Ariana Drehsler | AFP | Getty Images
A shift in federal health policy appears to be underway.
According to The Washington Post, President Joe Biden is expected to issue executive orders as early as Thursday to temporarily reopen health insurance grants and to address roadblocks encountered when low-income households attempt to access Medicaid. While the details are minor, the actions would reflect Biden’s broader goal of increasing health care coverage and improving affordability.
“Opening the market would be beneficial,” said Sara Collins, vice president for coverage and access to health care at The Commonwealth Fund. “A lot of people are out of work or lose their job and have not registered.”
On the Medicaid side, significant changes in eligibility requirements for people in the 12 states who have not expanded the program would likely require action from Congress, experts say. It is uncertain what would be included in an executive order.
It would be helpful to open up the market. Many people are out of work or lose their job and have not registered.
Sara Collins
Vice President for Coverage and Access to Health Care at The Commonwealth Fund
The White House did not respond to a CNBC investigation.
The presidential actions would be pending before the Supreme Court challenges the Affordable Care Act, which allowed the exchanges and financial aid for which enrollees could qualify. Some experts have suggested that Congress could essentially reverse the lawsuit through legislation addressing the non-coverage tax fine (setting it at $ 1) or other means.
Pre-pandemic, about 30 million people were already without coverage, a number that has been on the rise for several years. In addition, an estimated 2 million to 3 million workers lost employer-based health plans between March and September last year, according to the Kaiser Family Foundation.
Most subscribers in the market receive subsidies (technical tax credits), which reduce their premium payments. In addition, they may qualify for cost-sharing assistance, such as deductibles and premiums for certain plans.
According to the Kaiser Family Foundation, an estimated 4 million uninsured individuals could get an ACA plan with no premium payment and 4.9 million more could receive grants to reduce the cost of such a plan.
The premium subsidies through the exchanges are available to families with incomes ranging from 100% to 400% of the federal poverty level, based on household size. That translates to income of $ 12,760 to $ 51,040. For a family of four, it would be $ 26,200 to $ 104,800.
The marketplace subsidies that you qualify for are based on factors such as income, age and the second cheapest “silver” plan in your geographic area (which may or may not be the plan that you are enrolling in).
More from Personal Finance:
How Biden would stave off an impending benefits cliff
A year after Covid in America: a financial snapshot
Many Americans can file their taxes for free
Meanwhile, in states that have expanded Medicaid, you may be eligible for coverage through the program if your income is no more than 138% of the federal poverty level. For an individual, that would mean up to $ 17,609; for a family of four, $ 36,156. It’s also worth noting that if you qualify for Medicaid, you can apply at any time.
Biden also has other plans to expand coverage and affordability. His $ 1.9 trillion Covid incentive proposal, revealed last week, includes a provision that limits the amount paid for health insurance premiums to 8.5% of income.
He also wants to subsidize COBRA coverage – the right to continue employer-sponsored insurance after job loss – through September. It remains uncertain whether these proposals will be included in an incentive law to be voted on.
Regardless, some of Biden’s health care proposals in Congress face an uphill battle. The Senate is split 50-50 between Republicans and Democrats, with Vice President Kamala Harris getting the tiebreaker. However, many bills require a majority of 60 votes to clear the upper chamber.
“Everything has become a little bit more likely with the Democratic majority in the Senate, but it’s all still going to be pretty tough given the numbers,” said Tricia Neuman, executive director of the Medicare policy program at the Kaiser Family Foundation.
She also noted that the majority of Democrats in Parliament are slimmer than they were before the election. “That could make it harder to get tough legislation through the House, let alone the Senate,” said Neuman.
The proposals facing headwinds include a public health insurance option, which Biden has suggested as an alternative that would work in a similar way to Medicare. That is, it would negotiate rates with providers to keep costs down. He also wants to lower the age of eligibility for Medicare from 65 to 60.
According to the Centers for Medicare & Medicaid Services, US health care spending increased 4.6% in 2019 to $ 3.8 trillion, or $ 11,582 per person. Own expenses increased 4.6% in 2019 to $ 406.5 billion, a growth rate that exceeded the 3.8% growth in 2018.