The team got back together to celebrate that big fucking deal, the Affordable Care Act, with former President Barack Obama joining President Joe Biden at the White House Tuesday. It’s the first public appearance at the White House by President Obama since January 2017 and it’s to formally announce the already proposed rule to fix the “family glitch” in the law that has made health insurance too expensive for millions of families.
It was a happy reunion.
“It’s fitting that the first time you return to the White House is to celebrate a law that’s transformed millions of lives,” President Biden told Obama. “Because of you. […] A law that shows hope leads to change, and you did that. You did it. Let’s be honest, the Affordable Care Act has been called a lot of things, but Obamacare is the most fitting. Obamacare.”
“Twelve years later, Republicans are still promising to repeal the Affordable Care Act if they get the chance,” Biden continued. “Well, I got a better idea. Instead of destroying the Affordable Care Act, let's keep building on it.”
The White House fact sheet for the new proposed rule says that the Treasury Department and the Internal Revenue Service are proposing to simply eliminate the “family glitch,” a weedy and complicated determination made by those entities way back when that tried to define “affordable” and failed for many families.
They did cause the glitch in the first place, so they are in a position to eliminate it. They also explain what the glitch is:
Current regulations define employer-based health insurance as “affordable” if the coverage solely for the employee, and not for family members, is affordable, making family members ineligible for a premium tax credit even though they need it to afford high-quality coverage through the Marketplace. For family members of an employee offered health coverage through an employer, the cost of that family coverage can sometimes be very expensive and make health insurance out of reach.
It wasn’t the original intent of the law, but it’s been one of its biggest failings in the decade since Obamacare passed. The Kaiser Family Foundation (KFF) estimates that 5.1 million people are caught in it, the majority of them children. The majority of them—85%, or 4.4 million—are enrolled through employer-sponsored health care but are “likely spending far more for health insurance coverage than individuals with similar incomes eligible for financial assistance on the ACA Marketplaces.” The families “could spend less on premiums if they could enroll in Marketplace plans and qualify for subsidies” with the glitch eliminated, KFF finds.
In addition to fixing the glitch, the White House fact sheet says Biden will issue “a new Executive Order directing federal agencies to continue doing everything in their power to expand affordable, quality health coverage.” That includes making enrollment simpler and making it easier for people to understand coverage options, improving coverage, making benefits more generous, and “Continuing to make health coverage more accessible and affordable by expanding eligibility and lowering costs for Americans with ACA, Medicare, or Medicaid coverage.”
How the agencies are going to do all that is not spelled out, but Biden is apparently looking to them to be creative in figuring it out. That last one is key.
Biden and the congressional Democrats have a problem: the expiration of the American Rescue Plan’s enhanced premium subsidies at the end of the year. People with existing Obamacare plans are going to start getting notices in October of their new premium rates, which could as much as double with the expiration of ARP rates. Democrats intended to make them permanent in the Build Back Better plan, but Joe Manchin torpedoed that.
Vice President Kamala Harris called on Congress to fix that and pass the permanent extension of the expanded premiums. She also called for the last 12 states that are still blocking people from Medicaid to finally take the Obamacare expansion. "Currently there are 12 states in our nation that refuse to expand Medicaid for no reason other than petty partisan obstruction. As a result, 4 million people in our country are locked out of coverage."
So President Biden needs to do whatever he can do unilaterally to lower those costs.
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