Although the fate of the Senate remains undecided, President-elect Joe Biden’s Democratic win spells major changes for both the handling of the coronavirus disease 2019 pandemic and health care in the United States.
Former Vice President Joe Biden has won the US presidency thanks to last-minute slim majorities gained in the key battleground state of Pennsylvania.
Shortly after news desks called Pennsylvania for Biden, Nevada also fell in his column, pushing his Electoral College tally beyond the 270 needed to win. He also leads in Georgia and Arizona, which have not yet been called.
Although the fate of the Senate remains undecided, his Democratic victory spells major changes for both the handling of the coronavirus disease 2019 (COVID-19) pandemic and health care in the United States.
During the 2020 presidential campaign, Biden made it clear his vision of tackling the COVID-19 pandemic is in stark contrast to that of the 45th president, Donald Trump. Priorities outlined on the president-elect’s website include fixing Trump’s “testing and tracing fiasco,” to ensure all Americans have access to reliable and free testing.
In addition, Biden promises federal support when it comes to supplying personal protective equipment (PPE) to states struggling with the pandemic. Over the course of the past 10 months, shortages of PPE have been consistently reported, as obtaining and distributing critical materials were largely left up to state, city, tribal, and territorial health agencies.
Perhaps the most controversial promise, the president-elect also plans to implement a nationwide mask mandate “by working with governors and mayors.” This task may prove challenging as the majority of counties currently seeing spikes in COVID-19 cases voted overwhelmingly for President Trump’s reelection. Indeed, many Republican constituents have largely opposed mask-wearing mandates, which they claim impose on their individual rights.
Additional COVID-19–related goals of the Biden administration include providing evidence-based guidance on how communities can navigate the pandemic while providing the resources necessary to schools and small businesses. The administration also plans for an equitable distribution of treatments and vaccines, and protecting older Americans and those most at risk of COVID-19 complications.
On the international stage, Biden hopes to restore America’s position as a cooperating partner helping to defeat the global pandemic. The administration plans to repair the country’s relationship with the WHO, restore the White House National Security Council Directorate for Global Health Security and Biodefence, and re-launch the US Agency for International Development’s pathogen-tracking program, PREDICT, cut by Trump.
However, effective implementation of many of these policies hinges on the outcomes of the Senate races, as a Republican majority may aim to block or impede efforts for stronger federal control of the pandemic.
More than half of Americans (52%) said they trust Biden to lead the US health care system compared with Trump, according to a preelection poll conducted by West Health and Gallup. In comparison, 39% said they trusted Trump.
That gap grew among younger adults aged 18 to 29, as 62% of young adults say they trust Biden on health care issues, compared with only 25% who support Trump’s leadership of the health care system.
Biden has long been a supporter of a public option for health insurance in America. In the final presidential debate before the election, Biden claimed his plan would reduce drug prices and premiums by allowing for drug price negotiation through the Medicare program.
However, as the fate of the Affordable Care Act (ACA) hinges on a Supreme Court decision, expected by June 2021, it is unclear how Biden’s proposed expansion of the ACA will unfold.
Implementation of the ACA in 2010 led to significant increases in health insurance coverage across the country. In 2019, 11.4 million people enrolled in coverage through state and federal marketplaces. The ACA also expanded Medicaid coverage to adults up to 138% of the federal poverty level. Between 2013 and 2019, enrollment in Medicaid expansion states, of which there are 36, plus Washington, DC, increased by 13.1 million people.
Critics argue an overturning of the ACA by the Supreme Court is irresponsible during one of the greatest public health crises in American history.
“The ACA has had a tremendous effect and without the ACA, we would be in even worse shape right now heading into this double whammy of a public health crisis and an economic crisis,” Larry Levitt, MPP, executive vice president for health policy at the Kaiser Family Foundation told The American Journal of Managed Care®.
Biden’s plan, also largely opposed by more liberal Democrats who argued for a completely nationalized health care system, includes putting an end to “surprise billing,” lowering costs and improving outcomes by partnering with the health workforce, and repealing the exception allowing drug corporations to avoid negotiating with Medicare over drug prices.
The COVID-19 pandemic has brought racial health care disparities throughout the country to the forefront of the national conversation. To address racial health disparities, Biden plans to establish a permanent Infectious Disease Racial and Ethnic Disparities Task Force.