to apply. Communities that have used ARP funds to forgive medical debt include:

  • Cook County, Illinois. In July 2022, Cook County announced the use of $12 million in ARP funds to purchase and forgive up to $1 billion in medical debt. The program has already wiped out the medical debts of 45,000 people worth $26 million.
  • Toledo and Lucas County, Ohio. In November 2022, the Toledo City Council and Lucas County approved a cumulative $1.6 million in ARP funds to buy out medical debt of certain residents. In total, the localities expected that this purchase will wipe out approximately $240 million in debt.
  • New Orleans, Louisiana. In December 2022, the New Orleans City Council included in its annual budget a $1.3 million line item leveraging ARP funds to relieve up to an estimated $130 million in medical debt.
  • Pittsburgh, Pennsylvania. In January 2023, the Pittsburgh City Council approved a plan to use $1 million in ARP funds to eliminate up to an estimated $115 million medical debts for about 24,000 residents.

Taken together, these investments of about $16 million in ARP funding are expected to relieve up to nearly $1.5 billion in medical debt, a ratio of nearly 100-to-1, helping to mend household finances, improve mental health, and remove a barrier to accessing health care. Additional states and cities across the country are also considering using ARP funds to eliminate medical debt including most recently the state of Connecticut, where the governor proposed using $20 million in ARP funds to wipe out debts of about  $2 billion.   
 
Removing Medical Debt from Government Underwriting
 
Research shows that medical debt is not a reliable predictor of overall financial health – predominately reflecting inequities in health insurance coverage and the bad luck of a hospitalization or other medical event. A CFPB report found that including medical debt in credit scores understates consumers’ creditworthiness by 10 points, and including already paid medical debt understates consumers’ creditworthiness by as much as 22 points. This means that the use of medical debt in underwriting can cut off American’s access to credit without improving the accuracy and predictiveness of lending programs.
 
Informed by this research, the Biden-Harris Administration instructed all agencies to eliminate medical debt as a factor in underwriting of credit programs, whenever possible and consistent with law. Since then:

  • In October 2022, the Federal Housing Finance Agency (FHFA) validated and approved the use of VantageScore 4.0 and FICO 10T for the underwriting of mortgages by Fannie Mae and Freddie Mac. VantageScore 4.0 excludes medical debt entirely, and marks the first time that a credit score that excludes medical debt has been approved for mortgage underwriting of Enterprise loans.  Moreover, the national credit reporting agencies announced several changes affecting the reporting of medical debt in collections – including that paid medical collection debt would no longer be included on consumer credit reports, an extension of timing for reporting of unpaid medical collection debt from six to twelve months, and a minimum $500 threshold for medical collection debt reporting – meaning that the role of medical debt in FICO 10T will also be reduced. The Enterprises’ automated underwriting systems do not consider medical debt in collections.
  • The Small Business Administration (SBA) will be taking a number of steps to reduce the role of medical debt in the underwriting of loans in the 7a guaranteed loan program.  These steps include revising its Standard Operating Procedures to discourage lenders from considering medical debt and making technology investments in Lender Match to help borrowers find lenders that exclude medical debt from their credit decisions and empower such lenders to underwrite those loans via automated data compilation.
  • In February 2022, VA published a final rule under which it virtually ceased reporting medical debt, and other unfavorable debt, to the credit bureaus. This rule ensures that debt reported better reflects creditworthiness, while saving veterans from further financial struggles simply because they had to take on medical debt. VA is committed to mitigating the burden of medical debt in its Home Loan guarantee program and in the coming months will work with lenders and servicers to discuss how to best maximize the flexibility of their underwriting guidelines related to medical debt collections while monitoring investor reactions and access to capital for VA guaranteed loans

New Data on Medical Debt in Collections
 
The report from the CFPB documents trends in medical debt in collections that are listed on credit reports, with the data extending through the first quarter of 2022. Key findings include:

  • Between the first quarter of 2020 and the first quarter of 2022, the number of Americans with medical debt on their credit report fell by 8.2 million, a 17.9% reduction.
  • Medical debt in collections accounts for 57% of collections tradelines, exceeding the total number of collections tradelines from all other sources combined, including credit cards, personal loans, utilities, and phone bills.

