Amidst All the Noise, a Health Care Presidency Is Quietly Reinforcing the Middle Class

Hundreds of thousands of Wisconsinites have more secure, affordable health insurance coverage as Trump’s attacks are replaced by Biden’s initiatives.

In his recent State of the Union speech, President Joe Biden tackled a nearly impossible mission with 100% success—addressing the urgent threats of the crisis in Ukraine while also spelling out his ongoing domestic agenda. The sheer enormity of the presidency means not every issue can be included, and those that don’t make the cut may not get the attention they deserve. As a result, Americans may be missing a quiet revolution that’s making their lives a little easier. 

This nation once again has a president focused on making health insurance secure and affordable instead of trying to take it away.

In his speech, Biden did speak passionately about lowering the cost of prescription drugs by letting Medicare negotiate for lower prices and capping the cost of insulin at $35 per month. But that’s only part of the story of what Biden has done in his first year in office.

It started shortly after he was sworn in, with a special open enrollment period which allowed people to sign up for health insurance through the Affordable Care Act (ACA) marketplace. More than 30 million Americans now have health coverage because of the ACA, including a record 14.5 million covered under the Affordable Care Act marketplaces. (The administration of former President Donald Trump ferociously opposed offering a special enrollment period in the early weeks of the pandemic.)

In Wisconsin, the Centers for Medicare and Medicaid Services reports 212,209 people signed up for or were automatically renewed in 2022 individual market health insurance coverage through the ACA marketplace during the most recent open enrollment period—running from Nov. 1, 2021 through Jan. 15, 2022.

Crucially, the Biden Administration addressed the cost of health care along with access to health care. The American Rescue Plan ensured that ACA enrollees would have an option to purchase health insurance coverage for less than 8.5 percent of their income. Previously, families earning just above 400 percent of the federal poverty level spent an average of 15 percent of their incomes on health insurance.

The American Rescue Plan also expanded the eligibility for premium tax credits for two years and eliminated premiums altogether for Americans earning up to 150 percent of the federal poverty level (roughly $19,000 for a single person and $39,000 for a family of four) who buy their coverage on the marketplace, as well as for those receiving unemployment insurance due to the economic impact of the pandemic.

Biden also kept his promise to roll back discriminatory Medicaid work requirements in 12 states which were presenting obstacles to low-income individuals who needed access to affordable, quality health coverage. The American Rescue Plan also directly confronted the issue of access to maternal health care by allowing  states to extend postpartum coverage under Medicaid from 60 days to 12 months following pregnancy—a move aimed at reducing the country’s shamefully high maternal and infant mortality rates, especially in communities of color.

The president would not have been blamed had he devoted a larger portion of his speech to patting himself on the back for getting all of that done for working families. Instead, he chose to focus on the future—on the work still to be done that will only build on his legacy as a health care president.

He made clear that he is still pushing to give Medicare the power to negotiate for lower drug prices. He asked Congress to pass legislation that would cap the cost of insulin at $35 per month. And he proposed a Unity Agenda that will tackle the opioid crisis head-on, improve mental health care, and end cancer as we know it.

That proposed agenda, on top of the long list of health care accomplishments achieved during President Biden’s first year in office, would firmly cement his legacy as one of the most important health care presidents of all time. 

Amid all the noise, we should take note of these quiet but important victories.