This is the second installment of our series highlighting the policy areas we’re watching leading up to inauguration–and how we’re expecting President-elect Biden’s administration to approach them. Read last week’s entry on Food and Agriculture here.

Unless Democrats pull off two Senate victories in Georgia, President-elect Biden won’t be able to pursue significant health care reforms— like creating a public option— come  January 20. But his administration will do what it can to strengthen the Affordable Care Act (ACA) while grappling first and foremost with controlling the coronavirus crisis.

Biden’s health team will lead the pandemic response with a science-based approach that focuses on testing, vaccine distribution and supply shortages, all with an eye towards equity. The team comprises medical experts and experienced public servants including Dr. Anthony Fauci and California Attorney General Xavier Becerra, Biden’s nominee for Secretary of Health and Human Services. 

Becerra—who helped drive ACA’s passage and more recently led its Supreme Court defense– will play a key role in helping Biden reinforce the ACA through executive orders, regulation, guidance and eliminating Trump-era policies that made coverage enrollment more difficult. Likely actions include:

• Rolling back the Trump Administration guidance allowing for Medicaid work requirements/block grants
• Opening an immediate ACA Special Enrollment Period and restoring funds for enrollment outreach
• Reversing Trump Administration Section 1557 (ACA non-discrimination provision) rule
• Developing new Center for Medicare and Medicaid Innovation (CMMI) alternative payment models

Of course, if Democrats take the Senate, Biden’s health care agenda could become much more ambitious.