Dems aim to restore ACA as 'law of the land' with new health care proposal
Key among the bill's provisions are restoring protections for pre-existing conditions and making more Americans eligible for premium tax credits.
Meeting fire with fire, House Democrats have unveiled their plan to strengthen the Affordable Care Act with subsidies and additional provisions–but no Medicare for All.
The new plan of attack: cut premiums and deductibles, create more lower-cost options for uninsured Americans, reinstate pre-existing condition protections, fix the “family glitch” and restore enrollment outreach resources. Key provisions include:
Expansion of premium tax credits: The bill calls for changing the maximum paid for premiums for those making 150 percent of federal poverty level from 4 percent to 2 percent and from 10 percent to 7 percent for those making 300 percent of FPL and remove the overall income limit for receiving tax subsidies. Premium payments would be capped at 8.5 percent of total income.
The “family glitch” prohibiting low-income individuals from receiving subsidies if they are eligible for insurance through a family member’s employer-sponsored plan would also be fixed.
Walking back Trump administration changes: The bill would restore outreach funding for the federal exchange’s open enrollment period and restore protections for people with pre-existing medical conditions, which has been significantly reduced with the expansion of short-term and other alternative health plans.
“The Republicans did say during the campaign that they weren’t there to undermine the pre-existing condition benefit, and here they are, right now, saying they’re going to strip the whole Affordable Care Act as the law of the land,” Speaker Nancy Pelosi told reporters.
Reforms at the state-level: The bill would rein in the state-based waiver program that has allowed states to lessen or eliminate or to allow lesser or no “essential” benefits, such as mental health and addiction treatment coverage.
Additionally, the bill would promote state reinsurance programs, providing a mix of federal and state funds, and provide federal money to states that want to set up their own marketplaces but have not yet done so.
“With skyrocketing premiums in the federal marketplace, state-based exchanges have proven to be more effective at increasing the rate of coverage and lowering costs,” said Representative Brian Fitzpatrick of Pennsylvania.
Among the significant omissions: no funding for the cost-sharing reduction subsidies halted in 2017, and of course, no mention of Medicare for All.
Democrats plan to pass piecemeal, anticipating some support from across the aisle in both the House and the Senate for various provisions contained within it. While the legislation might not go anywhere significant till 2020, it serves as a strong counterpoint to the Trump administration’s most recent and more extreme filing against the ACA, advocating that the entire law be thrown out as unconstitutional instead of simply pursuing the elimination of a single part of the law.
“This is about very immediately answering the promises our members made in the campaign to lower health care costs,” a senior Democratic aide told Vox. “This isn’t the end of stuff we’re going to do on health care, in any regard.”
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