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With a Flick of His Pen, President Biden Can Advance Health Equity
Time to finally end junk insurance, and take the opportunity to roll back ICHRAs too.

This month, the Washington Post’s Rachel Roubein explored an interesting question – why hasn’t the Biden Administration yet taken action to reign in junk insurance? One of President Biden’s first acts in office was to flag harmful Trump-era health care rules for review, one of which expanded the definition of short-term limited duration insurance (STLDI) from three months to as long as three years, another was the creation of Individual Coverage Health Reimbursement Arrangements (ICHRAs) which further risks health equity. The short-term, or junk, insurance rule flooded the market with low-quality health plans, sometimes marketed dishonestly, that leave American families underinsured and at risk of huge medical bills if someone needs care.


As Keep US Covered has detailed, junk insurance can mean a lot of headaches for Americans who hold these “skinny,” inexpensive plans that were only intended to bridge brief gaps in an individual’s coverage. From the Post’s Roubein:


“Restoring the three-month duration has long been a priority for Democrats, who accused Trump of “Obamacare sabotage.” That’s because the plans don’t have to cover preexisting conditions and are allowed to sidestep the ACA’s requirement to cover services such as maternity care and mental health treatment. A 2020 probe from House Democrats found that some of the plans’ marketing materials provide misleading information about a plan’s exclusions.”


President Biden helped coin the term “junk plans” in his 2020 run for the White House. He’s not alone in wanting to see these plans go away: 40 Democratic Senators urged action to tighten the STLDI rules last February. In recent weeks, Rep. Cindy Axne of Iowa led 41 of her House colleagues in making a similar plea. The president has the support of both houses of Congress – but he doesn’t need congressional action to make this important change. If the president were to end junk insurance, he could credibly tell the American people that he took concrete steps to reduce health care costs and expand access to quality coverage, thereby meaningfully advancing health equity. Members of Congress could also campaign on this achievement.


But President Biden Shouldn’t Stop There…


Junk insurance wasn’t the only flawed policy launched by the previous president. Alongside STLDI, ICHRAs were created by the same Trump-era health rule. We know President Biden is eyeing ICHRAs for possibly “suspending, revising or rescinding,” because they open the door to discrimination in workplace health benefits. A recent study shows that as many as 1.5 million – and counting – working Americans have been or will be pushed onto this stipend-based system for health coverage by the end of 2022, risking higher costs and less access to the doctors they want.


Junk insurance and ICHRAs similarly leave working Americans with inferior coverage, only serving to expand the troubling health disparity gap in this country. Addressing both in tandem presents a real opportunity for the Biden Administration to deliver on their health care priorities. Polling Keep US Covered conducted last year shows that 68% of President Biden’s core voters – critical to his party’s success in the upcoming midterms – support overturning the expansion of junk insurance and that 71% would be more likely to vote in 2022 if he took action on ICHRAs. He should do both, and he should do it soon.


President Biden got the ball rolling earlier this month with executive action to fix the family glitch issue. He can continue putting wins on the board, build momentum heading into the fall (and end the questions of when he’ll act) by reigning in the junk insurance and ICHRA rules that are hurting working Americans.


To learn more about Keep US Covered and its partners’ work to educate policymakers on these regulations and the social determinants of health, visit or follow the campaign on Twitter and Facebook.

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