Biden’s Health Care Hangover Is Still Hurting Americans

The Biden administration's health care legacy continues to create problems for taxpayers, patients, and the broader health care system. Years after key policies were enacted, the effects are still visible in Obamacare enrollment data and in the implementation of the Inflation Reduction Act's drug price controls.

The Trump administration has begun reversing several of these policies, but significant work remains.

Biden’s Drug Price Controls Continue to Raise Concerns

A recent Washington Examiner column by Stephen Moore and Phil Kerpen argues that the Biden administration made the Inflation Reduction Act's drug price controls even more damaging through decisions made at the Centers for Medicare and Medicaid Services (CMS).

The law itself established a framework for government-directed drug pricing. Critics have warned that such policies reduce incentives for pharmaceutical research and development, potentially slowing the introduction of future treatments and cures.

According to Moore and Kerpen, Biden-era CMS officials compounded those concerns by adopting implementation policies that stretched beyond the law's intended scope. They cite examples in which CMS compared innovative medicines to drugs facing biosimilar competition, grouped together products approved many years apart, and relied on broad therapeutic comparisons to justify deeper government intervention in pricing decisions.

Drug pricing policy has consequences that extend far beyond today's medicines. New treatments require years of research and billions of dollars in investment. Expanding government price controls reduces the incentive to take those risks, potentially slowing the development of future therapies and cures.

CMS now has an opportunity to revisit those policies and restore a more restrained approach that better aligns with congressional intent.

Obamacare Enrollment Problems Persist

The Biden administration's approach to Obamacare created a different set of challenges.

A recent analysis from the Paragon Health Institute found that improper enrollment remains a significant problem within the Affordable Care Act exchanges. The report estimates that more than 6 million exchange enrollees in 2026 may be improperly enrolled, generating billions of dollars in questionable subsidy payments.

The largest enrollment growth since 2020 has occurred among individuals reporting incomes between 100 and 150 percent of the federal poverty level. This is also the income category where improper enrollment appears to be most concentrated.

According to CMS enrollment data, HealthCare.gov enrollment in this income range increased dramatically between 2020 and 2026. Roughly two-thirds of total enrollment growth during that period came from the 100 to 150 percent federal poverty level category.

This trend coincides with changes enacted during the Biden administration that made exchange coverage effectively free for many enrollees within that income bracket. While the policy expanded enrollment, critics argue that it also weakened incentives for accurate income reporting and increased opportunities for improper enrollment and phantom sign-ups.

The result has been growing concern about the integrity of exchange enrollment data and the accuracy of subsidy payments.

A Common Pattern of Poor Policy Design

Although drug pricing and Obamacare enrollment involve different programs, both reflect a broader pattern that characterized the Biden administration's approach to health care policy.

Federal intervention expanded while accountability weakened. New subsidies, new regulations, and new price controls were often accompanied by inadequate safeguards and insufficient oversight.

The consequences are now becoming clearer. Taxpayers face higher costs, program integrity concerns remain unresolved, and policies intended to improve affordability risk creating new long-term problems.

The Trump administration has already begun pursuing reforms aimed at strengthening oversight, restoring accountability, and limiting the reach of Biden-era regulations. Congress should support those efforts by improving eligibility verification within Obamacare, strengthening safeguards against improper enrollment, and ensuring that CMS does not further expand drug price controls through administrative action.

CFE Takeaway

The Biden administration's health care agenda produced lasting consequences that extend well beyond its time in office. Drug price controls continue to threaten medical innovation, while Obamacare enrollment problems have exposed taxpayers to billions of dollars in potentially improper subsidies.

Reversing those policies and restoring stronger oversight should remain a priority for policymakers seeking a more accountable and sustainable health care system.