What Might President Biden Do on Health Policy Without Congressional Action?

President-elect Joe Biden campaigned on major health reforms, including building on the Affordable Care Act, better managing the COVID-19 pandemic and lowering prescription drug costs, but a narrowly divided Congress could stifle efforts to enact such major legislation. The Biden administration instead may choose to move forward on a variety of policy changes administratively, without Congressional action, to achieve some of the same goals.

A new KFF resource outlines more than 50 potential administrative actions that the Biden administration could take on key health policy issues, many of which would reverse or modify controversial regulations or guidance implemented by the Trump administration that sparked significant legal or partisan pushback. The list of actions is drawn from specific campaign pledges made by President-elect Biden and proposals from prominent Democratic policymakers.

The compilation includes actions involving the federal response to the pandemic; the Affordable Care Act and private health insurance; Medicaid; sexual and reproductive health; mental health and substance abuse; immigration and health; long-term care; HIV/AIDS policy, and LGBTQ health. The list does not include potential policy actions in some areas, such as lowering drug prices and Medicare policies, where there is no clear indication about whether and how the incoming Biden administration would alter Trump administration policies.

The brief notes that the Biden administration may identify other administrative actions it can take in health care, especially if its policy agenda is stymied by Congress.