WASHINGTON — Democrats in Congress plan to use the $1.9 trillion COVID-19 relief bill to advance President Joe Biden’s campaign promises to make affordable health care available to more Americans, reversing the Trump-era decline in the number of people with health insurance.
They propose to increase federal subsidies to help people buy private health insurance plans and to make those subsidies available to more people. They want to offer new incentives to entice the 12 states that have not yet expanded Medicaid under the Affordable Care Act to do so. And they want the federal government to temporarily pick up health insurance costs for those who have lost their jobs and their employer-sponsored coverage during the pandemic.
Expanding Medicaid, the more generous subsidies and the other changes related to private insurance could increase the number of Americans enrolled in health insurance by at least 5.3 million, according to various analyses, including one by the Congressional Budget Office and another by the Kaiser Family Foundation.
The progressive, Washington-based research organization, the Center on Budget and Policy Priorities, estimates that under the proposal, if all remaining states expanded Medicaid, they would receive nearly $22.8 billion in additional federal funding over two years. The House Joint Committee on Taxation estimates that more generous subsidies and other changes affecting private insurance would cost the federal government $45.6 billion over two years.
“It took my breath away when I saw the proposals,” said Judy Roitman, director of the Tennessee Health Care Campaign, which advocates for affordable health care in the Volunteer State.
Democrats are pursuing other measures in the COVID-19 relief package as well, including extending the time new mothers on Medicaid can receive benefits after giving birth, and enrolling soon-to-be released incarcerated people in Medicaid.
Additionally, the Biden administration last week announced it was rescinding permissions the Trump administration had given states to require Medicaid enrollees to work in order to receive benefits. The Trump administration cleared 13 states to impose work requirements, but courts have halted them. A case involving work requirements is now before the U.S. Supreme Court.
The COVID-19 package is likely to land on Biden’s desk. Democrats control both houses of Congress, and in the Senate, they are likely to use a legislative mechanism for budgetary matters that will allow them to sidestep a Republican filibuster, meaning they only need a simple majority. The health measures could be modified before final House approval or after the legislation reaches the Senate.
The package of health measures is in line with Biden’s campaign pledge not to replace the Affordable Care Act — arguably the signature piece of legislation signed by President Barack Obama — but to extend its reach.
“This is a down payment on the type of more comprehensive reform that [Biden] talked about during the campaign,” said Linda Blumberg, an expert in health policy and insurance at the Urban Institute, a nonpartisan think tank in Washington, D.C.