One driver of this decline in medical debt is the expansion of health insurance coverage during the Biden-Harris Administration. In the first quarter of 2022, the uninsured rate hit an all-time low of 8.0%, with 4.2 million people gaining coverage between 2020 and the first half of 2022. This milestone does not yet not capture the impact of the most recent increase in Marketplace enrollment, with a record 16.3 million Americans signing up on HealthCare.gov and the state-based Marketplaces during the 2023 Open Enrollment Period. This includes 3.6 million people who are new to the Marketplaces for 2023. Since President Biden took office, the number of people who have signed up for an affordable health care plan through HealthCare.gov has increased by nearly 50%. The Biden-Harris Administration continues to work to create a more fair and transparent health care system for consumers, including by protecting millions of consumers from surprise medical bills through its implementation of the No Surprises Act—preventing about 1 million surprise bills per month—and by advancing hospital price transparency so patients know the upfront price of hospital services.
 
The declines in medical debt also reflect continued actions by the CFPB to highlight problems with inaccurate reporting of debt in collections and put the industry on notice to correct their behavior.
 
The declines in medical debt on credit reports do not yet capture any effects of the Spring 2022 announcement where the three largest credit reporting agencies—Equifax, Experian, and Transunion—stated that they will no longer include certain forms of medical debt on credit reports, including all debts under $500, starting in 2023. While not shown in these data, CFPB estimates these changes will likely result in further reductions in medical debt appearing on credit reports.  
 
The decline in medical debt in collection represents one part of a broader decrease in the financial burden from medical bills during the Biden-Harris Administration. The CFPB report focuses on medical debt reported to credit bureaus, and does not capture medical debt that is placed on credit cards (including hospital credit cards) or paid for with personal loans or hospital payment plans.  However, a CDC report released last month showed that between 2020 and 2021, the number of people in families having problems paying medical bills declined by 5.5 million people, indicating that American families are indeed experiencing across-the-board relief.
 
These findings represent real progress in providing breathing room for American families. At the same time, too many Americans still face crushing burdens from medical debt. The Biden-Harris Administration will continue to fight to ensure that Americans who are sick or are caring for sick loved ones are not hit with a double whammy of illness and medical debt. This includes continuing to help Americans sign up for health insurance; calling on Congress to make permanent the lower premiums for people buying ACA coverage and to close the Medicaid coverage gap; and continuing to reduce the burden of medical debt via sweeping actions by government agencies.

Record 16.3 Million Signed Up for Obamacare

Affordable Care Act – Obamacare – gives access to affordable health insurance for individuals. The Biden Administration reported a record 16.3 million people signed up for Obamacare in the last open enrollment period, a nearly 50 percent increase in HealthCare.gov signups since President Biden took office; 3.6 million people signed up for health care coverage through the marketplaces for the first time. (c) Karen Rubin/news-photos-features.com

Nearly 50% increase in HealthCare.gov signups since President Biden took office, and 3.6 million people signed up for health care coverage on the Marketplaces for the first time this year

The White House provided this detail about a record 16.3 million people signing up for Obamacare in the just-concluded open enrollment season,  a nearly 50% increase in HealthCare.gov signups since President Biden took office, and 3.6 million people signed up for health care coverage on the Marketplaces for the first time this year

The Biden-Harris Administration announced that a record-breaking 16.3 million people have selected an Affordable Care Act (ACA) Marketplace health plan nationwide during the 2023 Marketplace Open Enrollment Period (OEP) that ran from November 1, 2022-January 15, 2023 for most Marketplaces. President Biden promised to strengthen and build on the Affordable Care Act, and this year, the 10th year of ACA Open Enrollment, more Americans signed up for high-quality, affordable health insurance through the ACA Marketplaces than ever before. Since President Biden took office, the number of people who have signed up for an affordable health care plan through HealthCare.gov has increased by nearly 50%. Because of the President’s plan, millions of working families saved an average of $800 on their health insurance premiums last year.
 
Total plan selections include 3.6 million people (22% of total) who are new to the Marketplaces for 2023, and 12.7 million people (78% of total) who had active 2022 coverage and made a plan selection for 2023 coverage or were automatically re-enrolled. Over 1.8 million more people have signed up for health insurance, or a 13% increase, from this time last year. The 3.6 million plan selections from people who are new to the Marketplaces represent a 21% increase in new-to-Marketplace plan selections over last year.
 
