The Health 202: Biden is extending Obamacare enrollment through most of the summer

The purpose is to give people even more time to buy a new private plan — or change plans — using extra federal subsidies recently made available as part of the $1.9 trillion coronavirus relief bill. The expanded subsidies, available to people along the income spectrum, won’t be in place until April 1, given the time it is taking to update the federal website with the new eligibility thresholds.

“Every American deserves access to quality, affordable health care — especially as we fight back against the covid-19 pandemic,” Health and Human Secretary Xavier Becerra, who was confirmed last week by the Senate, said in a statement. “Through this special enrollment period, the Biden administration is giving the American people the chance they need to find an affordable health care plan that works for them.”

The Post’s Seung Min Kim:

The president also touted his actions to expand upon President Barack Obama’s landmark health-care law during a visit to a hospital in Columbus, Ohio.

“With the American Rescue Plan and the Affordable Care Act, millions of families will be able to sleep a little bit more soundly at night because they don’t have worry about losing everything if they get sick,” Biden said.

The enrollment extension applies to people in the 36 states that use the HealthCare.gov website instead of running their own marketplaces. But most other states have also reopened enrollment and may follow suit in lengthening the special sign-up period.

The regular HealthCare.gov sign-up period lasts from the beginning of November to the middle of December every year. Similarly, employer plans typically offer short sign-up periods at the year’s end. That’s because insurers typically hate the idea of people being able to buy coverage whenever they want to, considering that healthy people would be likely to avoid signing up until they are sick and need expensive care.

But when Biden took office, he quickly reopened HealthCare.gov for a three-month period, citing the need to give Americans an extra chance to get covered amid the pandemic. 

Insurers didn’t object — and then a few weeks later were overjoyed when Biden signed his relief bill, allowing the government to subsidize the plans they sell on the marketplaces even more heavily than before.

David Anderson, researcher at Duke University’s Margolis Center for Health Policy:

And they represent the first real expansion of the 2010 Affordable Care Act, after a decade of Republicans trying to repeal and then dismantle it.

The new thresholds allow people earning up to 150 percent of the federal poverty level (about $19,000 for an individual) to purchase a plan with the premiums fully subsidized by the federal government. Furthermore, there’s no longer a cap on subsidies for people earning 400 percent or more of the federal poverty level. These individuals or families would be expected to pay no more than 8.5 percent of their income in monthly premiums.

The Centers for Medicare and Medicaid Services estimates the extra subsidies mean each person will pay an average of $50 less for premiums. The agency also said 1 in 4 enrollees will be able to upgrade to a more generous plan while paying the same or less in premiums.

Murthy will reprise the role he held during the Obama administration after the Senate voted 57 to 43 in favor of his confirmation. Sens. Bill Cassidy (R-La.), Susan Collins (R-Maine) and Mitt Romney (R-Utah) were among the seven Republicans who crossed the aisle to support Murthy, The Post’s Dan Diamond reports.

The confirmation ensures that Murthy will be a prominent public spokesperson in the U.S. response to the coronavirus pandemic. While the surgeon general generally has a limited role in policymaking, Biden has pledged that Murthy will have an expanded portfolio. 

During the Obama administration, Murthy worked on public health issues, including the opioid crisis. He also pursued his own work combating the stigma of mental health issues. 

Some ethics watchdogs raised concerns over potential conflicts of interest related to Murthy’s coronavirus-related consulting work over the past year, for which he was paid more than $2 million by the cruise, travel and other industries. But lawmakers largely sidestepped the issue.

“He will be a key public voice on the covid response to restore public trust and faith in science and medicine,” Biden said when he nominated Murthy in December. “One of the reasons, Doc, I asked you to do this: When you speak, people listen. They trust you. You have a way of communicating.”

Becerra said that health officials must “reach people where they are,” bringing vaccines into farm fields and onto construction sites to address racial and ethnic disparities in access to the shots, The Post’s Amy Goldstein reports.

During his first interview since being sworn in as the nation’s top health official, Becerra also said that the government should address problems such as addiction, mental illness and a spike in suicides, which have been exacerbated by the coronavirus pandemic. Becerra won Senate confirmation by a razor-thin 50-to-49 margin on Thursday. 

Becerra also said the administration is reviewing Trump-era policies that weakened the Affordable Care Act, including rules that made it easier for consumers to buy skimpy, inexpensive health-care plans that bypass the ACA’s insurance protections, Amy writes.

