The bill Biden signed provided $35 billion for premium subsidies in the ACA marketplace, and expanded the eligibility for those subsidies as well as making them more generous. As originally passed, Obamacare set an income cap of 400% of poverty to limit who could get subsidies. In 2021 dollars, that’s $51,040/annually for a single person; $104,800 for a family of four. For the next two years, that cap is gone and everyone, regardless of income, will be guaranteed premium help to ensure they don’t pay more than 8.5% of their income for insurance premiums in the individual market.
While it’s too soon to know precisely what groups those 1.5 million people represent—people who lost their jobs and their coverage because of the pandemic, people who were in the Medicaid coverage gap, or people who have simply gone uninsured because they couldn’t afford the individual coverage—Larry Levitt of the Kaiser Family Foundation thinks there’s good reason to believe many wouldn’t have had insurance otherwise.
He told HuffPost: “We don’t know for sure, but I suspect this is mostly people who didn’t have coverage at all before,” based on data published thus far. “Maybe they had employer coverage at one point, but likely not recently. We just had an open enrollment period, and the number of layoffs has slowed significantly. Also, throughout this pandemic-fueled economic crisis, the people losing work have mostly been in lower-wage jobs that often didn’t come with health benefits to begin with.”
The American Rescue Plan made that insurance even more affordable, with premiums down 25% since February, before the bill passed. According to the Department of Health and Human Services (HHS), enrollees who signed up during the special enrollment period starting on Feb. 15 through March had an average $117 monthly premium. That dropped to $86 when the tax credits in the new law hit as of April 1. That’s benefitting people who were already enrolled as well. Almost 2 million customers have used the open enrollment period to shop for new insurance, and have seen premiums drop by as much 40%.
“Across America there is a need and demand for high-quality, low-cost health insurance,” HHS Secretary Xavier Becerra said in announcing the new enrollment milestone. “That’s why we are doing all we can to reach people who need coverage.” That “everything” includes a record-breaking $80 million in funding for navigators for the 2022 plan year. “The funding, which will be used for outreach and education efforts, is the largest allocation [Centers for Medicare & Medicaid Services (CMS)] has made available for Navigator grants to date and represents an eight fold increase in funding from the previous year,” HHS announced. That’s an eight-fold increase from the Trump administration, which tried to kill the program as part of its ongoing efforts to sabotage the law.
The increased affordability for the plans is just for the next two years, and Biden wants to make it permanent, which his American Families Plan would do. “My American Rescue Plan lowered premiums for nine million Americans who buy their coverage through the Affordable Care Act, saving families an average of $50 per person per month,” Biden said in his statement. “Today’s milestone demonstrates that there is a need and a demand for high quality, affordable health insurance across this country. It is up to Congress to hear them, and act quickly to pass the American Families Plan.”
As always, though, it depends on getting rid of the filibuster. Republicans simply are not going to let it happen. They might have given up the legislative fight to try to repeal the law, but that doesn’t mean they’re going to participate in anything that will strengthen it. The lawsuits and extremist Trump courts pushing them aren’t going to end either. What all this means is that the 50 Senate Democrats we have need to pull up their big boy and girl pants, and get serious about governing.