ACA 2.0

Ahead of tomorrow evening's State of the Union address...via the White House:

FACT SHEET: President Biden Takes New Steps to Lower Prescription Drug and Health Care Costs, Expand Access to Health Care, and Protect Consumers

The President believes that health care is a right, not a privilege, and since day one, he has delivered health care to millions more Americans while also lowering health care costs. The President continues to build on, strengthen, and protect Medicare, Medicaid, and the Affordable Care Act, signing laws such as the American Rescue Plan Act and the Inflation Reduction Act to lower prescription drug costs and health insurance premiums. Thanks to the President’s efforts, more Americans have health insurance than under any other President, and are better protected against surprise medical bills and junk fees.

This actually happened way back in January, but I didn't stumble upon the press release until now:

Shaheen Reintroduces Legislation to Lower Health Care Costs & Expand Access to Insurance for Millions More Americans

  • Provisions of the Improving Health Insurance Affordability Act were signed into law through the Inflation Reduction Act & the American Rescue Plan Act
  • Estimates suggest 8.9 million Americans have lower premiums thanks to enhanced tax credits
  • **Shaheen’s efforts mark the most significant update to Affordable Care Act in a decade

(Washington, DC) – U.S. Senator Jeanne Shaheen (D-NH) today reintroduced her legislation, the Improving Health Insurance Affordability Act. The bill would make permanent enhanced tax credits that led to record Marketplace enrollment, while reducing health care costs for millions of additional Americans.

Yesterday I did a write-up about Covered California's 2022 Open Enrollment Period Executive Summary, which included a bunch of important data and demographic breakouts about how the largest state-based ACA exchange performed over the 2022 OEP.

However, I deliberately left out a section because I wanted to discuss it separately. If you scroll down to pages 31 & 32, you'll see a summary of two important pieces of ACA-related legislation which have been introduced in the California state legislature.

One of these is SB 967, introduced by CA State Senator Robert Hertzberg, which would do the following:

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Last Friday I took an in-the-weeds look at the healthcare provisions of the pared-down (but still hugely significant) Build Back Better Act.

Well, as the long-gestating legislation finally heads into the endgame this week, there's been a last-minute rush to add to & change some provisions of the bill before it actually gets voted on, and earlier today, the House Rules Committee released a revised/updated version of the bill, including a handy comparison version which shows exactly what legislative language has changed since the prior version.

Many of these changes are either simple grammatical or wording tweaks to make sure it all passes legal muster, while others simply provide clarification. Other changes involve simply increasing or decreasing the amount of federal money which would be allocated to one program or another.

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UPDATE 11/19/21: The revised Build Back Better Act passed the House of Representatives this morning, so I'm re-upping this for a few days. It now moves to the Senate where it will likely be tinkered with a bit more; if it passes there, it will then move back to the House for one more final vote before hopefully being signed into law by President Biden. Make sure to also read about some additional revisions to the bill made after I wrote this post.

The legislative text of the updated Build Back Better (BBB) bill is now available, and as I suspected, for all the understandable disappointment about what isn't part of it any longer, there's a lot more healthcare-related stuff in there than most people think. A lot of it gets kind of wonky or may seem like "small potatoes" to most folks, but pretty much everything in it would make a huge positive impact on those it benefits.

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A couple of hours ago, the Biden White House posted a completely updated version of what's being described as a "framework" for his Build Back Better policy agenda, which has been significantly pared down from the more ambitious version last spring. There are three main reasons for this: Congressional/Senate Republicans as a whole; Senator Joe Manchin of West Virginia; and Senator Kyrsten Sinema of Arizona.

There's still no way of knowing whether or not this version of Biden's #BBB agenda will pass either, but assuming it does, here's what will make the final cut:

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Regular readers may have noticed that I haven't checked in on the status of #BidenCare (aka #ACA 2.0) since way back in early August. There's several reasons for this: At first I was swamped with my COVID vaccination/case/death rate project; then, more recently, I had to scramble to get my annual Rate Change project up to date.

Both of these have indeed monopolized my time, but the main reason is simply that President Biden's Build Back Better (BBB) plan (which ACA 2.0 is a part of) has gotten bogged down over the past few months due to infighting and intransigence by a handful of "moderate/centrist" Democrats in the House but especially by two Democratic Senators in particular (Joe Manchin of West Virginia and Kyrsten Sinema of Arizona).

(Needless to say, I'm not even mentioning any Republicans in either the House or Senate, since not a single one of them is willing to support the bill.)

It seemed a bit pointless to write up a lengthy, in-depth analysis of the latest developments on the bill when what does or doesn't have a serious shot at making the final cut kept changing every few days.

ACA 1.5

Welp. Back in March, I wrote a 3-part series about what types of healthcare policy improvements/upgrades might be in the offering now that Democrats have taken control of the White House, (just barely) retained control of the House of Representatives and (just barely) taken control of the Senate (mostly).

Given the razor-thin margins in both the House and especially the Senate, I was already cautioning people to pare back expectations for the 117th Congressional Session. No, Medicare for All wasn't gonna happen. No, Medicare for America wasn't gonna happen. I already knew that even President Biden's own less-dramatic federal Public Option was unlikely to happen.

At the time, however, it did seem like at least a few Big Ticket items might make the cut, hopefully including:

President Biden, Vice-President Harris, Speaker Pelosi

As expected, the healthcare section of President Biden's first address to a joint session of Congress (technically not a State of the Union, but close enough) included a call for making the subsidies expanded under the American Rescue Plan permanent as part of the American Families Plan.

Also as expected, he did not call for other major healthcare reform priorities to be baked into the #AmFamPlan.

He did, however, spend significant time calling for those other priorities to be passed separately from the AFP...considerably more than he did on the subsidies themselves.

Before I get into the proposed healthcare policies: Early on in the speech, Biden gave a shout-out to his Administration for the success of the current, ongoing COVID Special Enrollment Period:

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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 #AmFamiliesPlan comprises the second half, and includes the following: