1. Susan L. Hayes et al., What’s at Stake: States’ Progress on Health Coverage and Access to Care, 2013–2016 (Commonwealth Fund, Dec. 2017); and Robin A. Cohen, Emily P. Zammitti, and Michael E. Martinez, Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, 2016 (National Center for Health Statistics, May 2017).
2. Jesse C. Baumgartner et al., How the Affordable Care Act Has Narrowed Racial and Ethnic Disparities in Access to Health Care (Commonwealth Fund, Jan. 2020); and Sherry A. Glied, Stephanie Ma, and Anaïs Borja, Effect of the Affordable Care Act on Health Care Access (Commonwealth Fund, May 2017).
3. There are more than 1,000 instances in the Affordable Care Act where Congress explicitly directed or permitted federal officials to act (such as issue new regulations or award grants). Simon F. Haeder and Susan Webb Yackee, “A Look Under the Hood: Regulatory Policy Making and the Affordable Care Act,” Journal of Health Politics, Policy & Law 45, no. 5 (Oct. 2020): 771–86. Beyond explicit directives from Congress, federal agencies have authority to interpret federal laws within their purview and to, for instance, clarify statutory terms or requirements. Courts have generally deferred to agency interpretations of federal laws that are silent or ambiguous so long as the agency’s interpretation is reasonable. This is generally known as the Chevron doctrine. Valerie C. Brannon and Jared P. Cole, Chevron Deference: A Primer (Congressional Research Service, Sept. 19, 2017).
4. The 100 Days Agenda: A Patient-First Blueprint, Recommendations on Behalf of 33 Patient Advocacy Organizations (Leukemia & Lymphoma Society, Oct. 2020); Families USA Health Equity Task Force, Eight Recommendations for Federal Policy Priorities in 2021 (Families USA, Jan. 2021); Stan Dorn and Frederick Isasi, “President-Elect Biden Can Take Administrative Action to Dramatically Cut Consumers’ Health Care Costs and Cover Millions of Uninsured,” Health Affairs Blog, Dec. 7, 2020; Sarah Lueck, Administration Should Act to Expand and Improve Health Coverage (Center on Budget and Policy Priorities, Jan. 2021); Margaret A. Murray, “ACAP Recommendations for Regulatory Changes to Medicaid, Medicare, and the Marketplaces to the Biden–Harris Agency Review Team for the Department of Health and Human Services,” letter from the Association for Community Affiliated Plans to Chiquita Brooks-LaSure of the Biden–Harris Agency Review Team, Dec. 22, 2020; Charles N. Kahn III, Letter re: Transition Team Recommendations, letter from the Federation of American Hospitals to the Biden–Harris Transition Team, Dec. 22, 2020; Sr. Mary Haddad, Letter re: Transition Team Recommendations, letter from the Catholic Health Association of the United States to the Biden–Harris Transition Team, Jan. 7, 2021; Jacqueline W. Fincher, Letter re: Transition Team Recommendations, letter from the American College of Physicians to the Biden–Harris Transition Team, Dec. 10, 2020; Trish Riley, “State-Based Marketplace Strategies for Insurance Market Stabilization and Improvement,” letter from the State Health Exchange Leadership Network of the National Academy for State Health Policy to the Biden–Harris Transition Team, Nov. 20, 2020 (these recommendations are consistent with similar analyses of the priorities of state marketplace officials); Rachel Schwab et al., Federal Policy Priorities for Preserving and Improving Access to Coverage: Perspectives from State-Based Marketplaces (Commonwealth Fund, Feb. 2021); and “Priorities to Strengthen Insurance Coverage and the ACA,” letter with recommendations on behalf of 11 state insurance commissioners to the Biden–Harris Transition Team, Dec. 23, 2020.
5. Recommendations from Families USA, for instance, focused primarily on “affirmative” steps that the Biden administration could take and only generally note the need to “revers[e] harmful Trump administration policies.” See Dorn and Isasi, supra note 4. In acknowledging the need to “go beyond reversing harmful Trump administration policies,” Families USA linked to a piece that encouraged federal administrative action consistent with those recommended by others here. These actions included authorizing a COVID-19 emergency enrollment period for HealthCare.gov; increasing marketing, outreach, and enrollment assistance; fixing the family glitch; and reversing the public charge rule. See Katie Keith, “CMS Could Do More in Light of the Coronavirus Crisis,” Health Affairs Blog, Mar. 25, 2020.
6. Joseph R. Biden Jr., Executive Order on Strengthening Medicaid and the Affordable Care Act, White House, Jan. 28, 2021.