“Unprecedented investments lead to unprecedented results,” said HHS Secretary Xavier Becerra. “Thanks to President Biden’s leadership, more than 16 million Americans have health insurance through the Affordable Care Act Marketplaces – an all-time high. The Biden-Harris Administration has made lowering health care costs and expanding access to health insurance a top priority – and these record-breaking numbers show we are delivering results for the American people. We will keep doing everything we can to ensure more people have the peace of mind that comes with high-quality, affordable health care.”
 
“President Biden promised to build on the success of the Affordable Care Act and make it easier for people to enroll and find affordable, quality coverage – and that promise has been kept,” said CMS Administrator Chiquita Brooks-LaSure. “On the tenth anniversary of the ACA Marketplaces, the numbers speak for themselves: more people signed up for plans this year than ever before, and the uninsured rate is at an all-time low.”
 
The Biden-Harris Administration has made expanding access to health insurance and lowering health care costs for America’s families a top priority, and under their leadership, the national uninsured rate reached an all-time low earlier this year, and the 2023 Marketplace Open Enrollment Period saw the highest number of  plan selections of any year since the launch of the ACA Marketplaces ten years ago.
 
This year, individuals benefited from a highly competitive Marketplace. Ninety-two percent of HealthCare.gov enrollees had access to options from three or more insurance companies when they shopped for plans. Also, new standardized plan options were available in 2023 through HealthCare.gov, which helped consumers compare and select plans. Thanks to the Inflation Reduction Act, more people this year continued to qualify for help purchasing quality health coverage with expanded financial assistance, resulting in four out of five people returning to HealthCare.gov being able to find a plan for $10 or less after tax credits.
 
Today’s snapshot represents activity through January 15, 2023 for the 33 Marketplaces using HealthCare.gov and through January 14 or 15, 2023 for the 18 State-based Marketplaces (SBMs) in 17 states and the District of Columbia that are using their own eligibility and enrollment platforms.
 
Marketplace Enrollment Snapshot Overview:
 

Marketplace and Consumer TypeCumulative 2023 OEP Plan Selections

Total: All Marketplaces

16,306,448
New Consumers3,603,067
Returning Consumers[1]12,703,381
Total HealthCare.gov Marketplaces12,203,622
New Consumers3,000,155
Returning Consumers9,203,467
Total SBMs[2]4,102,826
New Consumers602,912
Returning Consumers3,499,914

1 The returning consumers metric in this report includes both consumers who have returned to their respective Marketplace through the reporting date and selected a plan for 2023 coverage and consumers who have been automatically re-enrolled in their 2022 plan or a suggested alternate plan.
2 In addition to reported plan selections, New York and Minnesota have a Basic Health Program (BHP), which provides coverage to consumers with incomes below 200 percent of the FPL who are not eligible for Medicaid or CHIP and otherwise would be eligible for a QHP.  From November 1 – January 14, 2023, New York had a total of 1,114,406 individuals enroll in a BHP. Minnesota’s BHP data was not available at the time of this report. 

While the 2023 Open Enrollment Period has closed for the 33 Marketplaces using HealthCare.gov, State-Based Marketplace deadlines vary and enrollment continues in several states. State-specific deadlines and other information are available in the State-based Marketplace Open Enrollment Fact Sheet.

Individuals who meet certain conditions may be eligible for a Special Enrollment Period (SEP) and can determine if they qualify by visiting HealthCare.gov, or CuidadoDeSalud.gov, or by calling 1-800-318-2596.

FACT SHEET: By The Numbers: Millions of Americans Would Lose Health Care Coverage, Benefits, and Protections Under Congressional Republicans’ Plans

This fact sheet on the impact on health care coverage, benefits and protections under the Congressional Republicans’ plans was provided by the White House:

While President Biden has secured a cap on insulin costs at $35/month, a cap on out-of-pocket prescription drug costs to $2000, enabled Medicare for the first time to negotiate drug prices, and lowered the cost of health care premiums, Congressional Republicans have promised to strip Medicare of the right to negotiate drug prices and remove the $2,000 cap on out-of-pocket pharmacy expenses and would  put Medicare, Medicaid, and Social Security on the chopping block every five years. © Karen Rubin/news-photos-features.com

President Biden’s top priority is to lower costs for the American people. He was proud to sign the Inflation Reduction Act into law, taking on Big Pharma to allow Medicare to negotiate prescription drug costs for the first time, capping seniors’ drug costs at the pharmacy and the cost of insulin, and lowering health insurance premiums for people who get coverage through the Affordable Care Act. President Biden and Congressional Democrats are committed to protecting and strengthening Social Security and Medicare.
 
