President Biden is expected to reopen the Affordable Care Act (ACA) exchanges for enrollments as well as make enrolling in Medicaid simpler in executive action as soon as Thursday. The marketplaces could have been opened at any time during this pandemic, when so many people were losing their jobs and health insurance. But of course the Trump administration wasn't going to do that.
One order will reopen Healthcare.gov for "at least a few months" in open enrollment period. Under Biden's predecessor, that enrollment period had been cut in half to just six weeks ending on Dec. 15. Biden will allow a special enrollment period for all the 39 states using the federal exchange, joining the 11 states and District of Columbia that extended enrollments. That should come with an effort by the administration to restart the Obama-era efforts to help people get signed up, both through the contracted "navigator" program and simply by advertising the fact that the opportunity exists.
It's not clear yet what he'll be doing on Medicaid. The Washington Post's sources say the action "is intended to reverse Trump-era changes to Medicaid." Whether that means undoing orders that allowed states to do things like impose work requirements or treat Medicaid like a block grant isn't clear at the moment. Biden can also revise the previous administration's hostility to Obamacare by providing all kinds of incentives for states that haven't expanded Medicaid to do it now. He can also "simply direct federal health officials to review rules to make sure they expand coverage to the program that insures about 70 million low-income people in the United States," according to what the Post is hearing.
These are the immediate, COVID-19 emergency actions Biden is taking, but just the start to the Obamacare expansion he's got in the pipeline, but which will require congressional action. That includes adding a public option to the exchanges and closing the Medicaid gap by increasing eligibility to subsidies for low-income people who live in states that didn't expand their programs. It's important to do this now, though, because the Supreme Court is still pondering the fate of the ACA. Judging by the response of the justices in the Nov. 10 hearing on the states' challenge to the law, it's probably safe. But adding a few million more enrollees in the coming weeks would help cement that.
In addition to those orders, Biden is expected to rescind the Mexico City policy, the global gag rule that prohibits any international aid to international groups that provide or facilitate abortions in foreign countries. The order was first imposed by the Reagan administration, rescinded by Clinton, reimposed by Bush, lifted by Obama, reimposed by the last guy, and here we are now. It's also possible that he'll order a review of the changes the previous administration made to the Title X family planning program, lifting the restrictions that led to Planned Parenthood pulling out of the program, preventing it from receiving federal funding for its family planning programs.