ACA 2.0

A week or so ago I reported that New Jersey is moving forward with fourteen bills related to protecting, repairing and improving the ACA at the state level...including several related to the state's transitioning to their own full state-based ACA exchange.

Today, Lilo Stainton of the New Jersey Spotlight reports that while things are proceeding smoothly for the most part, at least one of the bills is causing a few concerns:

Last week I reported that California and New Jersey were pushing through a long list of "Blue Leg" ACA protections at the state level; it turns out that Rhode Island has been quietly pushing through their own suite of ACA protection legislation as well! This is from May 16:

PROVIDENCE — The state Senate approved legislation Thursday intended to protect Rhode Islanders’ access to health insurance in the face of threats to the federal Affordable Care Act.

The legislation was sponsored by Sen. Joshua Miller, D-Cranston, chairman of the Senate Health and Human Services Committee. The House version of the bill was sponsored by Rep. Joseph M. McNamara, D-Warwick,  chairman of the House Health, Education and Welfare Committee. The bill aims to ensure that the standards of the Affordable Care Act remain in effect in Rhode Island, even if the courts or Congress were to eliminate the federal laws that created it.

Over at Axios, Drew Altman of the Kaiser Family Foundation has posted about a new focus group study which has some depressing, if not surprising findings:

...voters were only dimly aware of candidates’ and elected officials’ health proposals.

  • ...These voters are not tuned into the details — or even the broad outlines — of the health policy debates going on in Washington and the campaign, even though they say health care will be at least somewhat important to their vote.
  • Many had never heard the term “Medicare for all”...

Welp. That didn't take long...just a week ago, Connecticut Governor Ned Lamont announced that he and the state legislative leaders had put together a robust package of impressive healthcare reform bills, including:

  • expanding subsidies to at least some of those eanring more than 400% of the Federal Poverty Level (like California is in the process of doing)
  • expanding Medicaid up to 170% FPL (it used to be 201% FPL but was dropped down to 155% a couple of years ago)
  • reinstating the ACA's individual mandate penalty (similar to what Massachusetts, New Jersey and DC have done and what California is in the process of doing)
  • implementing a state-level reinsurance program (as over a half-dozen states, including several GOP-controlled ones, have done)

Holy Smokes! Right on top of my post earlier today about nearly twenty healthcare/ACA bills being pushed through the California legislature, here's a similar story about another batch of ACA improvement/protection bills being pushed through the New Jersey state assembly! via Lilo Stainton of NJ Spotlight:

Democratic lawmakers introduced a dozen bills late last week to create the infrastructure, funding, and regulatory structure for a state-based system that would enable New Jersey officials to create, market, and sell health insurance policies to low-income individuals and small businesses with fewer than 50 employees.

Last October, shortly before the midterm election, Democratic gubernatorial nominee Ned Lamont of Connecticut announced that if elected, he'd push hard for a robust reinsurance program along the lines of other states which have successfully implemented reinsurance 1332 waivers under the ACA:

HARTFORD, CT — Democratic gubernatorial candidate Ned Lamont has much lower expectations for what he’s going to be able to do to improve the health of Connecticut residents than one might expect from a Democratic candidate this year.

Sounds like Lamont would not push for CT to reinstate the ACA individual mandate penalty:

...Does he believe everyone in Connecticut has to purchase health insurance now that it’s not mandated by the federal government?

I didn't write about this yesterday because I was both swamped and a little confused about how the various bills were being packaged and voted on, but I think I have it straightened out now.

Back on March 26th, the House Democrats formally rolled out H.R. 1884. The official title of this bill is the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019", or PPECMHCMAA, which is terrible, so I've simply shorthanded it as "ACA 2.0".

HR 1884 is actually more of a catch-all collection of a dozen or so smaller, standalone ACA improvement bills, each of which either repairs an ACA provision which has been damaged or sabotaged in the past; protects an existing ACA provision from future sabotage; or strengthens & enhances the ACA going forward.

A little over a year ago, on March 21, 2018, Sen. Elizabeth Warren introduced a robust ACA 2.0 upgrade bill in the U.S. Senate called the "Consumer Health Insurance Protection Act", or CHIPA. It was largely a companion bill to a House version which had been introduced a couple of weeks earlier by Reps. Frank Pallone, Bobby Scott and Richard Neal, although there were some significant differences as well.

At the time, I noted that besides both bills including many "wish list" items which I've been hoping would be added to the ACA for several years now, Warren's Senate CHIPA bill was also noteworthy for one other reason: The list of cosponsors:

...Sanders is actually a co-sponsor of the Warren bill, as are Democratic Sens. Kamala Harris (Calif.), Maggie Hassan (N.H.), Kirsten Gillibrand (N.Y.) and Tammy Baldwin (Wis.).

Saturday, May 18th, 9:00am: Fems for Change: Healthcare, Who Knew It Could Be So Complicated?

  • Birmingham First United Methodist Church, 1589 W. Maple Rd., Birmingham, MI 48009

Turn on the TV, open a newspaper, browse social media: everyone is talking about new ideas for expanding American healthcare coverage. As consumers and voters, it can be hard to know which option is best for our families, our neighbors, and our nation.

This timely forum will help you make sense of Medicare for All; Medicare and Medicaid Buy-Ins; adding public plan features to private insurance; improving the Affordable Care Act (ACA); and other options discussed in the media.

 

As I'm typing this, the House Energy & Commerce Health Subcommittee is holding markup hearings regarding twelve different healthcare-related bills. The first six relate to prescription drug pricing and regulation, and some of them appear to have genuine bipartisan support.

The other six are directly related to the ACA...these are the six "mini ACA 2.0" bills which cover six of the eleven ACA repairs & improvement provisions included the the larger ACA 2.0 bill introduced yesterday. Here's summaries of all twelve bills being debated today:

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