LOS ANGELES TIMES – For years, Democrats have been trying to fix some of the most glaring flaws in the Affordable Care Act: Premium subsidies are too stingy; red states have too little incentive to expand Medicaid.
They’ve been blocked at every turn by Republican obstructions.
But with a couple of provisions quietly inserted into the American Rescue Plan, the $1.9-trillion relief measure due to be voted on Wednesday by the House and promptly signed by President Biden, those goals will be met — a least for the next two years.
With the COVID relief plan poised for final passage, the first significant enhancement of the Affordable Care Act is about to become law. – Larry Levitt, Kaiser Family Foundation
That’s because the new measure dramatically changes the structure of the ACA’s premium subsidies so they apply to everyone, rather than cutting off households that earn more than 400% of the federal poverty limit ($106,000 for a family of four), as the original ACA did.
Moreover, the subsidies for all those who were eligible under the old rules will be increased.
The relief bill also incentivizes Medicaid expansion through an offer that the 12 holdout red states can’t refuse, unless their political leadership is terminally dense.
The offer doesn’t just pay for the expansion; it provides much more in federal cash than the expansion would cost in any of those states, according to calculations by the Kaiser Family Foundation.
Expansion in all those states would add 4 million residents to the ranks of the insured, the foundation estimates.
Although both provisions expire after two years, it’s a fair bet that they become permanent.
A general rule of legislating is that it’s very difficult to take away a benefit after it’s put in place.
Larry Levitt, KFF’s executive vice president for policy, observed by tweet:
“With the COVID relief plan poised for final passage,” “the first significant enhancement of the Affordable Care Act is about to become law, more than a decade after it was enacted … ”
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