Trump left Biden $1 billion to spend on healthcare enrollment efforts, new report finds

• A report from the Kaiser Family Foundation found that the administration of former President Donald Trump left $1 billion in unused healthcare enrollment spending.
• President Joe Biden plans on issuing an executive order on Thursday to expand enrollment efforts in the Affordable Care Act, rolling back Trump’s healthcare actions.
• Although some of Biden’s healthcare proposals require congressional approval, the availability of unspent funds will assist in carrying out his executive orders. 
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Former President Donald Trump significantly reduced spending on enrollment efforts in the Affordable Care Act, leaving President Joe Biden with around $1 billion in unused funds to spend on healthcare, according to the Kaiser Family Foundation.

In a new report released on Monday, the Kaiser Family Foundation found that over fiscal years 2018-2020, the Trump administration reduced funding on key activities that support healthcare enrollment, including marketing and outreach, the Healthcare.gov website, and the federal marketplace call center. The unused funds over those years accumulated to over $1 billion, and Biden will likely use those funds to revamp enrollment efforts in upcoming executive actions.

“It appears that more than $1 billion in unspent federal user fee revenue has accumulated and could be used to invest in changes that would make it easier for consumers to enroll in health coverage,” the report states. 

According to sources familiar with the plan, Biden on Thursday will take actions to strengthen Medicaid and start an open enrollment period under the ACA, and as indicated in the report, Biden can use the leftover funds to further those goals. This comes in response to his predecessor’s weakening of Medicaid, which Biden consistently pledged to reverse.

Although some of Biden’s healthcare proposals will require congressional action, like expanding ACA subsidies, reforming the enrollment process can be done by executive action, according to the report, which is made easier by the leftover unspent funds.

“The availability of unspent, carryover user fee revenue could make possible immediate investments in marketing and outreach, support for enrollment assistance, and other improvements,” the report said.

According to the U.S. Census Bureau, 2.3 million more people became uninsured between 2016 and 2019, and with Trump declining to provide a special enrollment period for those who became uninsured during the pandemic, Biden said he would favor doing so.