A $1.75 trillion social and climate spending framework Democrats unveiled Thursday would reform the health-care market in several ways, expanding access and reducing costs for millions of Americans.
Chiefly, the proposal would expand subsidies available for Affordable Care Act marketplace health plans, add coverage of hearing services to Medicare and improve access to home care for seniors and disabled Americans.
Together, the measure — the result of months of negotiations between progressive and moderate Democrats — would pump about $315 billion into these initiatives, according to White House estimates.
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The legislation is still in flux, and it hasn’t secured a public endorsement from some key lawmakers. The White House cut some health policies from the initial $3.5 trillion package (such as the ability to negotiate prescription drug costs and paid family and medical leave) to meet demands of centrist holdouts like Sen. Joe Manchin, D-W.Va., and Sen. Kyrsten Sinema, D-Ariz.
Here are some of the big-ticket items in Democrats’ latest framework.
Insurance subsidies
The measure would expand subsidies for health insurance in two ways, according to Cynthia Cox, director of the Affordable Care Act program at the Kaiser Family Foundation.
(The federal assistance helps reduce health insurance premiums and other costs for private marketplace plans.)
It would preserve a temporary expansion of the subsidies enacted earlier this year by the American Rescue Plan and expand access to low earners who don’t qualify for Medicaid in some states.
Together, the reforms would cost $130 billion, the White House estimates. The provisions would last through 2025. (An earlier version passed by the House would have made them permanent.)
“If it’s passed, then for the next few years almost every American citizen will have access to affordable coverage,” Cox said.
The American Rescue Plan, a pandemic relief law passed in March, made more people eligible for premium tax credits and boosted assistance for those who already qualified.
For example, prior to the pandemic law, Americans didn’t qualify for aid if their income was more than 400% of the federal poverty level (about $51,000 for a single individual or $105,000 for a family of four). New rules got rid of the upper income threshold; they also capped premiums at 8.5% of household income for a benchmark health plan.
The White House estimates extending these reforms would reduce premiums for 9 million Americans, by an average $600 a year per person, and 3 million people who’d otherwise be uninsured would gain insurance.
