Health reforms in the United States: The outlook after Biden's first 100 days

Abstract

The November 2020 election of Joe Biden, coupled with the election of a Congress controlled by the Democratic Party, has the potential to dramatically alter the direction of health policy in the United States. Donald Trump failed to repeal the Affordable Care Act (ACA) but he managed to whittle down aspects of coverage protection. Historically, the first 100 days of a presidency are a bellwether of accomplishments to come. During this period Biden reversed several of Trump policies through both executive orders and a large economic stimulus bill. The stimulus bill substantially increased premium subsidies to encourage people to purchase health insurance coverage, albeit with funding guaranteed only for a two-year period. Larger accomplishments, such as making these enhanced premium subsidies permanent, reining in prescription drug spending, enacting a public health insurance option to compete with private insurers, and improving public health and health equity, will require further legislation. The political environment in the U.S. is now extraordinarily contentious. Each of these proposed initiatives faces major political hurdles and the window of opportunity for enacting each of these goals very well may be brief.