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With all that’s going on these days including President Joe Biden’s inauguration, it can be difficult to sort through the headlines. You might be wondering what the Biden administration has in store for healthcare. There have been several reports outlining some of the key measures that have been discussed, along with how much Bidencare might cost in terms of government financing, at the insurance provider level, and the expenses of consumers. Many are questioning if the current Obamacare platform will see significant changes. Will Bidencare enhance options for individuals or require more of those participating providers? We’ll highlight the latest news and see what can be expected, at least for now.

President-Elect Joe Biden’s Proposed Changes

The Bidencare plan isn’t going to be a transition to a kind of Medicare for all or universal healthcare plan. Instead, the outline suggests a series of more incremental changes. But these subtle enhancements are anything but small and may have a big impact on the industry. Some more independent estimates are suggesting that the Bidencare plan would ensure some 15 to 20 million Americans will gain health insurance when they normally wouldn’t qualify or be able to afford an Obamacare variation. And for those participating, premiums would drastically be reduced. And it’s not a rose-colored glasses perspective on change, either.

Middle-class families might benefit the most, especially with the sharp reduction in monthly health insurance premiums. Bidencare proposes increasing the subsidies available, meaning those who rely on the Marketplace for coverage would see immediate financial relief. The current limit for upper-income families would also be removed under the plan, allowing more Americans to qualify for the financial assistance. Another perk includes significant assistance for those requiring long-term care, mental health care, and rural healthcare services.

Looking at the price tag for such a lofty reform plan, the Committee for a Responsible Federal Budget points out the cutting of costs would run up a tab of some $850 billion over ten years. And while that sounds exorbitant, it’s a smaller figure than the cost of the 2017 tax cut. That tax cut, which was initially designed to trickle down to adjust premiums, mostly went to corporations that ultimately didn’t end up increasing investments as originally planned.

What the Bidencare Plan Is Projecting to Include

President Joe Biden has used terms in the past, like “public options” to describe his plan, likening it to a model similar to Medicare, where Americans would be afforded a choice outside of private insurance options. It sounds more like a first step toward a single-payer platform. And here are few of the measures included in the plan.

The tax bill signed by the GOP in 2017 included removing the individual mandate and penalty. The Bidencare plan, should it be adopted, would reinstate the penalties for individuals not enrolled in health insurance. A Biden campaign official said to do this, a series of executive orders would be leveraged, along with Biden’s “longstanding history of getting things done in Congress.”

Prescription drugs would see a reduction in cost, as well, under the proposed Bidencare plan. To do this, the existing law that currently prohibits Medicare from negotiating better pricing with manufacturers would be repealed. There would also be a limit in price increases among brand, abusively priced generic, and biotech drugs. Bidencare would allow Americans to buy cheaper prescriptions from other countries whenever possible, which would help stimulate the competitive market among manufacturers. And getting rid of the advertising tax breaks would help lower drug costs, as well.

The Bidencare proposed healthcare plan also includes the participation of undocumented immigrants. These immigrants will be allowed to buy into an unsubsidized, public option. This is a contrast to the original Affordable Care Act system in which these individuals were prevented from participating.

Consumers will also be able to engage and sample the individual marketplace and select their healthcare providers of choice. As an extension of this expansion, Americans will only be allowed to spend 8.5% of their annual income on a health insurance plan. Currently, under the Affordable Care Act, it’s possible people could spend nearly 10% of their income just on quality insurance.

A Transition to Bidencare

Back in October, on the campaign trail, Joe Biden announced he would invoke the term, Bidencare. When he discussed his plans, he emphasized it would improve upon the existing Obamacare system, but transform it into something entirely new, thus the new label. Biden said he would work to pass the “Obamacare with a public option” agenda.

The rebrand wouldn’t imply a government takeover of the healthcare system. In fact, Biden has long been opposed to such a move. Instead, he positioned his plan as the solution to gaps and setbacks within the current systems. It would improve upon Obamacare, allowing consumers to still obtain health insurance from their employers, and both Medicaid and Medicare would be preserved. The ACA would expand, ensuring millions of Americans who find themselves ineligible or unable to afford coverage now would have health insurance.

None of these changes proposed under the Bidencare plan would have much of a shot without legislative approval. And prior to the presidential election, along with the Georgia state runoff election, it was unclear if Bidencare would stand a chance. But with the Democratic party solidifying control of the Senate, the House of Representatives, and now the office of the President, there’s a likelihood that many of the proposed changes will be adopted. Only time will tell.

As a health insurance provider or vendor within the healthcare solutions industry, you may be wondering what effects will impact how you conduct business. At many levels, there could be an influx of competition, driving better rates and service. And with the prospect of millions of new consumers shopping within the market, there will also be the opportunity for growth as a company. Nothing is certain just yet, and Bidencare is still in its proposal phase right now. But if you need help strategizing to plan ahead for your next move, including a revamp of how your business engages consumers, contact us.