Biden to Sign Orders Aimed at Expanding Health Care Access

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President Biden will sign an executive action reopening enrollment for health coverage through the Affordable Care Act, also known as Obamacare.
Credit…Anna Moneymaker for The New York Times

President Biden, seeking to expand access to health care and strengthen the Affordable Care Act, will on Thursday order the reopening of enrollment in the health law’s marketplaces and a re-examination of Trump administration policies that undermined protections for people with pre-existing medical conditions.

Mr. Biden is also seeking to expand access to abortion, and will sign an executive action overturning his predecessor’s restrictions on the use of taxpayer dollars for clinics that refer or counsel patients to terminate pregnancies, both in the United States and overseas.

Taken together, Mr. Biden is trying to put a quick stamp on health policies that have been critical to a Democratic resurgence, especially those that back the Affordable Care Act, which he helped secure as President Barack Obama’s vice president. President Donald J. Trump failed to overturn the health law, but he spent four years undermining it with a series of executive actions, including allowing the sale of cheap, short-term and small-business health plans that do not meet the law’s health coverage mandates.

Mr. Biden’s first step will be to reopen enrollment for health coverage offered through the federal marketplace created under the health law, also known as Obamacare. His intent is to offer coverage not only to those who lost it during the pandemic, but also to those who did not have insurance and now want it, according to a senior administration official who previewed the new policy during a conference call Thursday morning.

The so-called special enrollment period will run from Feb. 15 to May 15. The official said the reopening would be accompanied by the kind of robust patient outreach — including “paid advertising, direct outreach to consumers and partnerships” with community organizations and advocacy groups — that was abandoned by the Trump administration.

Typically, Americans in the 36 states that rely on the federal marketplace can buy Obamacare insurance only during a six-week period in the fall, a restriction meant to encourage people to hold coverage even when they are healthy. The sign-up period for this year’s coverage ended in mid-December, with enrollments only slightly higher than they were last year. But the Trump administration did little to advertise it.

Once the coronavirus struck, Mr. Trump faced pressure to reopen enrollment for the millions of Americans losing their jobs, but he refused.

Mr. Biden’s actions will take aim at a number of Mr. Trump’s policies. In 2018, citing complaints about the price of Obamacare coverage, the Trump administration issued a rule that extended the length of less expensive “short” term policies from three months to up to three years. Such policies do not have to cover pre-existing conditions and can exclude common benefits like maternity care, mental health care or prescription drugs. The former administration also made it easier for small businesses to band together and offer plans that escape some of the requirements of the Affordable Care Act.

Mr. Biden is asking federal agencies to re-examine these rules, which could take months to undo. Should the rules be overturned, patients who have such policies would be unable to renew them, which could leave them without insurance if they think coverage is too expensive. Mr. Biden campaigned on raising the subsidies for Obamacare plans to make them more affordable.

Mr. Biden’s executive actions on abortion will put him in the center of the nation’s long-running culture wars. Like his Democratic predecessors, Presidents Bill Clinton and Barack Obama, he will immediately rescind the global gag rule — often called the “Mexico City Policy” — which bars international nonprofit organizations that provide abortion counseling from using American tax dollars.

The rule has been riding a philosophical seesaw for decades — in place when a Republican occupies the White House, and overturned when a Democrat moves in.

Mr. Biden is also directing the Department of Health and Human Services to “take immediate action,” his administration said, to consider whether to rescind the so-called domestic gag rule — a regulation imposed by the Trump administration that prohibits family planning clinics that receive federal funding from counseling patients about abortion. Such a change would likely require the department to write new regulations, a process that could take months.

The president’s Obamacare directive will also instruct federal agencies to review policies — including waivers that allowed states to impose work requirements — that discourage participation in Medicaid, the public health insurance program for the poor and disabled. Enrollment in Medicaid has grown substantially during the coronavirus pandemic, in part because people who have lost jobs and their health insurance have turned to Medicaid for coverage.

If confirmed, Cecilia Rouse would be the first Black economist ever to chair the White House Council of Economic Advisers.
Credit…Kriston Jae Bethel for The New York Times

Cecilia Rouse, a Princeton University economist who is President Biden’s pick to lead the White House Council of Economic Advisers, told a Senate committee this morning that Congress “must take action” to shore up an economic recovery that has left many Americans behind.

“As deeply distressing as this pandemic and economic fallout have been,” she said, “it is also an opportunity to rebuild the economy better than it was before — making it work for everyone by increasing the availability of fulfilling jobs and leaving no one vulnerable to falling through the cracks.”

In a hearing before the Senate Banking Committee, Ms. Rouse said that if confirmed, she will make it a priority for the council to gather more detailed data, in order to better see how economic policies are affecting nonwhite Americans in particular.

“Too often economists focus on average outcomes, instead of examining a range of outcomes,” she said. “As a result, our analyses tell us about average economic growth and the middle of the distribution — but as our economy grows more and more unequal, that analysis fails to capture the experience of the many people who are left behind, particularly people of color.”

Ms. Rouse is a labor economist whose work includes a longtime focus on education and discrimination. If confirmed, she would be the first Black economist ever to chair the council. She previously served as a council member under former President Barack Obama.

Her testimony comes at a precarious moment in the economic recovery from the pandemic and she is likely to face questions about the $1.9 trillion stimulus package that Mr. Biden has proposed to help get the virus under control and aid struggling families and workers.

Data released on Thursday morning showed that the economic recovery stumbled but didn’t collapse at the end of last year and that it could have a strong rebound in 2021 once the virus is arrested. Gross domestic product rose 1 percent in the final three months of 2020, the Commerce Department said Thursday.

Republicans have already expressed skepticism about whether the economy needs a $1.9 trillion jolt given the $900 billion stimulus package that Congress passed in December. But with millions still out of work and the virus not yet under control, many economists say workers and businesses will need more help to make it through.

The reconciliation process allows Congress to advance certain spending and tax bills on a simple majority vote.
Credit…Oliver Contreras for The New York Times

If President Biden wants to quickly enact his $1.9 trillion stimulus proposal over Republican opposition, Democrats have a powerful tool they could use to do it: a fast-track process known as budget reconciliation.

With reconciliation, Democrats could muscle through the package — which would provide billions of dollars for vaccine deployment, another round of stimulus checks and an extension of unemployment benefits — on a simple majority vote, bypassing a messy filibuster fight that would require them to win over enough Republicans to reach a 60-vote threshold.

While Mr. Biden has said he wants to abandon the partisan tactics of the past and forge compromises with Republicans, he has also proposed an ambitious plan that stands little chance of broad support from the party. And there is little time to maneuver it through both chambers before jobless benefits lapse in March.

“We want to work with our Republican colleagues to advance this legislation in a bipartisan way,” Senator Chuck Schumer of New York, the Democratic leader, said at a news conference on Tuesday. “But the work must move forward — preferably with our Republican colleagues, but without them if we must.”

The reconciliation process allows Congress to advance certain spending and tax bills on a simple majority vote, freeing lawmakers from the 60-vote threshold most legislation must meet to be considered.

Since 1980, the first year the process was put in place, 21 reconciliation bills have been enacted into law. Initially envisioned as a mechanism for lowering the deficit, it was used most recently by Republicans to push through President Donald J. Trump’s tax overhaul and in a failed attempt to repeal the Affordable Care Act.

Here are four important things to know about the process, and how Democrats might use it:

  • Budget reconciliation allows Congress to change taxes or spending, usually with a simple majority vote.

  • The process is subject to strict rules that limit what can be included.

  • Time is of the essence, and reconciliation moves fast.

  • The conventional route could be faster — but would most likely result in a smaller bill.

Senator Mitch McConnell, the minority leader, has been circumspect about how the Republican Party can break away from former President Donald J. Trump’s grip.
Credit…Oliver Contreras for The New York Times

Three times in recent weeks, as Republicans grappled with a deadly attack on the Capitol and their new minority status in Washington, Senator Mitch McConnell of Kentucky carefully nudged open the door for his party to kick Donald J. Trump to the curb, only to find it slammed shut.

So his decision on Tuesday to join all but five Republican senators in voting to toss out the House’s impeachment case against Mr. Trump as unconstitutional seemed to be less a reversal than a recognition that the critical mass of his party was not ready to join him in cutting loose the former president. Far from repudiating Mr. Trump, as it appeared they might in the days after the Jan. 6 rampage at the Capitol, Republicans have reverted to the posture they adopted when he was in office — unwilling to cross a figure who continues to hold outsize sway in their party.

