Welp. Back in March, I wrote a 3-part series about what types of healthcare policy improvements/upgrades might be in the offering now that Democrats have taken control of the White House, (just barely) retained control of the House of Representatives and (just barely) taken control of the Senate (mostly).
Given the razor-thin margins in both the House and especially the Senate, I was already cautioning people to pare back expectations for the 117th Congressional Session. No, Medicare for All wasn't gonna happen. No, Medicare for America wasn't gonna happen. I already knew that even President Biden's own less-dramatic federal Public Option was unlikely to happen.
At the time, however, it did seem like at least a few Big Ticket items might make the cut, hopefully including:
UPDATE 4/13/21:An earlier version of this post had misinterpreted Linda Blumberg's estimate how much S.499 would cost--I thought that the $350 billion estimate was the gross projected 10-year cost without taking into account the impact of eliminating Silver Loading, but it turns out that it's the net cost after taking that into account as well. My apologies for such a bone-headed error.
Having said that, there's still the possibility of up to $196 billion in additional savings elsewhere, so it's still worth discussing the relative costs of both proposals and seeing whether both, or at least parts of both, could still be worked into the American Families Plan. I've significantly reworked the the wording of the post accordingly.
The White House is expected to roll out the health care priorities for its two-part infrastructure package sometime this Spring, and the health piece potentially could move separately now that the Senate parliamentarian has agreed Democrats have another shot passing their priorities through a simple majority. While there appears to be consensus that the bill will expand, or make permanent, the Affordable Care Act tax credits from the American Rescue Plan, other policies are less clear and will likely depend on the amount of offsets lawmakers can glean from drug-pricing measures.
Pelosi: Drug Pricing May Pay For Health Care Pieces Of Infrastructure Bill
House Speaker Nancy Pelosi (D-CA) said everything is on the table for the next legislative package that is expected to focus on infrastructure improvements and include health care provisions like a permanent increase to the Affordable Care Act tax credits — and she said the package likely will be paid for by tackling prescription drug prices.
...Pelosi said including House Democrats’ drug pricing bill, H.R.3, would pay for $500 billion of the cost of the infrastructure bill, part of which could be used to boost ACA tax credits and make ACA coverage more affordable. The savings also could also be used for other health-related efforts, she said. For example, House Energy & Commerce Chair Frank Pallone (D-NJ) has been working with Rep. Jim Clyburn (D-SC) to expand community health centers and to improve broadband services, which would support telehealth.
Sen. Mark Warner's Health Care Improvement Act of 2021 (S.352)
Sen. Michael Bennet & Sen. Tim Kaine's re-introduced "Medicare X" Act (S.386, I believe)
Sen. Jeanne Shaheen's Improving Health Care Affordability Act (S.499)
Of the three, the one which seems most likely to actually have a shot at passing both the House and Senate and being signed into law by President Biden during the 2021 - 2022 legislative session is Sen. Shaheen's S.499, which would:
Sen. Mark Warner's Health Care Improvement Act of 2021 (S.352)
Sen. Michael Bennet & Sen. Tim Kaine's re-introduced "Medicare X" Act (S.386, I believe)
Sen. Jeanne Shaheen's Improving Health Care Affordability Act (S.499)
Of the three, the one which seems most likely to actually have a shot at passing both the House and Senate and being signed into law by President Biden during the 2021 - 2022 legislative session is Sen. Shaheen's S.499, which would:
Back in late January, Senator Mark Warner of Virginia announced the introduction of a new-ish bill called the Health Care Improvement Act of 2021. Tell me if any of the major provisions look familiar:
Capping health care costs on the ACA exchanges
Establishing a low-cost public health care option
Authorizing the federal government to negotiate prescription drug prices
Allowing insurers to offer health care coverage across state boundaries
Supporting state-run reinsurance programs
Incentivizing states to expand Medicaid
Expanding Medicaid eligibility for new moms
Simplifying enrollment
Increasing Medicaid funding for states with high levels of unemployment
There's still millions of ballots left to count, and no doubt some legal battles gearing up, but as of 11:00am on November 4th, the most likely scenario going into 2021 will be:
Joe Biden will be sworn in as the 46th President of the United States.
Democrats will continue to control the U.S. House of Representatives, albeit with a smaller margin than they have today.
Republicans will continue to control the U.S. Senate, albeit with a smaller margin than today (either 52-48 or possilbly 51-49 depending on an upcoming runoff election in Georgia).
The Texas Fold'em lawsuit (official name: CA v. TX, formerly TX v. Azar) is scheduled to be heard by the U.S. Supreme Court (6-3 conservative) just 6 days from today, on November 10th.
Keep in mind, however, that while the hearing will happen next week, their actual decision isn't expected to be announced until next spring...most likely between April and June.
