An America-First Healthcare Plan
This Executive Order, titled An America-First Healthcare Plan and signed in September 2020, reiterates the President’s aim to put patients first by expanding choices, lowering costs, and improving care while protecting people with pre-existing conditions. It builds on prior actions to broaden coverage options (such as renewable short-term, limited-duration plans, health reimbursement arrangements, and association health plans), promote telehealth, and increase price transparency. The order also emphasizes efforts to reduce drug costs (including generic/biosimilar approvals and support for safe drug importation) and to curb surprise bills, requiring the Secretary of Health and Human Services (HHS) to work toward a legislative fix by December 31, 2020, with a fallback to administrative action if Congress does not act. It directs agencies to enhance price transparency, reduce waste and fraud, and continue improvements in veteran and rural health, including quality of care and targeted research. The EO is not a law; it directs agency actions and policy direction and relies on existing authorities and appropriations.
Key Points
- 1The policy goal: Expand Americans’ healthcare choice, lower costs, and ensure access to affordable coverage, including protections for people with pre-existing conditions. The order frames these aims as ongoing national priorities.
- 2Giving Americans more choice: Directs Treasury, Labor, and HHS to maintain and build on actions that broaden access to affordable options, such as short-term plans, health savings accounts, and association health plans, and to support flexibility in the health insurance market.
- 3Lowering costs and increasing price information: Calls for continued efforts to expand affordable medicines (faster generic/biosimilar approvals, and safe drug importation), promote price and quality information for consumers before care, and pursue measures to reduce government payments that distort pricing. Emphasizes transparency as a tool to empower shoppers.
- 4Surprise billing and hospital pricing: Commits to pursue a legislative solution to end surprise medical bills by December 31, 2020; if Congress does not act, authorizes administrative actions to prevent patients from paying unforeseen out-of-network costs. Requires updates to Medicare.gov Hospital Compare within 180 days to include billing-related information (compliance with price transparency rules, itemized discharge receipts, and information on hospitals’ legal actions against patients).
- 5Care quality and targeted reforms: Maintains focus on better care for veterans and rural populations, continues efforts to improve care quality, and promotes ongoing medical innovation for conditions like COVID-19, Alzheimer’s, sickle cell disease, pediatric cancer, and other public health priorities.
- 6General provisions: Reaffirms that the order does not diminish authorities of executive departments, complies with the law, and does not create enforceable rights. Implementation depends on existing law and appropriations.