Congressional Republicans have a very different vision. They have promised to strip Medicare of the right to negotiate drug prices and remove the $2,000 cap on out-of-pocket pharmacy expenses. Florida’s Republican Senator and Chair of the National Republican Senatorial Committee Rick Scott has championed a plan to put Medicare, Medicaid, and Social Security on the chopping block every five years. Further, Congressional Republicans have repeatedly pledged to hold the American economy hostage by refusing to raise the debt limit unless they can cut Social Security and Medicare benefits that tens of millions of Americans have already paid into. 
 
Here’s what Congressional Republicans’ plan would mean:

Part I: Putting Bedrock Programs like Social Security and Medicare on the Chopping Block and Threatening the Global Economy Unless Those Programs Are Cut

All Medicare, Medicaid, and Social Security beneficiaries would see their benefits threatened under Sen. Rick Scott’s plan to put those programs on the chopping block every five years. Sen. Ron Johnson’s vision of putting them up for a vote every year would make that even worse. 
 
Congressional Republican leaders have also repeatedly said they will use the debt limit as leverage to cut these bedrock programs. Congressional Republicans have supported Medicare and Social Security cuts including:

  • Gradually increasing the Medicare eligibility age to 67 and the Social Security eligibility age to 70. (Republican Study Committee FY 2023 Budget)
     
  • Transforming Medicare benefits into a voucher where seniors would get a fixed amount of money to purchase a private health plan (Better Way Plan) or offering beneficiaries the option to transition to a premium support system (Republican Study Committee FY 2023 Budget) – which could lead to hundreds or thousands of dollars in additional out of pocket costs for seniors throughout the country.


Part II: Repealing the Prescription Drug and Health Care Provisions in the Inflation Reduction Act
 

President Biden has worked for decades to let Medicare negotiate drug prices, and that is finally happening thanks to the Inflation Reduction Act.  This will save billions of dollars for both Medicare beneficiaries, who will see reduced premiums and out-of-pocket costs, and the federal government. Kaiser Family Foundation estimates suggest that some 5 to 7 million beneficiaries each year use the types of high-cost drugs that could be subject to negotiation and will directly face higher cost sharing if these provisions are repealed.

The Inflation Reduction Act also requires prescription drug companies to pay rebates if they increase drug prices faster than inflation. According to an analysis by the Department of Health and Human Services, the cost of 1,200 prescription drugs rose faster than inflation in the last year alone – some prescription drugs increasing by $1000 in just one year. If Congressional Republicans repeal the Inflation Reduction Act, drug companies will be able to continue raising prices without paying a rebate, rather than putting that money back into Americans’ pockets.
 

Before the Inflation Reduction Act, Medicare beneficiaries with conditions like cancer, multiple sclerosis, and lung disease could face thousands of dollars in out-of-pocket prescription drug costs per year. Thanks to President Biden and Congressional Democrats’ Inflation Reduction Act, those costs will be capped at $2,000 per year, saving over 1 million beneficiaries an average of over $1,300 per year. If Congressional Republicans get their way and repeal the law, over 1.4 million Medicare beneficiaries will pay more each year – thousands of dollars more in some cases – for drugs at the pharmacy.
 

Drug manufacturers have raised insulin prices so rapidly over the last few decades that some Medicare beneficiaries struggle to afford this life-saving drug that costs less than $10 a vial to manufacture. Today, Medicare beneficiaries are enrolling in plans that must cap the out-of-pocket cost of insulin at no more than $35 per month per prescription, a protection they will lose if the law is repealed.
 

The Inflation Reduction Act saves 13 million Americans an average of about $800 per year on their health care premiums, by continuing the improvements to Affordable Care Act (ACA) premium tax credits enacted in the American Rescue Plan. By making health care more affordable, these improvements have expanded coverage to millions of people, helping bring the uninsured rate to an all-time low. Starting today, during Open Enrollment season, Americans can choose health insurance plans that lock in the Inflation Reduction Act’s cost savings for 2023. But Congressional Republicans would repeal this assistance, drive premiums higher, and jeopardize the progress the Biden Administration has made in driving the uninsured rate to a historic low. Older Americans would see especially large premium spikes; in most states, annual premiums for a 60-year old making $60,000 would more than double to over $10,000.