Updated at 2:10 p.m. ET
President Biden signed two executive actions Thursday that are designed to expand access to reproductive health care and health insurance through the Affordable Care Act and Medicaid.
"There's nothing new that we're doing here other than restoring the Affordable Care Act and restoring Medicaid to the way it was before [Donald] Trump became president. Because by fiat, he changed — made [it] more inaccessible, more expensive and more difficult for people to qualify for either of those two plans," Biden said in a brief Oval Office signing ceremony.
"I'm not initiating any new law, any new aspect of the law," Biden stated. "This is going back to what the situation was prior to Trump's executive order."
An executive order Biden signed instructs the Department of Health and Human Services to open a special enrollment period for the Affordable Care Act through HealthCare.gov, the federally run health insurance marketplace. The enrollment period will run from Feb. 15 to May 15, giving Americans who have lost their employer-based health insurance because of the coronavirus pandemic an opportunity to sign up for coverage.
"As we continue to battle COVID-19, it is even more critical that Americans have meaningful access to affordable care," a White House fact sheet reads.
The measure also orders federal agencies to reexamine current policies that may undermine the Affordable Care Act and the health insurance exchanges created under the law. Biden is also requesting a review of policies that could make it more difficult for Americans to enroll in Medicaid.
His second executive action aims "to protect and expand access to comprehensive reproductive health care" by rescinding the Mexico City policy, also known as the global gag rule. This policy, reinstated and expanded by the Trump administration, bars international nongovernmental organizations that provide abortion counseling or referrals from receiving U.S. funding.
Biden on Thursday called the gag rule an "attack on women's health access."
Affordable Care Act
Biden's executive actions will undo some of the Trump administration's efforts to undermine the ACA.
Last November, the Trump administration and several Republican-led states argued at the U.S. Supreme Court that the program should be voided, which would have eliminated popular elements of the law such as protections for those with preexisting conditions.
The Supreme Court will hear a case that could decide the legality of work requirements for Medicaid recipients. The Trump administration granted waivers to several states to allow work requirements for Medicaid, though some of those waivers have not been implemented and others have been blocked by courts.
Biden is reversing course and directing federal agencies to reconsider those work requirement rules. He is also asking agencies to review policies that undermined protections for people with preexisting conditions, including complications related to COVID-19.
The Trump White House also refused to advertise the ACA as an option for the millions of Americans who have lost their jobs and health insurance during the pandemic. The administration faced pressure to open HealthCare.gov for anyone to enroll in the Affordable Care Act in response to the pandemic, but it never did.
Global gag rule
For decades, Democratic and Republican presidents have alternately rescinded or reinstated the global gag rule, with Democrats, such as Biden, opposing the policy. Republicans have argued that the rule would reduce the number of abortions.
However, a study released in 2019 suggested the policy failed to reduce the rate of abortions and ultimately had the opposite effect. The study said the rate of abortions increased by about 40% in the countries studied — most likely because the funding ban caused a reduction in access to contraception and a consequent rise in unwanted pregnancies.
Under the actions announced on Thursday, the president is telling federal agencies to review a Trump-era rule that limited the use of Title X federal funds meant for family planning and reproductive health services for low-income patients. Under this program, organizations that provided abortions or abortion counseling could not have access to those federal funds.
The White House said, "Across the country and around the world, people — particularly women, Black, Indigenous and other people of color, LGBTQ+ people, and those with low incomes — have been denied access to reproductive health care."
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