Health Affairs January 25, 2021
President Biden takes office with the expectation that he will face stiff Republican opposition to expanding the Affordable Care Act (ACA). That may well turn out to be true for his most ambitious coverage goals, such as a public option or Medicare at age 60. Nevertheless, the President will have many opportunities to build on the ACA foundation that offers Medicaid or subsidized coverage for individuals with incomes up to 400 percent of the federal poverty level.
The ACA took some hits during the Trump years but avoided a knockout blow and even registered some surprising gains, as states continued to expand Medicaid and establish State-based Marketplaces (SBMs). After years of ACA-driven coverage gains, however, overall progress has stalled; the...
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