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Four Years Ago Today: House Republicans Voted to Repeal the Affordable Care Act and the Politics of Health Care Changed Forever

Washington, D.C. — Four years ago, House Republicans took a fateful vote to repeal the Affordable Care Act (ACA), which would have ripped coverage away from more than 20 million Americans and protections from 135 million Americans with pre-existing conditions. Four years later, the law is stronger than ever as President Biden is delivering on his promise to build on the health care law and expand access to affordable health care. In response, Protect Our Care Executive Director Brad Woodhouse issued the following statement:

“Elections matter. Republicans paid for this disastrous vote in 2018 when they lost the House and again in 2020 when Democrats took back control of the White House and Senate. President Biden has already made good on his promise to strengthen the ACA by passing the American Rescue Plan, opening a special enrollment period to help people gain coverage during the pandemic, and reversing former President Trump’s efforts to sabotage the health care law. And just last week, President Biden unveiled the American Families Plan which will help millions of people continue to save on their health coverage and called for Congress to give Medicare the power to negotiate with drug companies to lower drug prices for Americans. What a difference four years and a couple of elections make.”


100 Days In: Joe Biden’s Health Care Presidency

After just 100 days in office, President Biden has proven he is a health care president. In a stark contrast to the past four years of Republican sabotage on health care, President Biden has taken swift action to expand coverage, lower costs, and reduce racial disparities in health care all while working to contain the coronavirus pandemic. President Biden championed the American Rescue Plan to help the country get the pandemic under control, put forth policies that will build on the strong foundation of the Affordable Care Act (ACA), opened a special enrollment period to help Americans get coverage, removed barriers to enrolling in Medicaid, and reversed the Trump administration’s dangerous position trying to invalidate the ACA. 

And just last week, President Biden unveiled the American Families Plan, which builds on the historic health care gains of the American Rescue Plan by making its dramatic reduction in health insurance premiums permanent. President Biden also reaffirmed his commitment to giving Medicare the power to negotiate for lower drug prices and lowering the eligibility age of Medicare to get more Americans covered. 

The American Rescue Plan

On March 11, President Biden signed the American Rescue Plan into law, historic legislation that includes measures to expand coverage and to dramatically lower health care costs for millions of Americans. The American Rescue plan: 

  • Lowers health care costs for millions by increasing financial assistance in the exchanges for the next two years and making financial assistance more widely available to middle class families, ensuring people purchasing coverage on the ACA marketplaces do pay more than 8.5 percent of their income for coverage. In addition to lowering costs for the nine million people currently receiving financial assistance on the marketplace, the American Rescue Plan makes generous subsidies available to 14.9 million uninsured people, according to estimates from the Biden administration. Experts say as many as 25 million Americans could benefit from these provisions. 
    • Uninsured couples earning more than $70,000 will save $1,000 per month on premiums. 
    • A family of four earning $90,000 will save $200 per month.
    • An individual making $19,000 will not have to pay a monthly premium, saving roughly $66 per month on average.
  • Expands coverage by providing robust financial incentives for the 14 states that have not yet implemented Medicaid expansion. Even after paying for the cost of expansion, these states could receive billions in additional funding that could be used to offset spending in other state programs or budget shortfalls. The Urban Institute estimates that more than 6 million people could enroll in Medicaid coverage if the remaining states implemented expansion. This includes at least 2.4 million people of color, 500,000 people with disabilities and almost a million older Americans who are currently uninsured. 
  • Increases vaccine distribution by investing $160 billion in direct COVID-19 response, including ramping up vaccination efforts, boosting testing, shoring up supplies of PPE, expanding sequencing and analytics efforts, and hiring 100,000 public health workers. This much needed funding will make sure more Americans are able to get vaccinated more quickly, which is key to getting the pandemic under control. Already, more than 230 million doses have been administered — more than doubling the President’s original goal of 100 million shots in 100 days. Roughly 96 million Americans have been fully vaccinated. 
  • Strengthens health care in vulnerable communities by providing health services for underserved populations, including expanding Community Health Centers and investing in health services on tribal lands. These funds will support the expansion of COVID-19 treatment and care as well as provide the vaccine to underserved populations.

Increasing Health Care Access & Prioritizing Health Care Equity 

  • President Biden reopened for a special enrollment period to help Americans gain coverage as they continue to suffer from the health and economic impacts of the pandemic. More than 528,000 Americans signed up for insurance through the ACA Marketplace during the first six weeks of the special enrollment period, and 17 percent of sign-ups came from Black Americans. 
  • The Biden administration is investing $50 million in marketing and education efforts during the special enrollment period to reach groups that have historically experienced lower access to health coverage and greater disparities in health outcomes. The administration is also providing a record $80 million in Navigator funding for the 2022 plan year to further boost enrollment.
  • In order to address racial disparities in coverage rates, the administration has re-engaged with partner organizations, such as the NAACP, UnidosUS, and AARP to ensure Black and Latino Americans in particular are able to enroll. 
  • President Biden established a COVID-19 Health Equity Task Force to mitigate the health disparities revealed and exacerbated by the pandemic. 
  • President Biden directed federal agencies to consider actions to strengthen and protect access to health care. 

Reversing Trump Sabotage

  • The Biden administration announced it will defend the Affordable Care Act in California v. Texas, the lawsuit before the Supreme Court to completely dismantle the law. This move reverses the Trump administration’s support for ripping away coverage from more than 20 million Americans and protections for 135 million people with pre-existing conditions.
  • President Biden directed federal agencies to re-examine policies that undermine the ACA and Medicaid. These policies include:
    • Policies that undermine protections for people with pre-existing conditions, including COVID-19
    • ACA and Medicaid waivers that could reduce enrollment, including Medicaid work requirements and block grants 
    • Policies that undermine the ACA Marketplace, like Georgia’s waiver request to pull out of with no state-based replacement 
    • Policies that make it more difficult to enroll in the ACA or Medicaid
    • Policies that reduce coverage affordability or limit financial assistance
  • The Biden administration sent letters to states signaling it would end Trump’s disastrous work requirements program. So far, the Biden administration has rescinded permissions for work requirements programs in Michigan, Wisconsin, Arkansas, and New Hampshire. The Biden administration also put on hold Georgia’s limited Medicaid expansion waiver that required recipients to work, which was previously approved by the Trump administration.
  • The Biden administration began rolling back Trump’s gag rule that barred family planning providers from mentioning abortion to patients in order to receive Title X funding. Trump’s rule forced more than 1,000 clinics to leave the program and reduced the provider capacity of the Title X network by nearly half. The Biden administration’s rule will restore essential funding back to these providers, like Planned Parenthood, which offer essential health care services to low-income patients, including STI screenings and contraception. 
  • The Biden administration is reviewing Trump’s expansion of association health plans, which can skirt the ACA’s important protections. 
  • The Biden administration rescinded Trump’s public charge rule, which effectively served as a wealth test for people seeking residency in the United States. Experts point to Trump’s immigration policies, such as the public charge rule, for having deterred many Latino families from obtaining insurance, resulting in steep coverage losses, especially for children.