Section 673(2) of the Omnibus Budget Reconciliation Act (OBRA) of 1981 (42 U.S.C. 9902(2)) requires the Secretary of the Department of Health and Human Services to update the poverty guidelines at least annually, adjusting them on the basis of the Consumer Price Index for All Urban Consumers (CPI-U). The poverty guidelines are used as an eligibility criterion by Medicaid and a number of other Federal programs.
The poverty guidelines issued here are a simplified version of the poverty thresholds that the Census Bureau uses to prepare its estimates of the number of individuals and families in poverty.
As required by law, this update is accomplished by increasing the latest published Census Bureau poverty thresholds by the relevant percentage change in the Consumer Price Index for All Urban Consumers (CPI-U). The guidelines in this 2022 notice reflect the 4.7 percent price increase between calendar years 2020 and 2021.
Well, as the long-gestating legislation finally heads into the endgame this week, there's been a last-minute rush to add to & change some provisions of the bill before it actually gets voted on, and earlier today, the House Rules Committee released a revised/updated version of the bill, including a handy comparison version which shows exactly what legislative language has changed since the prior version.
Many of these changes are either simple grammatical or wording tweaks to make sure it all passes legal muster, while others simply provide clarification. Other changes involve simply increasing or decreasing the amount of federal money which would be allocated to one program or another.
UPDATE 11/19/21: The revised Build Back Better Act passed the House of Representatives this morning, so I'm re-upping this for a few days. It now moves to the Senate where it will likely be tinkered with a bit more; if it passes there, it will then move back to the House for one more final vote before hopefully being signed into law by President Biden. Make sure to also read about some additional revisions to the bill made after I wrote this post.
The legislative text of the updated Build Back Better (BBB) bill is now available, and as I suspected, for all the understandable disappointment about what isn't part of it any longer, there's a lot more healthcare-related stuff in there than most people think. A lot of it gets kind of wonky or may seem like "small potatoes" to most folks, but pretty much everything in it would make a huge positive impact on those it benefits.
A couple of hours ago, the Biden White House posted a completely updated version of what's being described as a "framework" for his Build Back Better policy agenda, which has been significantly pared down from the more ambitious version last spring. There are three main reasons for this: Congressional/Senate Republicans as a whole; Senator Joe Manchin of West Virginia; and Senator Kyrsten Sinema of Arizona.
There's still no way of knowing whether or not this version of Biden's #BBB agenda will pass either, but assuming it does, here's what will make the final cut:
The Biden Administration's first major bill was, of course, the American Rescue Plan, which actually consisted of perhaps a dozen smaller bills which were debated and passed out of a bunch of different House/Senate committees individually before being merged together into the larger package bill.
The next major legislative effort in the works is supposed to be an even larger omnibus infrastructure bill, broken into two major sections: "The American Jobs Plan" and "The American Families Plan". The "Jobs Plan" is supposed to include so-called "hard infrastructure". Here's the summary of the major bullets according to the White House website:
...there's also another small but critical detail included in the table above which escaped my attention last summer in H.R. 1425.
Take a look at the first line of Rep. Underwood's 2019 version (H.R 1868):
Over 100.0 percent up to 133.0 percent
Now take a look at the first line under both H.R. 1425 and H.R. 369:
Up to 150.0 percent
Notice the difference? I'm not talking about the "up to 150%" part. I'm talking about the removal of the "Over 100.0 percent" part.
If this were to pass the House & Senate and be signed into law by President Biden using this exact language, it would apparently eliminate the Medicaid Gap...albeit with a couple of major caveats.
Obviously a lot has changed since then, primarily due to the COVID-19 pandemic, but I presume this is the most recent comprehensive, reliable data they've been able to compile:
The American Rescue Plan does plenty to make private ACA-compliant health insurance dramatically more affordable for everyone earning more than 100% of the Federal Poverty Level. For those below 100% FPL, however, it takes an indirect approach. As I wrote a few weeks ago:
One possible "solution" would have been to simply remove the lower-bound income cut-off point for ACA exchange subsidy eligibility (that is, to lower the threshold from 100% FPL to 0%)...However, this would create two new problems: First, Medicaid is far more comprehensive than nearly all ACA plans...Secondly, if the lower-end subsidy cut-off were removed, it's almost certain that quite a few states which have already expanded the program would reverse themselves and allow Medicaid expansion to expire, in order to save the 10% portion of the cost that they have to pay.
The short version is that because his income is so low, he normally wouldn't be eligible for ACA subsidies...except because he lives in Maryland, a Medicaid expansion state, he would normally be eligible for Medicaid...except that because he's an immigrant who's been in the United States for less than five years, he isn't eligible for Medicaid...except that, thanks to an obscure provision baked into the Affordable Care Act, he is eligible for ACA subsidies after all!
‘(B) SPECIAL RULE FOR CERTAIN INDIVIDUALS LAWFULLY PRESENT IN THE UNITED STATES.—If—
‘‘(i) a taxpayer has a household income which is not greater than 100 percent of an amount equal to the poverty line for a family of the size involved, and
Roughly two to three million people lost employer sponsored health insurance between March and September, and even families who have maintained coverage may struggle to pay premiums and afford care. Further, going into this crisis, 30 million people were without coverage, limiting their access to the health care system in the middle of a pandemic. To ensure access to health coverage, President-elect Biden is calling on Congress to subsidize continuation health coverage (COBRA) through the end of September. He is also asking Congress to expand and increase the value of the Premium Tax Credit to lower or eliminate health insurance premiums and ensure enrollees - including those who never had coverage through their jobs - will not pay more than 8.5 percent of their income for coverage.
Together, these policies would reduce premiums for more than ten million people and reduce the ranks of the uninsured by millions more.
