Does Biden have a health care plan or a realistic method of getting it passed

Politics & Elections
#1

I agree Covid relief should come first, its our biggest priority.

But can’t you only pass 1 budget reconciliation bill a year? If so, does anyone know if the Biden admin has talked about if they want to use reconciliation to pass health reform in 2022? I don’t think the democrats will hold the house or senate after 2022 no matter what they do, so that’ll be their last chance under Biden to get anything passed.

I know there has been talk of an ACA 2.0 which would have better subsidies, more consumer protections, etc but does anyone know if there are any actual plans to get this passed, or is that more something they’re thinking about after they’ve taken action on covid?

#2

One thing Biden is doing is opening up a special enrollment period for ACA from February 15 to May 15.

#3

I don’t know if Biden has said anything, but healthcare legislation at a bare minimum would require nuking of the filibuster. If that happened I’d bet on moderate Dems preventing major legislation from going through, but the dynamics with a 1 vote majority could force more unity than the Democrats have had at most points in the past on healthcare.

#4

But does it, I thought they could just tie it to the budget reconciliation process.

Like if they wanted to expand coverage for people between jobs and families, increase subsidies, add new protections, etc they could do it via reconciliation.

The democrats are considering increasing the minimum wage to $15/hr using reconciliation right now. The GOP passes tax cuts for the rich using reconciliation. It appears to be vague in what it allows.

#5

That’s a good point, increasing subsidies is something I could realistically see happening through reconcilliation. I’d imagine that most plans to expand coverage would fall outside of changing budgets on existing laws. Maybe they could do something with medicaid expansion like federally fund 100% of it and make it mandatory? If $15 can really be passed through reconciliation, then maybe it’s possible.

As far as I understand it, the nitty gritty on reconciliation (and anything related to senate rules) is that it’s basically enforced by honor system. If the majority tries to do something that goes against the senate rules, the senate parliamentarian will object, and then the senate can vote (by majority) to overrule the objection. So if they really wanted to, the Dems could use reconciliation to effectively nullify the filibuster. I would be surprised if that was how it wound up happening, although it may depend on whether the media would report on it as being equivalent to nuking the filibuster or not. I know the GOP had things in their reconciliation healthcare bill that were obviously not allowed under reconciliation rules, so I think there was an unspoken understanding that they were going to overrule the parliamentarian and effectively nullify the filibuster if they could actually agree on a bill. I think in 2021 there is going to be at least one test bill to see if it’s possible to pass uncontroversial legislation without a GOP filibuster, and then failing that there is at least going to be a push from some leadership to completely eliminate or at least drastically reform the filibuster to widely expand the power of 51 senators.

#6

Talk of medicare age going down to 55 or 60. Don’t know if that is in Biden’s plan.

#7

I’m sure there is one locked away somewhere or another. Which is where it should stay. Clinton and Obama both lost their congressional majorities after attempting healthcare reform. This isn’t the time to try for a third round.

#8

I worry democrats will lose congress no matter what they do. might as well pass health reform before it happens.

#9

Yes, that is part of his plan, including making ACA stronger, and free or cheaper to the lower income classes.

So, if you are working FT for a decent company , you get insurance. Then Medicare at 55.

Low income you get ACA free, until 55, then Medicare.

Not exactly UHC, but it will do the job.

I dunno how hard the GOP will fight this. I dont think this will be the Hill they are willing to let the filibuster die on.

The dems can & will nuke the filibuster… if they need to. And so the GOP has to pick their filibuster battles. Fight against controversial stuff. Seek compromise, like now with Biden and the Covid plan.

#10

There are a whole lot of small businesses that I would consider to be “decent” companies that cannot afford to give their employees health insurance.

Really, it is small businesses, who are hurting quite a bit right now, and who really are the drivers of hiring growth, that a comprehensive healthcare plan would help.

#11

And for that we have ACA.

There is also Small Business Health Care Tax Credit for Small Employers, and 17 states have SHOP plans with extras.

#12

The current system has as many holes as swiss cheese, but unfortunately the very narrow margin the Dems have right now is going to make it difficult to plug those holes.

Increasing the subsidy for plans on the exchange thru a reconciliation bill will hopefully happen and should at least put less pressure on the current system to continue to function.

Any real reform that actually works on plugging all the holes (which would likely have to come in a future political environment) necessitates having the ability for every American to get health insurance from the federal government, either through a single-payer or multi-payer system.

#13

They currently have that with the ACA. Are there millions of people excluded from the ACA I dont know about?

#14

Are you referring to the exchanges? Yes the government subsidizes a private healthcare marketplace.

This is insufficient and a public option at the very least is necessary. Voluntary participation in the market by insurers can give people no affordable option, and the lack of competition at times can prevent a market solution to affordability. Existing public programs require people to prove they qualify, which means they don’t act as a real competitor to private insurers and keep them honest, and means that there’s always a margin of people who don’t qualify for something like medicaid but also can’t afford to buy healthcare.

The proof of the pudding is in the eating. There is still about an 8-10% uninsured rate in the US (which is of course an improvement on the alternative with no ACA), and medical reasons are still involved in a staggering number of bankruptcies. We know systems exist where the uninsured rate is effectively 0 (maybe it’s 1 or 2% in some cases due to people who completely fall through the cracks, due to being homeless, etc) and medical bankruptcy is likewise essentially nonexistent.

#15

seasonal workers, people who were laid off, family members of people whose jobs only cover the employees themselves, people who live in states where medicaid wasn’t expanded. people whose income is 401% of the poverty line.

and that’s just to get insurance. if you have insurance you have to worry about out of network charges, balance billing, high co-pays and deductibles, insurance refusing to cover needed care, etc.

#16

The ACA isn’t exactly a panacea.

And there are a number of problems with just saying that the Small Business tax Credit solves much. For one, it doesn’t actually do anything for the owners, so still disincentives people to open their own places. It also is only applicable for 2 years. After that, you are on your own, not really a long term solution.

#17

One of the problems with govt helping small business is the idea of what is a small business. I would consider a person with an auto repair shop with 3-4 employees a small business. The govt would consider chain of repair shops with hundreds of employees a small business. Federal govt programs are basically worthless for real small businesses. The recent covid relief highlighted this very well. They can’t get through the paperwork and take the risk of not being eligible. Tax credits are only helpful if your paying a lot in taxes. Most small business would spend more on the accountant to fill out all the forms than they would save on taxes. They need to require companies over a certain size to provide health insurance to the employees and smaller companies can either provide it themselves or pay into a govt insurance program for each employee. By having both they kinda prevent either one from getting out of hand.

#18

Those people are excluded from ACA? I am gonna need a cite for that.

#19

Yes, it does:

If you are a small employer, there is a tax credit that can put money in your pocket.

The small business health care tax credit benefits employers that:

Are you 100% sure Congress wont extend it?

#20

The small business health care tax credit benefits employers that:

** Have fewer than 25 full-time equivalent employees*