Continuing To Strengthen Americans' Access to Affordable, Quality Health Coverage

This executive order directs federal agencies to continue reviewing policies and practices to expand affordable health coverage, strengthen benefits, and reduce medical debt under the Affordable Care Act and Medicaid. It builds on prior actions taken under Executive Order 14009 and the American Rescue Plan Act of 2021.

Federal Register Open PDF 87 FR 20689

Key directives

Agencies with health coverage responsibilities shall review agency actions to identify ways to expand affordable coverage, improve quality, strengthen benefits, and increase enrollment
Agency heads shall examine policies/practices for consumer enrollment and retention
Agency heads shall examine policies/practices strengthening benefits and provider access
Agency heads shall examine policies/practices improving coverage comprehensiveness and protecting against low-quality coverage
Agency heads shall examine policies/practices expanding eligibility and lowering costs in ACA Marketplaces, Medicaid, Medicare, and other programs
Agency heads shall examine policies/practices improving linkages between healthcare system and other stakeholders for health-related needs
Agency heads shall examine policies/practices reducing burden of medical debt on households

Who is ordered

Timeline

Immediate

Agencies directed to begin or continue review of policies related to health coverage access, quality, and affordability

Near term (90d)

Agency heads to examine specific policy areas: enrollment/retention, provider access, coverage comprehensiveness, eligibility/cost expansion, health system linkages, medical debt reduction

Long term

Potential regulatory and policy changes flowing from agency reviews; continued implementation of American Rescue Plan enhanced subsidies; potential state Medicaid expansion incentives

Risks & tensions

No specific deadlines or calendar dates provided for agency reviews or reporting
Implementation explicitly subject to availability of appropriations, creating uncertainty if Congressional funding shifts
Vague directive language ('review,' 'identify ways,' 'examine') without mandatory action requirements may limit enforceability
Non-expansion states remain political obstacle; EO cannot compel state Medicaid expansion
Medical debt reduction goal lacks concrete mechanism in EO text