Pieces of the Covid-19 relief package House Democrats released Monday night include the first major expansion of Affordable Care Act subsidies in more than a decade — a key plank of President Joe Biden’s health care agenda that they hope to pass in the coming weeks.
Democrats are hoping that the beefed up subsidies, combined with Biden’s recent executive order to reopen the ACA’s markets and advertise heavily to entice people to enroll, will make a major dent in the ranks of uninsured Americans that have grown during the pandemic and ensuing economic recession.
The bill, which the Ways and Means Committee will mark up later this week, would fully subsidize ACA coverage for people earning up to 150 percent of the federal poverty level and those on unemployment insurance. It also ends the so-called subsidy cliff for people making over 400 percent of the federal poverty level, making them eligible for subsidies for the first time and capping their premium costs at 8.5 percent of income.
The subsidy boosts would only last for two years, though Congress later could vote to extend them or make them permanent.
Another provision would have the federal government cover 85 percent of the cost of private health insurance for workers laid off during the pandemic through Sept. 21.
What happens next: House Democrats plan to advance the American Rescue Act using budget reconciliation, which will allow the bill to avoid a Senate filibuster and pass with a simple majority in that chamber. Senate Democrats have yet to unveil their version of the bill.
What it means: Democrats’ new control of the White House and Congress gives them the opportunity to make changes to the ACA they’ve long promised, and the pandemic has provided added urgency to push them through.
These provisions, which enjoy support from the insurance and hospital industries, are also a much easier lift than the bigger health policy changes Biden campaigned on, including a public option and lowering the Medicare eligibility age.
Still, experts worry that even with the enhanced subsidies, millions of Americans will still be unable to afford an insurance plan, putting them at risk of high out-of-pocket health costs as the pandemic continues to rage.
Stan Dorn of the consumer advocacy group Families USA said while the COBRA provision will help some of the newly jobless remain in their workplace health plans, requiring people to pick up 15 percent of the cost could “leave many people behind.”
“Fifteen percent of an employer-based plan could still be more than $200 per month for family coverage,” he said. “People may not be able to afford it, and the enrollment could be mainly people with health problems, which isn’t good."
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