Biden Administration Takes Two Big Steps in Support of Health Care Coverage

The Biden administration recently took two important steps to preserve health care coverage for millions of Americans. First, the Department of Justice (DOJ) reversed course on its non-defense of the Affordable Care Act (ACA) and notified the U.S. Supreme Court of its change in stance. Second, the administration asked the Supreme Court to cancel upcoming oral arguments in a case centering on Medicaid work requirements, because it plans to roll back the ability of states to impose such restrictions.

In November 2020, the Supreme Court heard oral arguments in a case challenging the constitutionality of the ACA. The suit was initially brought several years ago by a group of Republican state attorneys general and governors. They claim the entire law is unconstitutional because Congress reduced the financial penalty for not having insurance to zero in the 2017 tax bill. Though this argument was dismissed by many legal scholars, the Trump administration’s DOJ first supported the lawsuit, then asked for the entire law to be struck down.

On February 10, the Biden administration reversed course, informing the Supreme Court in a letter that the change in administration had led to a change in DOJ’s position and that the law as it stands is valid. Even if the specific provision of the law at issue, the now-zeroed out penalty, is unconstitutional, the administration argues that it can simply be cut out and the rest of the law can stand.

This shift is a step in the right direction to protect care for millions who rely on the ACA. Ending the law would have devastating consequences, including disrupting coverage for pre-existing conditions, re-opening the Medicare donut hole, and eliminating the Medicaid expansion.

In other news, the administration also reversed course on Medicaid work requirements, states’ attempts to create hurdles that prevent people from accessing the coverage they need. Federal courts have found work requirements impermissible and not in keeping with the primary objectives of Medicaid, but Arkansas, backed by the Trump administration, argued that the requirements were legal. The Supreme Court decided to hear the case and oral arguments are scheduled for March.

But the Biden administration has already taken steps to pull back this authority, notifying states that they will not be permitted to institute work requirements. The administration also requested that the Supreme Court throw out pending cases because states will not be permitted to institute such barriers, making a Supreme Court decision unnecessary.

We support both actions and urge the administration to do more to protect health coverage through Medicare, Medicaid, and the ACA.

Read more about what is at stake in the ACA case.

Read more about how work requirements in Medicaid impact older adults.