The 3 big ways Democrats’ social plan would extend health coverage

President Joe Biden on October 29, 2021 in Rome, Italy.

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Insurance subsidies

The measure would increase subsidies for health insurance in two ways, according to Cynthia Cox, director of the Affordable Care Act program at the Kaiser Family Foundation.

(Federal assistance helps reduce health insurance premiums and other costs for private plans.)

This would preserve a temporary expansion of subsidies enacted earlier this year by the US bailout and expand access to low-income people who are not eligible for Medicaid in some states.

Together, the reforms would cost $ 130 billion, estimates the White House. The provisions would last until 2025. (An earlier version passed by the House would have made them permanent.)

“If passed, then over the next several years almost all US citizens will have access to affordable coverage,” Cox said.

The American Rescue Plan, a pandemic relief law passed in March, made more people eligible for premium tax credits and increased assistance to those who already qualified.

For example, before the Pandemic Act, Americans were not eligible for assistance if their income was over 400% of the federal poverty line (about $ 51,000 for a single person or $ 105,000 for a family of four. ). New rules removed the upper income threshold; they also capped premiums at 8.5% of household income for a benchmark health plan.

The White House estimates that extending these reforms would reduce premiums by 9 million Americans, by an average of $ 600 per year per person, and that 3 million people who otherwise would not be insured would benefit from a assurance.

Additionally, in 12 states that have not passed Medicaid expansion under the Affordable Care Act, some low-income people are not currently eligible for Medicaid or market subsidies, making coverage largely unaffordable.

The Build Back Better framework would extend subsidies (premium tax credits) to those in what is known as the coverage gap. About 4 million uninsured people in those states would be eligible for such assistance, estimates the White House.

“[They’d] receive very large grants in ACA markets that would essentially make their coverage free, ”Cox said.

Home Care

The legislation would invest $ 150 billion in home and community care for the elderly and Americans with disabilities.

This care is generally designed to allow people to stay in their homes instead of moving to a facility. According to the Centers for Medicare and Medicaid Services, it can include services such as skilled nursing, personal care, adult child care, and meal-at-home programs.

Medicaid is the largest payer of home and community services in the United States, according to Jennifer Sullivan, director of health and housing integration at the Center on Budget and Policy Priorities.

It is absolutely one of the largest investments in home and community services that we have seen in recent memory.

Jennifer sullivan

director of health and housing integration at the Center on Budget and Policy Priorities

Federal funds would help strengthen the Medicaid program; reduce the backlog of care (the waiting list is estimated at over 800,000 people); and improve the working conditions of home helpers, according to the White House.

“This is absolutely one of the largest investments in home and community services that we have seen in recent memory,” said Sullivan.

Currently the system is facility and institutional oriented, but the legislation would help rebalance the “strained” system, she said.

For example, the framework would offer grants to states to expand access to home and community care and provide funding to states implementing an improvement program, among others, according to a legislative plan released Thursday by the House. Rules Committee. It would also provide funding for education and training in palliative care and palliative care.

Health Insurance

Build Back Better would also extend Medicare, the public health plan for the elderly, to cover hearing services.

According to Juliette Cubanski, deputy director of the Kaiser Family Foundation’s Medicare Policy Program, this would add coverage for benefits like hearing aids and visits to an audiologist.

The policy would cost around $ 35 billion.

Earlier versions of the Democrats’ plan had also added dental and visual benefits, which were removed from the most recent iteration. It also wouldn’t let the federal government negotiate the prices of prescription drugs for Medicare beneficiaries.

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“There isn’t much left in the Medicare bill,” Cubanski said. “What remains standing is a hearing benefit – which is not negligible.

“A lot of people on Medicare have trouble hearing, and hearing aids are very expensive,” she added.

Specifically, it would provide Medicare Part B hearing aid coverage for people with severe or profound hearing loss in one or both ears, once every five years, according to a legislative plan.

About Therese Williams

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