Healthcare Financing

Healthcare financing is a critical component of a nation’s overall health strategy, playing a pivotal role in ensuring that citizens have access to essential medical services. Well-structured financial healthcare plans foster economic stability by mitigating financial burdens while ensuring that citizens become healthy (Japinga et al., 2022). The Bidden administration has worked tirelessly to plan for the nation’s healthcare financing and deal with the issue of healthcare costs. This administration has laid a plan to strengthen primary care and bolster infrastructure to help more practices deliver accessible and equitable care. This paper discusses the current healthcare plan of the Bidden-Harris administration and the proposed changes to improve healthcare delivery.

Organization of the Healthcare Plan

The current presidential administration in the United States has approached the organization of the nation’s healthcare plan with a focus on expanding access, improving affordability, and enhancing the quality of care. To achieve this, the government has planned to strengthen the Affordable Care Act, primarily by increasing enrollment in ACA. For example, in 2023 the government invested $98.9 million in Navigator grant funding to promote enrollment of people to the ACA program (U.S. Department of Health and Human Services (HHS), 2023). This plan comes after the government promised to make it easier for Americans to find and enroll in affordable quality coverage. Based on this plan, the government saw 16.4 million people sign up with 4.4 million more enrolling for healthcare insurance under the Bidden-Harris administration (HHS, 2023). The plan for this government also involves expanding subsidies to make health insurance more affordable for a larger number of people, particularly those in the middle-income bracket.

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The second aspect of the healthcare plan involves the expansion of healthcare through the Medicaid and CHIP enrollment changes. The government has noted that state policy choices have real consequences for children and families during Medicaid and CHIP renewals. The government plans to work with the Centers for Medicare & Medicaid Services (CMS) to better provide coverage for children and alleviate barriers to Medicaid plans (Cole et al., 2021). This plan also includes dealing with issues of Medicaid expansion in states like Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming that have not expanded Medicaid (HHS, 2023). The administration has proposed financial incentives for these states aiming to reduce the coverage gap and provide more Americans with access to healthcare.

Another key aspect of the financial healthcare plan by the Bidden-Harris administration is lowering prescription drug costs. The government intends to take steps toward lowering the cost of prescription medications, including promoting the use of generic drugs and biosimilars, negotiating drug prices for Medicare, and capping insulin costs for Medicare beneficiaries (Gavulic & Dusetzina, 2021). In 2022, the administration passed the  Inflation Reduction Act which gives the government the power to negotiate prescription drug prices directly with companies. The CMS plans to work closely with these companies to improve consumer access to some of the most expensive drugs for people with Medicare. The government announced the plan to negotiate 10 initial drugs selected for the first cycle including insulin (Centers for Medicare and Medicaid Programs (CMS), 2024). The Medicare Prescription Payment Plan which will begin in 2025 will give people with Medicare prescription coverage a chance to spread out-of-pocket fees over the year rather than the current full monthly payments at the pharmacy.

The American Rescue Plan Act (ARPA) is another crucial element of the Bidden-Harris administration that demonstrates a long-term healthcare plan for this nation. This Act was signed into law in 2021 to provide short-term pandemic relief but has extended to include essential aspects of healthcare delivery. For example, the plan has ensured additional funding for states with $350 billion to aid in vaccination, recovery, and other economic initiatives (Japinga et al., 2022). The new plan by the government is to ensure that direct and flexible aid is given to local, tribal, and territorial governments. In addition, the plan involves using this aid to fund projects that will connect families and businesses to affordable high-speed internet. The government also plans to continue launching public health programs using the rescue plan to facilitate recovery from the pandemic and economic development.

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Social Determinants of Health

Social determinants of health are increasingly evident in existing healthcare policies in the United States. These determinants include a range of socio-economic factors that influence individuals’ health outcomes, such as economic stability, education, social and community context, health and healthcare access, and the built environment. The Medicaid expansion plan under the Affordable Care Act aims to provide healthcare to low-income individuals to address issues like access to healthcare (Cole et al., 2021). This plan will ensure that low-income communities and vulnerable populations faced with different economic challenges can access quality healthcare services.

The governemnt has set policies that support health education and outreach efforts, especially in marginalized communities. Through the CMS and agencies like the Substance Abuse and Mental Health Services Administration (SAMHSA), the government plans to improve education about mental health in various states (CMS, 2024). The use of Certified Community Behavioral Health Clinics (CCBHCs) is another strategy that is in place to ensure communities receive health education and necessary support for victims of drugs and mental health issues (Japanga et al., 2022). The Bidden-Harris administration has also provided a plan to improve housing and urban development. For example, the Emergency Rental Assistance (ERA) program has made over $12.3 million in payments to families at risk of eviction (HHS, 2023). More funds are being allocated to ensure economically vulnerable and traditionally underserved homeowners are assisted.

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Summary

The United States government has numerous health initiatives and priorities that can change the state of healthcare in the nation. One of the key initiatives is a plan to expand access to quality, affordable health care. The plan is to provide Medicaid coverage to individuals in states that have not adopted the Medicaid expansion (Japinga et al., 2022). Secondly, the Bidden-Harris administration has a plan to reduce drug and other healthcare costs for all Americans. The plan involves limiting Medicaid Part D cost-sharing for high-value drugs to no more than $2 and curbing inflation for prescription drugs like insulin (Gavulic & Dusetzina, 2021). Protecting and strengthening Medicare through reforming tax codes is another key aspect of the plan. The administration also strives to improve Medicaid home and community-based services. This plan will see the Medicaid Certified Community Behavioral Health Clinic (CCBHC) program become permanent and ensure communities receive better services.

References

Centers for Medicare and Medicaid Programs. (2024). Biden-Harris Administration Issues Final Guidance to Help People with Medicare Prescription Drug Coverage Manage Prescription Drug Costs. https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-final-guidance-help-people-medicare-prescription-drug-coverage

Cole, M. B., Shafer, P. R., & Gordon, S. H. (2021). What the new Biden administration may mean for Medicaid. JAMA Health Forum, 2(1), e201497. https://doi.org/10.1001/jamahealthforum.2020.1497

Gavulic, K. A., & Dusetzina, S. B. (2021). Prescription drug priorities under the Biden administration. Journal of Health Politics, Policy and Law, 46(4), 599–609. https://doi.org/10.1215/03616878-8970810

Japinga, M., Bartz, A., Saunders, R., & McClellan, M. (2022). Health policy priorities for the Biden administration. Clinical Gastroenterology and Hepatology, 20(3), 477–480. https://doi.org/10.1016/j.cgh.2021.11.024

U.S. Department of health and Human Services. (2023). Biden-Harris Administration Celebrates the Affordable Care Act’s 13th Anniversary and Highlights Record-Breaking Coverage. https://www.hhs.gov/about/news/2023/03/23/biden-harris-administration-celebrates-affordable-care-acts-13th-anniversary-highlights-record-breaking-coverage.html