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A change in federal health policy appears to be underway.
As early as Thursday, President Joe Biden is expected to issue executive orders to temporarily reopen health insurance grants, according to The Washington Post, and resolve roadblocks found when low-income families try to access Medicaid. While details are scarce, the actions reflect Biden’s broader goal of increasing health coverage and improving accessibility.
“Opening the market would be useful,” said Sara Collins, vice president for health and access coverage at The Commonwealth Fund. “Many people are unemployed or losing their jobs and have not signed up.”
On the Medicaid side, significant changes in eligibility requirements for people in the 12 states that have not expanded the program would likely require Congressional action, experts say. It is uncertain what would be included in an executive order.
Opening the market would be useful. Many people are out of work or losing their jobs and have not signed up.
Sara Collins
Vice President for Health Coverage and Access to The Commonwealth Fund
The White House did not respond to a CNBC inquiry.
Presidential actions would come as a pending case before the Supreme Court challenges the Affordable Care Act, which authorized exchanges and financial aid for which applicants can qualify. Some experts suggested that Congress could basically suspend the court’s challenge through legislation that addresses the tax fine for non-coverage (setting it to $ 1) or other means.
Before the pandemic, some 30 million people were already without coverage, a number that had been growing for several years. In addition, about 2 million to 3 million workers lost employer-based health insurance last year between March and September, according to the Kaiser Family Foundation.
The majority of those enrolled in the market receive subsidies (technically tax credits), which reduce what they pay in premiums. In addition, they may qualify for help with cost sharing, such as deductibles and premiums on certain plans.
It is estimated that 4 million uninsured individuals could obtain an ACA plan without premium payment and 4.9 million more could obtain subsidies to reduce the cost of such a plan, according to the Kaiser Family Foundation.
Premium subsidies through exchanges are available for families whose income ranges from 100% to 400% of the federal poverty level, based on family size. This translates to an income of $ 12,760 to $ 51,040. For a family of four, it would be $ 26,200 to $ 104,800.
The market subsidies you are entitled to are based on factors that include income, age and the lowest cost “silver” background in your geographic area (which may or may not be the plan you subscribe to).
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Meanwhile, in states that have expanded Medicaid, you can qualify for coverage through the program if your income does not exceed 138% of the federal poverty level. For an individual, that would mean up to $ 17,609; for a family of four, $ 36,156. It is also important to note that if you qualify for Medicaid, you can apply at any time.
Biden also has other plans to expand coverage and accessibility. His $ 1.9 trillion Covid stimulus proposal, revealed last week, includes a clause that would limit the amount paid for health insurance premiums to 8.5% of revenue.
He also wants to subsidize COBRA coverage – the right to continue with employer-sponsored insurance after losing his job – until September. It is not yet known whether these proposals will be included in any stimulus project that is voted on.
Separately, some of Biden’s proposed health plans face an uphill battle in Congress. The Senate is split 50-50 between Republicans and Democrats, with Vice President Kamala Harris getting the tiebreaker vote. However, many bills need a majority of 60 votes to pass the upper house.
“Everything has become a little more likely with the Democratic majority in the Senate, but it will still be very difficult given the numbers,” said Tricia Neuman, executive director of the Medicare policy program at the Kaiser Family Foundation.
She also noted that the majority of Democrats in the House are smaller than before the elections. “This can make it difficult to pass difficult legislation in the House, let alone the Senate,” said Neuman.
Proposals that face an obstacle include a public health insurance option, which Biden launched as an alternative that would work in a similar way to Medicare. That is, he would negotiate fees with providers to keep costs low. He also wants to reduce the Medicare eligibility age from 65 to 60.
Health spending in the United States grew 4.6% in 2019, reaching $ 3.8 trillion, or $ 11,582 per person, according to the Centers for Medicare and Medicaid Services. Direct spending grew 4.6% in 2019, to $ 406.5 billion, a growth rate higher than the 3.8% growth recorded in 2018.