After weeks of anticipation and jockeying for policy priorities to be included by various advocacy groups, President Biden is set to formally roll out the American Families Plan at a speech to a joint session of Congress this evening...the first such speech of his administration, falling just ahead of his 100th day in office.
The first half of Biden's larger "American Infrastructure Plan" is the "American Jobs Plan" which addresses "hard" infrastructure like road & bridge construction/repairs, green energy investment, broadband access, overhauling our clean water system and so forth.
The Urban Institute has come out with a brand-new analysis which projects the impact of making the ACA subsidies which have been expanded & enhanced temporarily under the American Rescue Plan permanent. In other words, this is what they expect the real-world impact would be if Congress were to finally #KillTheCliff and #UpTheSubs permanently (as opposed to for just 2021 - 2022), as I and other healthcare activists been pushing for for years now.
So, the American Rescue Plan includes two important provisions whch I've been fighting for for years: #KillTheCliff and #UpTheSubs. The only downside is that, for now at least, these ACA enhancements are only included for two years (including 2021...the beefed-up & expanded subsidies are retroactive to January 1st of this year).
As a reminder (this is like the 20th time I've posted a table like this), here's the official ACA subsidy formula compared to the improved formula under the American Rescue Plan (ARP):
Note: The Federal Poverty Level (FPL) is 15% higher per household in Hawaii and 25% higher in Alaska.
...there's also another small but critical detail included in the table above which escaped my attention last summer in H.R. 1425.
Take a look at the first line of Rep. Underwood's 2019 version (H.R 1868):
Over 100.0 percent up to 133.0 percent
Now take a look at the first line under both H.R. 1425 and H.R. 369:
Up to 150.0 percent
Notice the difference? I'm not talking about the "up to 150%" part. I'm talking about the removal of the "Over 100.0 percent" part.
If this were to pass the House & Senate and be signed into law by President Biden using this exact language, it would apparently eliminate the Medicaid Gap...albeit with a couple of major caveats.
Single Parent; Nuclear Family; Empty Nesters w/College-age kid; 60-yr old couple
Here's how much the "Nuclear Family of four" example (40-yr old ocuple with 2 children) would theoretically save, assuming they choose the avg. national benchmark Silver plan:
On March 20th, the Vermont Health Connect ACA exchange joined other state-based exchanges in launching a formal COVID-19 Special Enrollment Period.
On April 15th, just ahead of the original SEP deadline, they bumped it out by a month.
Then, with the May deadline approaching, I took a look and sure enough, they've bumped it out another month.
And now, with the June deadline having come and gone...
Due to the COVID-19 emergency, Vermont Health Connect has opened a Special Enrollment Period until August 14, 2020.
I admit that this is starting to get a bit silly. At a certain point I'm guessing at least one of the state exchanges will just say "screw it" and open 2020 enrollment up for the full year.
When the $1.9 trillion American Rescue Plan (ARP) achieved final passage on March 10th, it did so almost exclusively along party lines. I say "almost" because there was a single Democratic House member who voted against it: Representative Jared Golden (ME-02).
I fully understand the tightrope that some swing district Dems have to walk. To his credit, Rep. Golden voted to impeach Donald Trump not once, but twice (though he only voted in favor of one of the 2 articles of impeachment against him the first time around). I certainly don't expect every single Democrat to vote the party line on every single bill.
In the end, the bill passed anyway, if only by a handful of votes; my guess is that he even received Speaker Pelosi's unofficial blessing to vote against it, as long as she knew for sure it would pass regardless.
It's important to note that the following guidelines only apply to residents of the 36 states hosted via HC.gov. The timing, policy and procedures for the new/expanded subsidies for residents of the 15 states which operate their own ACA exchanges may vary.
My biggest takeaway from the press releases below is that everyone will be made whole (that is, those eligible for additional subsidies or newly-eligible for subsidies at all will receive them in full), but that it may take anywhere from a few weeks to several months for that to happen, so cool your jets.
Covered California Hails the Signing of the American Rescue Plan Which Will Benefit Millions
SACRAMENTO, Calif. — Covered California’s executive director, Peter V. Lee, issued this statement following President Joe Biden’s signing of the American Rescue Plan. The landmark legislation provides new financial help to people who receive their health insurance through Affordable Care Act marketplaces like Covered California. The measure will lower health care costs by providing new and expanded subsidies to more Americans than ever before.
In early February, I posted a deep dive into HR 369, the Health Care Affordability Act, and how it would reduce net ACA premiums by permanently eliminating the income "subsidy eligibility cliff" (#KillTheCliff) and making the underlying subsidy formula more generous for all enrollees (#UpTheSubs).
I'm re-posting an updated, modified version of this analysis for two reasons:
First, because HR 1319, the American Rescue Plan, is about to actually pass and be signed into law, with a slightly different formula from HR 369 embedded within it (if only for two years).
Second, because my earlier analysis also threw in two other subsidy enhancement tables which confused the issue (California's state-based subsidies, and the predecessor to HR 369, both of which are/were less generous)
In this version I'm using the actual Advanced Premium Tax Credit (APTC) table under the American Rescue Plan, and I'm cutting out all references to the other two tables to avoid confusion.
