Why Biden’s healthcare policy changes will be remembered for decades to come

Say what you will about the US economy. And Biden’s foreign policy. And his age. And all the rest of his baggage.

But whether Joe Biden is re-elected or not, his healthcare policy changes will be remembered for decades to come.

Yes, there are still huge challenges, like the expunging of millions of Medicaid (ie, low income) enrollees for the first time since 2020, after a pandemic policy meant to prevent vulnerable people from suddenly losing health coverage expired earlier this spring when the US declared an official end to the COVID-19 public health emergency.

But Biden’s laser focus on increasing access to healthcare and lowering healthcare costs may truly be his lasting legacy. Firstly, there is the Inflation Reduction Act, which has sweeping healthcare implications for tens of millions of Americans, including capping insulin costs at $35 per month, lowering Medicare Part D prescription drug costs and making adult vaccines available at no cost. But there are two pillars of the Inflation Reduction Act that, on their own, are potentially seismic in their impact on healthcare costs, if they are implemented and enforced as expected: allowing Medicare to negotiate directly with participating drug companies to improve access to innovative treatments for people with Medicare and lower costs for the Medicare programme; and requiring drug companies that raise their drug prices faster than the rate of inflation to pay Medicare a rebate.

And there’s more. The Biden administration has also cracked down on ‘junk insurance’ plans that have lured Americans into paying for plans that offer little to no coverage and discriminate on the basis of pre-existing conditions. Biden is also trying to implement policies that will severely curtail surprise medical billing, which leaves millions of Americans on the hook for healthcare costs they thought were covered by their health plan. Examples of this include scenarios when people require emergency care and are taken to the nearest hospital instead of one that is ‘approved’ under their health plan, or when an individual undergoes surgery at an ‘approved’ hospital only to find out that the anesthesiologist who provided the services is actually from an ‘unapproved’ hospital.

But that’s not all.

The Biden administration is also cracking down on predatorial medical debt providers. According to a recent White House press release: ‘Increasingly, healthcare providers are signing up patients for third-party medical credit cards and loans to help pay for care. These credit cards often include teaser rates and deferred interest features that lead to higher costs for consumers and may be offered even when low- or no-cost alternatives, such as zero-interest payment plans, financial assistance or health coverage may be available. Healthcare providers may be promoting these products because they could allow providers to get paid faster, outsource servicing and collections costs to third parties, receive a higher payment from consumers who otherwise would pay a discounted price for care, and in some circumstances, receive a share of the interest revenue gained by the third-party financial company.’

Biden is also fighting hard to increase coverage and access for adult mental health services. He is also making it easier for children to get access to mental health services through their schools. His policies have also resurrected the Cancer Moonshot, with hundreds of millions of dollars for funding aimed at finding new ways to detect and treat cancer.

The criticisms abound. Where will the money come from? How long will it take to see the results of all these policies? Shouldn’t we be focusing on the larger economy and addressing more urgent issues?

No matter. When Biden leaves office in either 2024 or 2028, he will have left an indelible imprint on America’s struggle to provide more equitable access to healthcare at a lower cost. And he will have delivered a resounding message to pharmaceutical manufacturers, insurance companies, intermediaries like pharmacy benefit managers and hospital systems: you need to be part of the solution.

By ‘starting somewhere’, Biden has shown that the big beast of US healthcare, while an indomitable foe, can be cut down into manageable pieces to be addressed. He has shown that bipartisan support for issues that affect everyday Americans, well, every day, is possible to achieve.

Although we face geopolitical risk everywhere, a sputtering economy on the verge of recession, out-of-control technology that seems to be outpacing our ability to regulate it, one thing is clear from Joe Biden’s first term in office: if you aim at nothing, you will hit nothing.

References are available on request.