Abstract
Over the past decade, the Affordable Care Act (ACA) has successfully reduced uninsurance and improved access to and affordability of health care services for millions of Americans. But the law has been weakened over the past four years as the Trump administration shortened the open enrollment period in the federal Marketplace, reduced outreach and enrollment funding, and revised the public charge rule, among other actions. The incoming Biden administration will have the chance to reverse some of these changes and further strengthen the law to improve health care access and affordability. In this paper, I explore options to expand access to affordable coverage and care for those who do not qualify for Medicaid or Marketplace financial assistance, and further discuss opportunities to increase enrollment among those who are already eligible. I also examine opportunities to expand access to specific services, including reproductive health care, among those with insurance. Any attempts to modify or build upon the ACA will likely be complicated by the ongoing coronavirus pandemic as well as a divided Congress, but regulatory solutions will likely be easier to achieve than those that require changes to federal law or state policy.
The Affordable Care Act and Implications for Health Care Services for American Indian and Alaska Native Individuals
