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What impact will Biden’s executive orders have on health care?

A key part of one of the executive orders signed by President Biden Thursday will reopen enrollment for the Affordable Care Act. Biden's other executive action will revoke a policy that barred funding for groups overseas that performed abortions or offered information about them. Paige Winfield Cunningham, a Washington Post reporter covering health care policy, joins Amna Nawaz to discuss.

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  • Judy Woodruff:

    Let's look more closely now at the changes and orders President Biden announced today in health care.

    As Amna Nawaz explains, the moves are designed to expand coverage and reverse some of President Trump's actions on abortion and family planning.

  • Amna Nawaz:

    Judy, a key part of one executive order signed today will reopen enrollment for the Affordable Care Act, what many call Obamacare. Mr. Biden's other executive action will revoke the Mexico City policy, often known as the global gag rule. That rule barred U.S. funding for groups overseas that performed abortions or offered information on them.

    Covering all of this for "The Washington Post" is Paige Winfield Cunningham. And she joins me now.

    Paige, welcome to the "NewsHour," and thanks for being here.

    We reported earlier on some of the details around those executive actions. Let's talk about the impact, though.

    On this first move, reopening enrollment for the ACA from February 15 to May 15 at healthcare.gov, people know that site does not reach every state, right? So how many people and who exactly is the Biden administration trying to reach with this?

  • Paige Winfield Cunningham:


    Well, as you say, they opened healthcare.gov. There are more than a dozen states that also run their own marketplaces, instead of using the federal Web site. And most of those states announced that they are going to be opening their enrollment for that time period, limited time period, going up to May 15.

    And that's coming — those announcements have come from California, Minnesota, many of the large states that run their own marketplaces. So, really, this decision is going to apply to the vast majority of people in the United States.

    And what's interesting about this is, the pandemic is the reason that the president is citing for doing this, but I actually think the bigger impact is going to be around the timing of this.

    For years, tax experts have actually said you could maximize enrollment in health coverage if you aligned tax filing season with ACA enrollment. And that's because a lot of lower-income people who might be eligible for subsidies, but have trouble affording premiums, if you align that when they're filing their taxes and getting tax refunds back, that could actually help incentivize them to enroll in coverage at the same time.

    I have talked to analysts who are estimating that this could result in potentially tens or hundreds thousands more people enrolling in health coverage over this three-month period.

  • Amna Nawaz:

    Let me ask you about the other executive action that — again, that's getting a lot of attention, President Biden's decision to rescind the Mexico City policy.

    That, of course, dates back to the Reagan administration. It's ping-ponged, depending on who's in power, Democrat or Republican. But what is the practical impact of rescinding that policy today?

  • Paige Winfield Cunningham:

    Well, you're right that this has ping-ponged back and forth a number of times between Democratic and Republican presidents.

    I think there's even a bigger impact at this point. And that's because, when the Trump administration put in that policy in place four years ago, it actually made it even broader than what previous Republican presidents had done.

    It basically put this ban on referring for abortions or counseling about abortions not just on international aid funding focused on family planning, but on all international aid funding, which totaled billions and billions of dollars.

    And so now, by reversing this, it's really changing, removing restrictions from many, many nonprofits who had been forced to comply with these rules over the last four years.

  • Amna Nawaz:

    There was a related memo President Biden signed as well as asking HHS to review a Trump rule that cut off federal funds for groups here in the United States that did provide abortion services as well. What could that review lead to?

  • Paige Winfield Cunningham:

    Yes, you're right.

    So, we're talking about their Title X family planning funding. And the step the Trump administration took was a really unprecedented one in banning participants in that program from counseling or referring for abortion services. And it actually had a very practical effect, in that Planned Parenthood, which is, of course, the nation's largest abortion provider and, of course, a huge provider of contraceptive family planning services, withdrew from that program.

    That was back in 2019. And so now what you're going to see with this is probably HHS is going to probably come out with a new funding announcement which welcomes these providers back into the program and reverses that previous guidance.

  • Amna Nawaz:

    Paige, I have to ask you.

    With the previous administration, when you looked at some of their unilateral moves on health care, they ended up in court, a lot of them, right, immediately challenged by Democratic officials. And we have seen that already with this new Democratic president.

    When you have an immigration move, one related to deportation, he took earlier, you saw a Republican attorney general step in, challenge it, and a Texas court pause it.

    When you look at these moves made today, are we likely to see a lot of them end up in court?

  • Paige Winfield Cunningham:

    It depends, I think, on whether he's forging new ground here.

    With a lot of these things, he's rolling back really unprecedented things that the Trump administration had done. One thing we haven't talked about yet is what the past administration did on Medicaid. And they had really taken the unprecedented step of allowing states to put in place new requirements for enrollment, such as work or volunteering requirements, or allowing states to get block grants.

    That was something that we hadn't seen done previously to the Medicaid program. And so you're really going to see the new administration pull back on that. But I certainly would not rule out the possibility of litigation here.

    We're going to see the new administration do a wide variety of things, not just things around health insurance, but also having to do with discrimination in health care, other things reproductive rights which are obviously very controversial.

  • Amna Nawaz:

    Very briefly, Paige, you mentioned that some of these moves are controversial. But are there areas — for a president who says he wants to move forward with bipartisan support, are there some areas you think there could be that support in Congress?

  • Paige Winfield Cunningham:

    Well, the president really is someone who likes to bring about consensus, and this is what he said.

    Over the last couple of years, I have tracked, especially with efforts in Congress to pass reforms to lower drug prices. And this is something you have seen leading Democratic and Republican senators work together on we have seen in some bipartisan legislation.

    So, I wouldn't rule out that this might happen. But, you know, it all depends really on kind of how Republican — or how Democrats roll the dice and whether they decide it's going to be to their advantage to try to rope in Republicans and do something bipartisan, or try to pass something much more ambitious, which they can't get Republicans on board with, but then sort of use to hammer them with politically.

  • Amna Nawaz:

    Paige Winfield Cunningham of "The Washington Post," thanks for joining us.

  • Paige Winfield Cunningham:

    Thank you.

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