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Biden Signs Executive Order to Strengthen Medicaid, ACA

During his second week in office, President Biden released an executive order to strengthen Medicaid and the Affordable Care Act (ACA) to make high-quality health care accessible and affordable to all Americans.

The order directs the Department of Health and Human Services (HHS) to open a special enrollment period on the federally facilitated health insurance marketplace, giving uninsured or underinsured individuals — particularly those hardest hit by the COVID-19 pandemic — the opportunity to sign up for health coverage. The special enrollment period will begin Feb. 15 and run through May 15. The special enrollment period will only apply to the federal exchange; state-run marketplaces can open their own special enrollment period if they choose.

Biden also instructs several agencies to review existing regulations, orders, guidance documents, policies, and other actions for inconsistency with the goal of protecting and strengthening Medicaid and the ACA. As part of the review, agencies will examine:

  • policies or practices that undermine protections for people with pre-existing conditions, including complications related to COVID-19;
  • demonstrations and waivers under Medicaid and the ACA that could reduce coverage or undermine the programs, including those with work requirements;
  • policies or practices that undermine the health insurance marketplace or other markets of health insurance;
  • policies that make it more difficult to enroll in Medicaid and the ACA; and
  • policies that reduce affordability of coverage or financial assistance, including for dependents.

The executive order revokes previous orders under the Trump administration calling for the repeal of the ACA. The order also allows insurance to be sold over state lines and prioritizes association health plans, short-term limited-duration insurance, and health reimbursement arrangements.

In a separate memorandum, Biden directs HHS to take immediate action to consider whether to rescind regulations under its Title X family planning program.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Julie Kozminski is a senior policy analyst at America's Essential Hospitals.

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