For Mr. McConnell, a leader who derives his power in large part from his ability to keep Republicans unified, defying the will of his members would have been a momentous risk, putting his own post in peril and courting the ire of the far right.

But he made clear to associates in the aftermath of the Jan. 6 attack that he viewed Mr. Trump’s actions around the riot as impeachable and saw a Senate trial as an opportunity to purge him from the party. In a letter to colleagues, Mr. McConnell signaled that he was open to conviction. And then last week, he flatly said the president had “provoked” the mob that sent the vice president and lawmakers fleeing.

They were striking moves for Mr. McConnell, who for four years consistently supported and enabled Mr. Trump. But in the wake of the mob assault and a pair of Senate losses in Georgia, Mr. McConnell had come to view the former president as a dangerous political liability.

In the week since Mr. Trump decamped to his private club in Florida, it has become increasingly clear that his departure has done little to loosen his grip on rank-and-file Republicans in Congress. While few have defended his conduct, many fewer have dared to back the impeachment push. The 10 House Republicans who did join Democrats in voting to impeach him faced fierce backlash.

Emily Cochrane and Luke Broadwater contributed reporting.

President Biden swore in members of the White House staff remotely on Jan. 20.
Credit…Doug Mills/The New York Times

Senior staff members in West Wing offices are prohibited from meeting together in an office for more than a total of 15 minutes in a day, according to a senior Biden administration official. No more than six people are allowed to gather in the Oval Office at a time, and a maximum of five staff members are allowed to meet together in the spacious office of the chief of staff, Ron Klain, the official said.

That means that both the morning and afternoon senior staff meetings in the White House are conducted on video calls, even though many of the participants are working in offices near one another.

In the Roosevelt Room, gatherings are limited to 10 people. And when staff members remove their masks to eat lunch at their desks, they are required to close their doors.

Visitors are not allowed without approval, and West Wing staff members generally do not intermingle with the team working in the Eisenhower Executive Office Building across the street.

As the new administration finds its footing, life in the West Wing has become incredibly disciplined, partly because of the way President Biden’s team wants to work, but mostly because of the strict rules the administration has put in place to prevent the spread of the coronavirus. Unlike an administration functioning during normal times, the Biden team can’t simply add people to a meeting at the last minute, or run someone into the building.

It couldn’t be more different in feel and temperament from the opening weeks of the Trump administration, when the Oval Office was often compared to Grand Central Terminal. Former President Donald J. Trump’s office served as a bustling focal point of all West Wing activity as aides wandered in and out and then simply hung about, once it was clear that there was no formal structure for meetings or policymaking, and that for Mr. Trump, out of sight was out of mind.

All West Wing staff members are still tested daily even though a growing number of administration officials are getting vaccinated. There are also fewer people working in the building, and those who are there rarely leave the campus for lunch. There have been awkward moments in hallways, when staff members don’t recognize each other because everyone is required to wear an N95 mask and many have opted to double-mask, officials said.

The measures are in place because of a realization that while it may be impossible to prevent the coronavirus from entering the White House complex entirely, it is possible to reduce the risk of widespread infection if someone on the president’s team gets sick. The rules have been put in place by Anne Filipic, the director of management and administration, and Jeff Wexler, the White House director of Covid-19 operations.

A White House spokesman would not confirm the number of people allowed in meetings, or the time limits on such gatherings. But he said that in-person meetings were limited and that colleagues were socially distancing.

So far, officials said, the measures appear to be working. But they concede that it’s a difficult way to run a White House, just as it was a difficult way to run a campaign and a difficult way to run a transition.

“Adjusting to doing most meetings via video and doing most of our work with colleagues remotely has not been a massive leap,” said Jen Psaki, the White House press secretary. “It has been a long adjustment as humans to not being able to hug old colleagues or shake hands with new ones, but so far we don’t feel that it is prevented us from doing our jobs.”

Gov. Gretchen Whitmer of Michigan spoke to state lawmakers on Wednesday night in Lansing, in a virtual State of the State address seen here in a photograph provided by the governor’s office.
Credit…Michigan Governors Office, via Associated Press

Gov. Gretchen Whitmer of Michigan opened her annual State of the State speech on Wednesday by pleading with lawmakers to find common ground in fighting the staggering effects of the coronavirus pandemic in the state.

