Note: The views and opinions expressed in blog/editorial posts are those of the author. They do not purport to reflect the views or opinions of Misbar.
On Friday, February 15, 2021, President Trump declared a national emergency. After shutting down the US government for the longest period of time in history, the then-president created what some saw as a constitutional crisis by diverting almost $7 billion to fund the border wall. President Trump himself admitted on the day he signed the declaration that he, “didn’t need to do this, but I’d rather do it much faster.” And while this triggered a crisis, the border wall project was only canceled on the day that President Biden was inaugurated into office. So if President Trump could successfully divert funds for his own project, can President Biden achieve his healthcare reforms in the same way?
But what constitutes an emergency? When President Trump declared the emergency to fund the border wall, he defined the emergency in the following terms: “I hereby report that I have exercised my authority to declare a national emergency in order to address the border security and humanitarian crisis that is threatening the United States.” The “threat” on the southern border caused 1.9 homicides per 100,000 people in Texas between the years 2012 to 2018. But more than 26,000 Americans die a year due to a lack of health insurance. If up to 26,000 people a year are dying needlessly, could that not be considered an emergency that needs to be addressed far sooner than border security?
Of course, many hurdles may stop President Biden from passing his health care agenda, either through congress or via an emergency declaration, partially due to cost. President Biden is trying to pass a public option as an alternative to private health insurance. This plan is cheaper than Medicare for All, but it’s still expensive. Currently, it is estimated to cost $75 billion per year. So is this too high for Biden to fund via emergency declaration? It appears as if the answer is no, for several reasons:
- The National Emergencies Act, which gives the US president the power to declare and fund emergencies, does not limit the expense of an emergency declaration. Theoretically, the president can declare any amount of funding that he wishes.
- The yearly cost of the public option is not much more than President Trump’s own public health emergency declaration. This doesn’t refer to the border wall declaration. This refers to President Trump’s March 13th, 2020 coronavirus emergency declaration, which funded $50 billion for healthcare. If President Trump could declare $50 billion for public health then can President Biden declare $75 billion per year to fund the public option?
- A previous emergency declaration once eased the access of Medicare, Medicaid and other public health measures. In 2009, President Obama declared an emergency to combat the H1N1 influenza pandemic. In that order, the president informed the then Secretary of Health and Human Services to, “temporarily waive or modify certain requirements of the Medicare, Medicaid, and State Children’s Health Insurance programs.” Could Biden declare a similar order which then leads to a public option or Medicare for All?
As of early 2021, a President Biden emergency declaration that expands Medicare to all people or creates a Medicare like public option does not exist. So what is the likelihood of President Biden utilizing the National Emergencies Act to do so?
President Biden certainly has made strong statements about his healthcare ambitions. For example, on July 1, 2020, then-candidate Biden tweeted the following: “This is my promise to you: When I am President, I will take care of your health care coverage and your family the same way I would my own.” On November 10, 2020, three days after the presidential election had been called in his favor, then President-Elect Biden tweeted the following phrase: “We are going to build a health care system that puts you and your family first - and that every American can be proud of.” And on February 15, 2021, President Biden tweeted the following: “Health care is a right - and I will do everything in my power to ensure that all Americans have access to quality, affordable care. Starting today, we’re opening a special enrollment period for health insurance.”
One thing that is interesting to note is that President Biden’s statements get stronger and more forceful as time passes. In the election season Biden aims to “take care” of health care. After the election, he states that he will make, “a health care system that puts you and your family first.” Finally, once he is inaugurated, he declares that he will, “ensure that all Americans have access.”
One of the hallmarks of President Biden’s strategy is that he aims to underpromise and overdeliver. But without a filibuster proof majority in congress, how can he underpromise and overdeliver on ensuring access to healthcare? Perhaps it will be an emergency declaration. Or if voters reward him for his handling of the pandemic in the US midterms, perhaps he won’t need to resort to it.
