Presidential Documents

Federal Register / Vol. 86, No. 20 / Tuesday, February 2, 2021 / Presidential Documents 7793 

Executive Order 14009 of January 28, 2021 

Strengthening Medicaid and the Affordable Care Act 

By the authority vested in me as President by the Constitution and the 

laws of the United States of America, it is hereby ordered as follows: 

Section 1. Policy. In the 10 years since its enactment, the Affordable Care 

Act (ACA) has reduced the number of uninsured Americans by more than 

20 million, extended critical consumer protections to more than 100 million 

people, and strengthened and improved the Nation’s healthcare system. At 

the same time, millions of people who are potentially eligible for coverage 

under the ACA or other laws remain uninsured, and obtaining insurance 

benefits is more difficult than necessary. For these reasons, it is the policy 

of my Administration to protect and strengthen Medicaid and the ACA 

and to make high-quality healthcare accessible and affordable for every 

American. 

Sec. 2. Special Enrollment Period. The coronavirus disease 2019 (COVID– 

19) pandemic has triggered a historic public health and economic crisis. 

In January of 2020, as the COVID–19 pandemic was spreading, the Secretary 

of Health and Human Services declared a public health emergency. In March 

of 2020, the President declared a national emergency. Although almost a 

year has passed, the emergency continues—over 5 million Americans have 

contracted the disease in January 2021, and thousands are dying every 

week. Over 30 million Americans remain uninsured, preventing many from 

obtaining necessary health services and treatment. Black, Latino, and Native 

American persons are more likely to be uninsured, and communities of 

color have been especially hard hit by both the COVID–19 pandemic and 

the economic downturn. In light of the exceptional circumstances caused 

by the ongoing COVID–19 pandemic, the Secretary of Health and Human 

Services shall consider establishing a Special Enrollment Period for uninsured and under-insured Americans to seek coverage through the Federally 

Facilitated Marketplace, pursuant to existing authorities, including sections 

18031 and 18041 of title 42, United States Code, and section 155.420(d)(9) 

of title 45, Code of Federal Regulations, and consistent with applicable 

law. 

Sec. 3. Immediate Review of Agency Actions. (a) The Secretary of the Treasury, the Secretary of Labor, the Secretary of Health and Human Services, 

and the heads of all other executive departments and agencies with authorities and responsibilities related to Medicaid and the ACA (collectively, 

heads of agencies) shall, as soon as practicable, review all existing regulations, 

orders, guidance documents, policies, and any other similar agency actions 

(collectively, agency actions) to determine whether such agency actions are 

inconsistent with the policy set forth in section 1 of this order. As part 

of this review, the heads of agencies shall examine the following: 

(i) policies or practices that may undermine protections for people with 

pre-existing conditions, including complications related to COVID–19, 

under the ACA; 

(ii) demonstrations and waivers, as well as demonstration and waiver 

policies, that may reduce coverage under or otherwise undermine Medicaid 

or the ACA; 

(iii) policies or practices that may undermine the Health Insurance Marketplace or the individual, small group, or large group markets for health 

insurance in the United States; 


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7794 Federal Register / Vol. 86, No. 20 / Tuesday, February 2, 2021 / Presidential Documents 

(iv) policies or practices that may present unnecessary barriers to individuals and families attempting to access Medicaid or ACA coverage, including 

for mid-year enrollment; and 

(v) policies or practices that may reduce the affordability of coverage 

or financial assistance for coverage, including for dependents. 

(b) Heads of agencies shall, as soon as practicable and as appropriate 

and consistent with applicable law, consider whether to suspend, revise, 

or rescind—and, as applicable, publish for notice and comment proposed 

rules suspending, revising, or rescinding—those agency actions identified 

as inconsistent with the policy set forth in section 1 of this order. 

(c) Heads of agencies shall, as soon as practicable and as appropriate 

and consistent with applicable law, consider whether to take any additional 

agency actions to more fully enforce the policy set forth in section 1 of 

this order. 

Sec. 4. Revocation of Certain Presidential Actions and Review of Associated 

Agency Actions. (a) Executive Order 13765 of January 20, 2017 (Minimizing 

the Economic Burden of the Patient Protection and Affordable Care Act 

Pending Repeal), and Executive Order 13813 of October 12, 2017 (Promoting 

Healthcare Choice and Competition Across the United States), are revoked. 

(b) As part of the review required under section 3 of this order, heads 

of agencies shall identify existing agency actions related to or arising from 

Executive Orders 13765 and 13813. Heads of agencies shall, as soon as 

practicable, consider whether to suspend, revise, or rescind—and, as applicable, publish for notice and comment proposed rules suspending, revising, 

or rescinding—any such agency actions, as appropriate and consistent with 

applicable law and the policy set forth in section 1 of this order. 

Sec. 5. General Provisions. (a) Nothing in this order shall be construed 

to impair or otherwise affect: 

(i) the authority granted by law to an executive department or agency, 

or the head thereof; or 

(ii) the functions of the Director of the Office of Management and Budget 

relating to budgetary, administrative, or legislative proposals. 

(b) This order shall be implemented consistent with applicable law and 

subject to the availability of appropriations. 


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Federal Register / Vol. 86, No. 20 / Tuesday, February 2, 2021 / Presidential Documents 7795 

(c) This order is not intended to, and does not, create any right or benefit, 

substantive or procedural, enforceable at law or in equity by any party 

against the United States, its departments, agencies, or entities, its officers, 

employees, or agents, or any other person. 

THE WHITE HOUSE, 

January 28, 2021. 

[FR Doc. 2021–02252 

2–1–21; 8:45 am] 

Billing code 3295–F1–P 


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