“Based on the political environment this past year, you might think Republicans and Democrats in Lansing can’t find common ground on much of anything,” said Ms. Whitmer, a Democrat. She noted times when there had been bipartisan action in the Capitol. “Let’s tap into that same energy and end the pandemic, revitalize our economy and get our kids back in school.”

But Republicans were having none of it.

Hours before Ms. Whitmer gave her speech, Republicans in the State Senate refused to approve 13 appointments she had proposed for slots in state government, such as the leader of the Children’s Ombudsman Office, the Civil Rights Commission and members of agriculture boards.

Republicans said they had rejected the appointments because Ms. Whitmer was not including them enough in decision-making surrounding restrictions on businesses to stop the spread of Covid-19.

“She has continued to circumvent the Legislature,” said State Senator Aric Nesbitt, a Republican from Lawton. “I understand it’s not easy to compromise and try to work with 148 members of this Legislature. We have to use every tool available to compromise, and one of those tools is to not support her appointments.”

Republicans in the State House of Representatives followed suit, offering a Covid-19 relief plan that would withhold $2.1 billion in federal funding meant to help schools cope with the pandemic until Ms. Whitmer relinquished her authority to shut down in-person learning and sports during a health crisis. That power would shift to local health departments under the Republican plan.

The public — and pointed — rejections of the governor’s appointments and authority come as Ms. Whitmer is preparing to run for re-election in 2022. No top-tier Republican has come forward to challenge her.

Forced to speak remotely instead of in front of both chambers of the Legislature because of pandemic protocols, Ms. Whitmer offered plans to fix roads, provide extra hazard pay to teachers and allocate state resources to help residents who have lost their jobs during the pandemic find employment.

But it was the coronavirus, which has infected more than 600,000 Michigan residents and killed more than 15,000 since it was first reported in the state in March, that dominated her address.

Ms. Whitmer said she planned to start a statewide tour to encourage Michiganders, Republicans and Democrats alike, to try and find common ground as the state emerges from the pandemic. The tour is designed “to focus on what unites us, improve how we talk to each other,” she said. “My mission is to find common ground so we can emerge from this crisis stronger than ever.”

Senator Edward J. Markey of Massachusetts is one of several progressive Democrats who want to see the filibuster eliminated. 
Credit…Anna Moneymaker for The New York Times

President Biden has moved swiftly in his first days to start carrying out his agenda, signing executive orders and outlining new actions. But his most significant move may in fact be a reaffirmation of an old stance: that the Senate should protect the filibuster, the 60-vote threshold that has for years stymied expansive legislation, including on issues he now seeks to address.

Progressive grumbling over the filibuster rose this week after Senator Mitch McConnell of Kentucky, the minority leader, initially refused to agree to basic operating rules for the chamber unless Democrats agreed to maintain the procedural tactic. But it remained just a grumble, reflecting progressives’ desire to avoid intraparty warfare early in Mr. Biden’s term and their belief, shared more widely in Washington, that his hand may eventually be forced.

“We have to recognize that the Senate has fundamentally changed from the time President Biden served,” said Senator Edward J. Markey of Massachusetts, a progressive who has endorsed eliminating the filibuster. “And it’s made it impossible to move forward on big issues.”

Whatever the liberal wing of the party may want, eliminating the filibuster requires the support of the entire Democratic caucus. And several moderate senators, like Joe Manchin III of West Virginia, remain staunchly in favor of keeping it.

Some progressives believe that Mr. Manchin and others may change their minds if Republicans obstruct the Democratic agenda. For their part, some moderates argue that the threat of eliminating the filibuster could force Republicans into legislative compromise. The minority party has often used the filibuster to thwart signature items of the majority party, and some Democrats fear that, without it, they would be powerless to stop Republicans the next time they control the Senate.

Mr. Biden’s commitment to keeping the Senate filibuster harks back to the policy debates that animated the Democratic presidential primary.

The logic was informed by years of congressional gridlock under former President Barack Obama and the magnitude of challenges facing the country: Big problems need big solutions, they argued, and the filibuster was a blockade to progress.

With the Senate split 50-50 between Democrats and Republicans, that could empower Mr. McConnell and a small cadre of moderate voices to block nearly any piece of legislation. It could doom Mr. Biden to the same fate as his Democratic presidential predecessor, who blamed Republican obstructionism for blocking a more robust liberal agenda.

