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Biden To Expand Access To Reproductive Health Care And Obamacare


Former President Trump spent his whole term trying to undermine and weaken the Affordable Care Act and limit funding for reproductive health. Well, today, President Biden signed two executive actions that essentially turn back time on those changes. Here to tell us more is NPR health policy reporter Selena Simmons-Duffin.

Hi, Selena.


SHAPIRO: Begin by telling us about this time machine idea. What is Biden undoing with these actions today?

SIMMONS-DUFFIN: Well, first, there's a memorandum to undo the changes to Title X funding that affected health care providers like Planned Parenthood and rescind the global gag rule. So that means both domestically and internationally, there should soon be more access to federal funding for organizations that provide or refer for abortions. And then there's an executive order that takes aim at a whole slew of changes Trump made to the Affordable Care Act and Medicaid. For example, work requirements for Medicaid was something that states were encouraged to put in place under Trump. Biden even said himself while signing these actions, essentially, there's nothing new here. We're going back to how things were before Trump.

SHAPIRO: But Biden did do at least one new thing here - right? - a special enrollment period for Tell us about that.

SIMMONS-DUFFIN: Yeah, so this is something the Trump administration was pressured to do when the economy started cratering last spring because of the coronavirus pandemic, but they never did it. Biden says starting February 15, will be open for people to enroll in a plan for three months until mid-May.

I called up Katie Roders Turner earlier today. She works at the Family Healthcare Foundation in Tampa Bay, Fla. And she's what's called a navigator. They are unbiased and free for consumers. They're federally funded. And they just help people sign up for these plans. And as we were talking about the special enrollment period, I told her, you sound really excited about this.

KATIE RODERS TURNER: I'm so excited (laughter). I'm so excited. I really am. Thank you. Yeah. No, no, no. I do. I know. I'm, like, giddy.

SHAPIRO: She's very excited. But the regular annual open period just ended, right? Why is another one needed?

SIMMONS-DUFFIN: Yeah, that's true. Open enrollment wrapped up in mid-December, but Roders Turner says a lot of people might have missed it. The Trump administration barely advertised it at all. They famously slashed their outreach spending by 90%. And she says the lack of outreach caused a lot of confusion.

RODERS TURNER: We would have people come to us, consumers coming to us. They know they're uninsured. They know that we can potentially help them. But when we would, you know, go through the process of saying, like, this is the Affordable Care Act, the health insurance marketplace, they would say, oh, Obamacare; I thought that was gone.

SIMMONS-DUFFIN: So she thinks the combination of opening up this new enrollment period and telling people about it might get more people who are eligible for plans to sign up.

SHAPIRO: People who are eligible - like what? Talk about who might be likely to sign up during this enrollment period.

SIMMONS-DUFFIN: Well, there are about 26 million people who are uninsured right now. And Cynthia Cox, who's the vice president of the program on the Affordable Care Act at the Kaiser Family Foundation, recently did an analysis on this. So I asked her to describe the people who are eligible for low- or even no-cost plans on the exchanges but are uninsured.

CYNTHIA COX: They're more likely to be Hispanic and Spanish-speaking at home. They're more likely to work in construction or arts and entertainment - like, fields that typically don't offer health insurance. They are also more likely to have a high school education or less.

SIMMONS-DUFFIN: So she says knowing all of this could help the Biden administration figure out how to shape their outreach campaign, and she says they've got a healthy budget to work with - about a billion dollars in funding that the Trump administration had for this outreach and just left on the table.

SHAPIRO: That's NPR's Selena Simmons-Duffin on President Biden's health care actions today. Thanks a lot.

SIMMONS-DUFFIN: Thank you. Transcript provided by NPR, Copyright NPR.

Selena Simmons-Duffin reports on health policy for NPR.