President Joe Biden on July 21 announced his decision not to seek re-election this November.
And with that, Vice President Kamala Harris has seemingly secured her position as the Democratic nominee for the upcoming election. A key topic that has emerged as a result is: what would healthcare look like under her presidency?
It’s an important question, especially given the limited lead time for her to develop a plan that diverges significantly from the efforts Biden has implemented over the past four years.
While few things are certain at this point, based on the incumbent Vice President’s previous statements and current stance on healthcare, it’s clear that we can anticipate her defending several key healthcare points heading into election season. Below, we discuss the top five.
Greater Access to Affordable Healthcare
Following in Biden’s path, we can expect Kamala Harris to continue prioritizing policies that make healthcare more affordable for Americans, reducing out-of-pocket costs and expanding coverage options.
Under the Biden administration, health coverage obtained through state and federal marketplaces reached a record-high participation of over 21 million last fall. In fact, 15 key states saw participation in ACA coverage double between 2020 and 2024. But what spurred this exponential growth in ACA coverage?
Several things contributed, including the introduction of special enrollment periods, a larger window for signing up during the annual open enrollments, and greater outreach initiatives.
Given Harris’s role in supporting Biden during that time, it’s safe to assume that greater access to affordable healthcare will continue, including building off these key ACA developments, as well as including dental in medical coverage.
In fact, this is an area that she may double-down on. The current VP has on numerous occasions voiced the need for greater equity in healthcare, including through the expansion of Medicare and by introducing a first ever public health plan.
Expansion of Medicare and Medicaid
Building on the expansion of greater access to affordable healthcare, Harris is expected to begin by requiring the 10 remaining states that have not adopted the ACA’s expansion of Medicare and Medicaid to do so.
Since 2019, when Harris initially sought to become the 2020 Democratic candidate, she has promoted “Medicare for All,” and requiring expansion in the remaining outlier states would be the easiest place to start implementing that.
When the ACA first passed in 2010, the majority of U.S. states adopted the expansion, which permits states to offer residents more affordable coverage based on their income level rather than a disability.
Since then, several others, with South Dakota and North Carolina being the latest, have embraced the amendment. As a result of the program, millions of Americans have gained eligibility for government-subsidized health coverage.
Strengthening Abortion Rights
When the Supreme Court overturned the landmark Roe. vs Wade in 2022, the U.S. suffered a loss of equality. Since then, access to safe and affordable reproductive services has become paramount.
Harris outwardly criticized the Court’s decision and is actively campaigning for women’s rights in healthcare.
Most recently, Harris made history as the first president and vice president to tour an abortion clinic, visiting a Planned Parenthood in Minnesota earlier this year. She also spoke out against a Florida law that bans abortion after just six weeks.
Now, as the Democratic nominee for the 2024 election, it’s clear that her stance on this issue will remain a focal point of her healthcare policies.
In fact, her position on abortion rights has given her an advantage in the upcoming election, with a report by the Kaiser Family Foundation finding that 12% of voters consider access to abortion the most important issue.
We can assume that Harris will continue to focus on protecting and strengthening abortion rights.
Preservation in Existing ACA Protections
Key provisions of the ACA have come under fire during Biden’s presidency. However, the 46th president ensured that all of those ACA benefits remain intact.
Most recently, a Texas judge struck down the ACA’s preventive care services, which guarantees that eligible individuals received specific healthcare services, such as covid-19 vaccines, cancer screenings, and substance abuse counseling without need to pay a copayment.
The Judge then applied his ruling across the entire U.S., to which Biden issued a stay to preserve the mandate. An appeals court then upheld the preventive care services portion, ultimately affirming that the ruling should not apply to the nation at large and instead should only affect the parties involved in the case.
As evidenced by the outcomes of the case, Biden played a key role in upholding and protecting key provisions of the ACA.
Given the impact of removing benefits, Harris would work to preserve and strengthen them, ensuring that crucial benefits like coverage for pre-existing conditions remain in place.
Extended Premiums Tax Credits
Last but most certainly not least relates to the extension of ACA subsidies, commonly known as Premium Tax Credits (PTCs).
First introduced as part of Biden’s American Rescue Plan, the expansion of PTCs allowed Americans with income up to 150% of the Federal Poverty Level (FPL) to obtain silver-quality health plans for $0 monthly premiums, as well as pay significantly reduced deductible costs.
In addition, the program also expands ACA subsidized coverage to Americans who earn 400% and above the FPL and caps the amount they would have to contribute on a monthly basis to 8.5% of their household income.
The PTC extension was then renewed through 2025 as part of the Inflation Reduction Act. Since implementation, the PTC expansion has played a key role in helping individuals obtain affordable, quality coverage through state and federal marketplaces.
With the ACA subsidy expansion program currently set to expire next year, there are concerns about the potential loss of access to coverage for millions of Americans.
As Kamala Harris steps into the role of the new Democratic nominee for the upcoming election, several healthcare policy experts anticipate that she will extend PTC access again or make it a permanent feature of U.S. healthcare policy, as Biden attempted to do in 2021.
Healthcare on the Horizon
If Harris wins the election this November, we can anticipate healthcare and ACA protections that resemble many of Biden’s.
It’s true that many of these healthcare developments and protections bode well for the greater public, but some of them create compliance hurdles for employers.
The PTC expansion, for example, raises penalty risks for employers since PTCs are the trigger for the IRS in identifying instances of potential ACA non-compliance.
When an employee gets a PTC from a state or federal health exchange, the IRS compares the request with the employer’s ACA filings to spot organizations that might not be complying with the ACA’s Employer Mandate.
ACA Compliance Remains Imperative
So, come this November, there’s a lot at stake when it comes to healthcare and the ACA. Regardless, employers should remain diligent in keeping up with the responsibilities of the ACA’s Employer Mandate as the IRS increases its focus and attention to detail on non-compliance.
If you need assistance with ACA compliance and the subsequent year-end filing, contact Trusaic. Our comprehensive ACA Complete software offers all the resources employers need to achieve full ACA compliance and eliminate penalty risk.
From preparing 1095-C forms and conducting monthly monitoring to performing safe harbor calculations, handling year-end ACA filings, and providing IRS audit defense, Trusaic has assisted thousands of clients in eliminating billions in ACA penalties.
