Urban Institute.
J Health Polit Policy Law. 2021 Aug 1;46(4):549-562. doi: 10.1215/03616878-8970753.
For the past decade, the Affordable Care Act (ACA) has successfully reduced uninsurance and improved access to and affordability of health care services for millions of Americans. But the law was weakened when the Trump administration shortened the open enrollment period in the federal Marketplace, reduced outreach and enrollment funding, and revised the public charge rule, among other actions. The Biden administration will have the chance to reverse some of these changes and further strengthen the law to improve health care access and affordability. In this article, the author explores options for expanding access to affordable coverage and care for those who do not qualify for Medicaid or marketplace financial assistance and further discusses opportunities for increasing enrollment among those who are already eligible. The author also examines opportunities for expanding access to specific services, including reproductive health care, among those with insurance. Any attempts to modify or build on the ACA will likely be complicated by the ongoing coronavirus pandemic as well as slim Democratic majorities in the House and Senate, but regulatory solutions will likely be easier to achieve than those that require changes to federal law or state policy.
在过去的十年中，《平价医疗法案》（ACA）成功地减少了美国人的无保险人数，并改善了医疗服务的可及性和可负担性。但特朗普政府缩短了联邦市场的开放注册期、减少了外联和注册资金，并修改了公共收费规则等措施，削弱了该法律。拜登政府将有机会扭转其中的一些变化，并进一步加强该法律，以改善医疗保健的可及性和可负担性。本文作者探讨了扩大符合条件但不符合医疗补助或市场财务援助条件的人群获得负担得起的保险覆盖范围和医疗服务的选择方案，并进一步讨论了增加已经符合条件的人群参保率的机会。作者还研究了在有保险的人群中扩大特定服务（包括生殖保健）的机会。任何对《平价医疗法案》进行修改或扩展的尝试都可能会受到持续的冠状病毒大流行以及众议院和参议院民主党多数席位的限制，但监管解决方案可能比需要修改联邦法律或州政策的解决方案更容易实现。
