Harris Criticizes 12 Holdout States That Haven't Expanded Medicaid

President Barack Obama returned to the White House on Tuesday to savor the 12th anniversary of his signature Affordable Care Act, which is now part of the fabric of the American health care system and whose reach President Joe Biden is looking to extend.

Sign-ups under the health law have increased under Biden's stewardship, and more generous taxpayer subsidies have cut costs for enrollees, albeit temporarily.

Biden and Obama marked the 12th anniversary of the law, which back in 2010 the then-vice president had memorably called a "big ... deal." Its staying power has been enhanced by three Supreme Court victories and an emphatic thumbs-down vote by the late Sen. John McCain, R-Ariz., which took the wind out of President Donald Trump's efforts to repeal and replace it.

The law was such a bugaboo in 2010 that Democrats rarely invoked it as they went into a midterm election that turned out to be, in Obama's own words, a "shellacking." Now, Democrats are hoping the political equation will work to their advantage, and that a focus on shoring up the tween-age health law can help them avoid a debacle at the polls this November.

Shortly after taking office, Biden opened up the health insurance markets to anyone seeking coverage during the COVID-19 pandemic, and his coronavirus relief bill provided a significant, though temporary, increase in financial assistance. The result was a record 14.5 million people signed up for subsidized private coverage.

Biden signed an executive order on Tuesday to close the so called "family glitch" in the implementation of the 2010 law that his administration believes will help 200,000 people gain affordable coverage

People tripped up by the family glitch are dependents of workers who have an offer of employer coverage that the government interprets as being affordable. As a rule, people with affordable employer coverage are not eligible for taxpayer-subsidized ACA plans.

But the issue with the current interpretation is that affordability is determined by the cost for employee-only coverage, and not more expensive family policies. Workers able to afford their own share may not be able to cover premiums for the entire family. So the family is cut out of ACA coverage.

A Biden administration regulation addressing the issue recently cleared White House review. The intent of the original policy was to prevent people with employer coverage from going into the health law's subsidized markets, but advocates say it has proven too restrictive.

The White House estimates that the fix would help 200,000 people get insurance and bring costs down for nearly 1 million more.

Unless Democrats in Congress finally coalesce around a version of Biden's social legislation, his enhanced financial assistance for millions purchasing ACA plans will expire at the end of this year. A return to higher premiums would likely trigger an increase in the number of uninsured people, a political embarrassment for Democrats committed to expanding coverage.

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