Jeanne Shaheen

This actually happened way back in January, but I didn't stumble upon the press release until now:

Shaheen Reintroduces Legislation to Lower Health Care Costs & Expand Access to Insurance for Millions More Americans

  • Provisions of the Improving Health Insurance Affordability Act were signed into law through the Inflation Reduction Act & the American Rescue Plan Act
  • Estimates suggest 8.9 million Americans have lower premiums thanks to enhanced tax credits
  • **Shaheen’s efforts mark the most significant update to Affordable Care Act in a decade

(Washington, DC) – U.S. Senator Jeanne Shaheen (D-NH) today reintroduced her legislation, the Improving Health Insurance Affordability Act. The bill would make permanent enhanced tax credits that led to record Marketplace enrollment, while reducing health care costs for millions of additional Americans.

The ticking time bomb is getting louder every day as time runs out for the expanded ACA subsidies which were temporarily provided by the American Rescue Plan to be made permanent:

The looming disaster on Obamacare subsidies keeps looking worse

Congressional Democrats are confronting a ticking time bomb that threatens both the health security of millions of Americans and Democrats’ own political security in the midterm elections. If they don’t act fast, it’s going to explode.

...Now, another group of Democrats outside Washington is getting increasingly nervous about this prospect. Democratic governors, many of whom are up for reelection this year, don’t want to watch while Congress makes life more difficult for their constituents.

Underscoring the point, a group of Democratic governors has released a new letter imploring congressional leaders to extend the enhanced subsidies.

No, this is not a repeat, though it may sound like it. From March:

Since the collapse of the Build Back Better Act in the U.S. Senate last December (reminder: It passed the House but came to a screeching halt when all 50 Republican Senators along with conservative Democrat Joe Manchin refused to support it), Congressional Democrats have been quietly trying to put at least some of the pieces of the bill back together in an attempt to salvage something out of President Biden's signature social spending agenda.

...One of the other provisions of BBB which some members of Congress are trying to save has been reintroduced as a standalone bill in both the House (H.R. 6833) and Senate (S.3700), the Affordable Insulin Now Act.

The AINA does two simple (but important) things:

ACA 1.5

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.

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
  • Reducing burdens on small businesses

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