Throughout the 2020 presidential campaign, candidates from both sides of the aisle vigorously debated their ideologies to improve our healthcare. The plans ranged from Medicare for All, to Medicare for those who want it, to a public option, to providing consumers with more choices. There were fiery debates over which plan would be best for our citizens. With such robust discussion over healthcare and considering the current health pandemic that we’re experiencing, I expected healthcare legislation to be an immediate priority for the Biden administration.

However, despite Democrat campaign promises to build and protect the Affordable Care Act (ACA), the Biden administration still has not announced a healthcare agenda. President Biden’s American Rescue Plan, released in April, also did not include healthcare. And the White House’s 2021 budget was released without specific, actionable plans for healthcare in the near future.

Because healthcare hasn’t become a focus for the administration, perhaps the reality is that our healthcare system is working better than expected. Over the course of the last years, President Trump stabilized the ACA market and provided more options to consumers; and recently, President Biden increased ACA subsidies and created the special enrollment period. With so many adjustments to our healthcare, perhaps we have created a healthcare system that is sufficiently stable so that President Biden can focus on other national priorities.

Trump Enhanced ACA and Provided More Insurance Choices

During his presidency, President Trump approved ACA reinsurance waivers to lower premiums and expand choices in state health insurance markets. He also expanded the short-term limited duration plans that had been limited from 364 days to 90 days by the Obama administration so that they are now available for up to 36 months.

In addition, President Trump implemented executive orders to lower prescription drug costs and require hospitals to provide transparency in their pricing practices. Even President Biden supports hospital transparency and is cracking down on hospitals that do not comply.

ACA Subsidies Increased and Special Enrollment Period

Starting on February 15 and extending through August 15, 2021, the Biden administration opened the ACA for a special enrollment period that allowed anyone who was uninsured to sign up for an ACA plan. During the special enrollment period, over one million citizens signed up for ACA plans. Also, as part of the America Rescue Plan, the Biden administration increased ACA subsidies, which has made the plans more affordable starting April 1, 2021 and will go through 2022.

Medicaid Expansion Continues

The expansion of Medicaid also offers relief to those who were previously uninsured or under insured. So far, 39 states have adopted Medicaid expansion. States Republican such as Oklahoma, Arkansas, and Idaho are some of the newest states to expand Medicaid. And because the America Rescue Plan provides state funding to expand Medicaid, we may see more states adopt Medicaid in the next year.

Looking back on the heated Democratic presidential debates, I expected healthcare to be a big part of the White House’s very first proposals. Yet, we may have made more progress with healthcare than those debates would have suggested. Stabilizing the ACA market with more affordable premiums, reducing drug costs, providing more choice, and expanding Medicaid may have helped us come much closer to achieving the type of health insurance marketplace we need.

Jan Dubauskas is a healthcare expert, enthusiastic insurance pro, attorney, mom, and candidate for Arizona State Senate.