Becerra praised the idea of a government alternative that could compete against private plans on the ACA marketplaces, although he did not hint at when he or Biden might start pushing Congress to move forward with a public option.

“When D.C. residents awaiting coronavirus vaccinations turn to trackers that show the state-by-state progress of inoculations, they see alarming numbers,” The Post’s Julie Zauzmer reports.

“As of Monday, Bloomberg’s tracker reported that the District has administered just 68 percent of the shots in its arsenal, based on data posted by the U.S. Centers for Disease Control and Prevention and other sources, lower than any state but Alabama. D.C. has fully vaccinated just 10 percent of its population, the tracker says, a lower percentage than any state but Utah,” Julie writes.

But D.C. officials say the trackers show their rollout in a skewed light. The CDC data shows the number of doses delivered to the District, but it does not break down how many are actually under the local government’s control. In D.C., a large number of doses have been delivered to federal agencies, which have been slow to report their usage of the shots.

Meanwhile, D.C. has vaccinated a smaller percentage of its population than most states in part because it has given first doses to more than 55,000 nonresidents who work in the city. The city has requested more shots from the federal government to make up for its role in vaccinating out-of-state workers, but those requests have so far been denied.

The administration announced on Tuesday that it has just 4 million doses to deliver to states and federal partners next week — an amount that represents the biggest jump in weekly allocations so far but will not get the company even halfway to its goal of delivering 20 million shots by the end of the month, Politico’s Rachel Roubein and Erin Banco report.

“The supply situation has frustrated administration officials trying to deliver on President Joe Biden’s directive to offer vaccines to all U.S. adults by May. The White House was counting on the single-dose J&J shot to reach underserved populations and accelerate the country’s return to normal,” they write.

Johnson & Johnson has delivered 4.6 million doses of its vaccine so far and maintains that it will hit its target of delivering 20 million shots by the end of the month. The company is awaiting the Food and Drug Administration to authorize two American partners, Emergent BioSolutions and Catalent, to help produce the shots.

After an independent panel of experts appointed by the National Institutes of Health accused the drugmaker of presenting “outdated and misleading” data, health officials, journalists and experts bemoaned yet another stumble in the company’s rocky rollout.

One federal official told The Post that the AstraZeneca results were the equivalent of “telling your mother you got an A in a course, when you got an A in the first quiz but a C in the overall course.”

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has characterized the way the data was rolled out as an “unforced error.”

“The irony of this is that it’s very likely a very good vaccine, and this sort of thing does nothing but cloud the picture. I don’t think it reflects on the vaccine,” Fauci said in an interview. 

Stat News infectious-disease reporter Helen Branswell:

FiveThirtyEight founder and statistician Nate Silver: 

Durbin (D-Ill.) opened a Senate Judiciary Committee hearing calling gun violence a “public health crisis” and pressing for “a moment of action” in the wake of mass shootings in Atlanta and Boulder, Colo., USA Today’s Matthew Brown and Savannah Behrmann report.

Democrats have consistently characterized gun violence as a health crisis, although Republican lawmakers have been reluctant to adopt that framing. During his presidential campaign, Biden vowed to fund NIH and CDC research on the issue.

On Tuesday, Biden called for more immediate action, pressing the Senate to reenact an ban on assault weapons and pass two background-check bills that have already been approved by the House.

Those actions are likely to face Republican opposition. Sen. Ted Cruz (R-Texas) hit back on new restrictions during the Judiciary Committee hearing. “Every time there’s a shooting, we play this ridiculous theater where this committee gets together and proposes a bunch of laws that would do nothing to stop these murders,” Cruz said.

Angus Deaton, an economics professor at Princeton University and one of the co-authors of the study, said that between 1990 and 2018, the educational divide had grown even as racial gaps in life expectancy narrowed. 

“Throughout all of recorded history in the U.S., Black people have more frequently died earlier and younger than whites — that remains true,” Deaton told CNBC. “But what has happened is the gaps by race have narrowed and the gaps by education have widened within both groups. Differences by race, which have been there forever, are still there, but they’re becoming smaller than differences in education.”

The study ended before it could take into account the impact of the coronavirus pandemic. The CDC reports that Black Americans are nearly twice as likely to die of covid-19 as white Americans. The study authors predict that pandemic will also widen educational disparities in mortality.