Mr. Markey said he was confident that if Mr. Biden began to experience the same fate, he would come around.

Representative Scott Perry, Republican of Pennsylvania, was instrumental in promoting a plan in which President Donald J. Trump would fire the acting attorney general in an effort to stay in office.
Credit…Al Drago for The New York Times

Republicans in states across the country are lining up behind former President Donald J. Trump with unwavering support. And perhaps no state has demonstrated its fealty as tenaciously as Pennsylvania, where Republican officials have made loyalty to him the sole organizing principle of the party.

Just as in some Midwestern states, a surge in Pennsylvania of new Republican voters with grievances about a changing America was triggered by Mr. Trump, and only Mr. Trump.

And as a second impeachment trial approaches next month, many of the former president’s defenders see it as the culmination of years of unfair treatment by a Washington establishment that was always hostile to him.

Pennsylvania Republicans are already jockeying ahead of the 2022 primaries to prove that they fought the hardest for Mr. Trump, who, in spite of the losses by his party in the White House, the Senate and the House, still exerts a strong grip over elected Republicans and grass-roots voters.

Eight of the nine Republicans in Pennsylvania’s congressional delegation voted to throw out their state’s own electoral votes for President Biden on Jan. 6, just hours after a mob stormed the Capitol. One House member from the state, Scott Perry, was instrumental in promoting a plan in which Mr. Trump would fire the acting attorney general in an effort to stay in office. And a majority of Republicans in the General Assembly urged its congressional delegation in December to reject the commonwealth’s 20 electoral votes for Mr. Biden after the results were legally certified.

Republican lawmakers in Pennsylvania have also plunged into a lengthy examination of the November election, even though no evidence of more than trivial fraud has surfaced, and courts rejected claims that election officials had overstepped their legal mandates.

Senator Gary Peters of Michigan won his seat handily in 2014, but narrowly defeated a Republican challenger in November.
Credit…Al Drago for The New York Times

Senate Democrats on Thursday chose Senator Gary Peters of Michigan, a second-term moderate, to lead their campaign arm as the party seeks to hold onto and expand a razor-thin majority in 2022.

Mr. Peters has a limited national profile, but he was re-elected last fall in one of the tightest and most expensive Senate races in the country. He said on Thursday that he hoped to parlay that experience into helping Democrats protect seats in key battlegrounds like Georgia and Arizona and make gains in swing states like Wisconsin, Pennsylvania and North Carolina, where the party has had some recent success.

It will be a steep task. History suggests that voters tend to swing against the party in power in the first midterm election of a new presidency, and Republicans are entering the cycle determined to reclaim the Senate majority. Democrats are also preparing for a possible drop-off in enthusiasm among their voters now that former President Donald J. Trump, the Republican Party’s single greatest motivator in recent years, is out of power.

Still, with 14 seats currently held by Democrats and 20 currently held by Republicans on the ballot, the 2022 map generally favors Democrats. And Republicans are contending with retirements of incumbents in crucial states, including Senators Patrick Toomey of Pennsylvania and Rob Portman of Ohio, that could make their task more difficult.

Mr. Peters, 62, is also the incoming chairman of the Homeland Security and Governmental Affairs Committee. He won his Senate seat handily in 2014, but his re-election fight was a grind, and he ultimately eked out victory by a margin of less than 2 percent. Along the way, Mr. Peters raised more than $50 million, a key metric for the campaign post.

Senator Chuck Schumer, Democrat of New York and the majority leader, called him “battle-tested” on Thursday.

Republicans had a less flattering assessment, resurfacing one of their leading digs against Mr. Peters in his re-election campaign: that he is so bland and unrecognizable that voters forget his name.

“We are thrilled that Senator Peters was chosen for this position,” Chris Hartline, a spokesman for Senate Republicans’ campaign arm, said in a statement. “It is an inspiration to uninspiring people everywhere that even Jerry Peters can reach a leadership position in the Democrat Party.”

Republicans selected Senator Rick Scott of Florida, the ambitious former governor, to lead their campaign team. Mr. Scott has jumped into the job enthusiastically, campaigning in a pair of runoff elections in Georgia earlier this month that cost his party the Senate.

His chief task in the days ahead, though, may be ensuring that Republican colleagues facing re-election next year, including Senators Roy Blunt of Missouri and Charles E. Grassley of Iowa, run again rather than retire.

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