Public Health

The 3 Big Ways the Democrats’ Social Plan Would Expand Health Insurance

President Joe Biden in Rome, Italy on October 29, 2021.

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Insurance grants

According to Cynthia Cox, director of the Affordable Care Act program at the Kaiser Family Foundation, the move would expand health insurance subsidies in two ways.

(Federal aid helps lower health insurance premiums and other costs for private marketplace plans.)

It would maintain a temporary widening of the subsidies resolved by the American Rescue Plan earlier this year and expand access to low-income earners who are not eligible for Medicaid in some states.

Together, the reforms would cost $ 130 billion, the White House estimates. The provisions would apply until 2025. (An earlier version passed by the House would have made them permanent.)

“If passed, nearly every American citizen will have access to affordable coverage for the next few years,” said Cox.

The American Rescue Plan, a pandemic relief bill passed in March, made more people eligible for premium tax credits and increased support for those who had already qualified.

For example, before the Pandemic Act, Americans were not eligible for help if their income was more than 400% of the state poverty line (about $ 51,000 for a single person or $ 105,000 for a family of four). New rules have abolished the upper income limit; They also capped the premiums for a benchmark health insurance plan to 8.5% of household income.

The White House estimates that extending these reforms would lower premiums by an average of $ 600 a year for 9 million Americans, and get insurance for 3 million people who would otherwise be uninsured.

Additionally, in 12 states that haven’t rolled out Medicaid under the Affordable Care Act, some low-income earners don’t currently qualify for Medicaid or marketplace subsidies, making coverage largely prohibitive.

The Build Back Better framework would extend subsidies (premium tax credits) to those who find themselves in what is known as this funding gap. The White House estimates that around 4 million uninsured people in these states would be entitled to such help.

“[They’d] qualify for very significant subsidies in the ACA markets that would essentially free their coverage, “said Cox.

Home care

The bill would invest $ 150 billion in home and community-based care for seniors and Americans with disabilities.

This care is generally designed so that people can stay at home rather than move into an institution. According to the Centers for Medicare and Medicaid Services, services such as skilled nursing, personal care, adult daycare, and meals can be delivered to your home.

Medicaid is the largest payer of home and community services in the United States, according to Jennifer Sullivan, director of health and housing integration for the Center on Budget and Policy Priorities.

This is absolutely one of the most significant investments in home and community services that we have seen in recent times.

Jennifer Sullivan

Director of Health and Housing Integration at the Center for Budget and Policy Priorities

The federal funding would help strengthen the Medicaid program; Reduction of a care backlog (the waiting list is estimated at more than 800,000 people); and improve working conditions for home care workers, according to the White House.

“This is absolutely one of the most significant investments in domestic and community-based services that we have seen recently,” said Sullivan.

Currently the system is agency and institutional, but the legislation would help rebalance the “tense” system, she said.

For example, the framework would provide federal grants to expand access to home and community care, and funding states that are implementing an improvement program, among other things, according to a bill released Thursday by the House Rules Committee. It would also provide funding for education and training in hospice and palliative medicine.

Medicare

Build Back Better would also extend Medicare, the public health plan for the elderly, to hearing services.

This would increase coverage for benefits like hearing aids and visits to an audiologist, according to Juliette Cubanski, deputy director of the Medicare Policy Program at the Kaiser Family Foundation.

The policy would cost about $ 35 billion.

Earlier versions of the Democrats’ plan had also added dentistry and eyesight benefits that were removed from the most recent iteration. It would also not allow the federal government to negotiate prescription drug prices for Medicare beneficiaries.

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“There’s not much left of Medicare on the bill,” Cubanski said. “What is left is a hearing advantage – which is not insignificant.

“A lot of people at Medicare have hearing problems and hearing aids are really expensive,” she added.

In particular, according to a legal draft, it would provide Medicare Part B hearing aid coverage every five years for those with severe or profound hearing loss in one or both ears.

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