7. U.S. Department of Health and Human Services, “HHS Announces the Largest Ever Funding Allocation for Navigators and Releases Final Numbers for 2021 Marketplace Open Enrollment,” news release, Apr. 21, 2021; and Tami Luhby, “New Stimulus Obamacare Subsidies Start April 1,” CNN, updated Mar. 31, 2021.
8. Tara Straw, “Direct Enrollment” in Marketplace Coverage Lacks Protections for Consumers, Exposes Them to Harm (Center on Budget and Policy Priorities, Mar. 2019).
9. Sara Rosenbaum, “Biden Administration Begins Process of Rolling Back Approval for Medicaid Work Requirements, But Supreme Court Hangs On,” To the Point (blog), Commonwealth Fund, Apr. 8, 2021.
10. Tricia Brooks, The Family Glitch (Health Affairs, Nov. 2014).
11. Julie Appleby, “Advocates Fear Tax-Credit Rule Will Exclude Some from Health-Care Benefit,” Washington Post, Apr. 15, 2012.
12. Cynthia Cox et al., The ACA Family Glitch and Affordability of Employer Coverage (Henry J. Kaiser Family Foundation, Apr. 2021).
13. Tara Straw, “Trump Proposal Threatens Coverage of HealthCare.gov Enrollees,” Off the Charts (blog), Center on Budget and Policy Priorities, Dec. 7, 2020; and Aviva Aron-Dine and Matt Broaddus, Change to Insurance Payment Formulas Would Raise Costs for Millions with Marketplace or Employer Plans (Center on Budget and Policy Priorities, updated Apr. 26, 2019).
14. Centers for Medicare and Medicaid Services, “Notice of Benefit and Payment Parameters for 2022 Final Rule Part Two Fact Sheet,” Apr. 30, 2021.
15. Stan Dorn, Assessing the Promise and Risks of Income-Based Third-Party Payment Programs (Commonwealth Fund, May 2018).
16. Karen Pollitz et al., Understanding Short-Term Limited Duration Health Insurance (Henry J. Kaiser Family Foundation, Apr. 2018).
17. Katie Keith, “Appeals Court Upholds Rule Relaxing Short-Term Plan Restrictions,” Health Affairs Blog, July 19, 2020. One judge dissented, asserting that the Trump administration’s rule conflicts with the Affordable Care Act because it expanded a narrow statutory exemption for short-term plans into a parallel market that competes with Affordable Care Act coverage.
18. Association for Community Affiliated Plans v. U.S. Department of the Treasury, 966 F.3d 782, 790, United States Court of Appeals for the District of Columbia Circuit, July 17, 2020.
19. Timothy S. Jost, “The Past and Future of Association Health Plans,” To the Point (blog), Commonwealth Fund, May 14, 2019.
20. Sara Rosenbaum, “The New ‘Public Charge’ Rule Affecting Immigrants Has Major Implications for Medicaid and Entire Communities,” To the Point (blog), Commonwealth Fund, Aug. 15, 2019.
21. U.S. Department of Homeland Security, “Inadmissibility on Public Charge Grounds; Implementation of Vacatur,” 86 Fed. Reg. 14221-29, Mar. 15, 2021.
22. Katie Keith, “HHS Strips Gender Identity, Sex Stereotyping, Language Access Protections from ACA Anti-Discrimination Rule,” Health Affairs Blog, June 13, 2020.
23. U.S. Department of Health and Human Services, “HHS Announces Prohibition on Sex Discrimination Includes Discrimination on the Basis of Sexual Orientation and Gender Identity,” news release, May 10, 2021.
24. Joel McElvain, “The Administration’s Recent Guidance on State Innovation Waivers Under the Affordable Care Act Likely Violates the Act’s Statutory Guardrails,” Notice & Comment Blog (Yale Journal on Regulation), Dec. 11, 2018; and Christen Linke Young, “The Trump Administration Side-Stepped Rulemaking Processes on the ACA’s State Innovation Waivers — And It Could Make Their New Section 1332 Guidance Invalid,” Brookings (blog), Brookings Institution, Nov. 28, 2018.
25. Katie Keith, “The 2022 Final Payment Notice (Sorta),” Health Affairs Blog, Jan. 15, 2021.
26. Timothy S. Jost, “A Health Care Regulatory Agenda for the Biden Administration,” To the Point (blog), Commonwealth Fund, Jan. 13, 2021.
27. Federal agencies will need to acknowledge a change in the policy, explain why the agency believes the new policy is better, identify factual or policy arguments for why it is changing its position, and address the interests of those who may have relied on the prior interpretation.
28. Timothy S. Jost, “The Continuing Threat to the ACA and Health Care Reform,” To the Point (blog), Commonwealth Fund, Mar. 11, 2021.