Should Obamacare’s Healthcare Insurance Tax Credits Be Expanded & Trump’s ‘Sabotage’ Reversed? (H.R. 1884)
Do you support or oppose this bill?
What is H.R. 1884?
(Updated April 26, 2019)
This bill would aim to strengthen the protections for people with pre-existing conditions, reverse Trump administration actions related to health insurance plan regulations, increase premium assistance tax credits, and provide more funding for enrollment outreach under the Affordable Care Act (aka Obamacare). The bill’s authors have broken it into three sections — “Expanding Affordability”, “Undoing Sabotage”, and “State Innovation & Transparency” — which are described in greater detail below.
“Expanding Affordability”
This section of the bill would expand eligibility for premium assistance tax credits beyond the current threshold of 400% of the federal poverty line ($49,960 for individuals or $103,000 for a family of four), and would increase the size of the tax credits for all income brackets.
It’d also expand access to premium assistance tax credits for people who have an offer of coverage through their employer by allowing them to obtain subsidized coverage through an exchange if family coverage (rather than self-only coverage) is more affordable than the employer plan.
“Undoing Sabotage”
This section would block Trump administration executive actions regarding health insurance regulations by:
Preventing small businesses and individuals from obtaining coverage through association health plans (AHPs).
Reversing the expansion of short-term, limited-duration health plans for consumers, and not allowing tax credit subsidies to be used for such plans.
Requiring health insurance plans to cover all essential health benefits (EHBs) without allowing the substitution of benefits across benefit categories or limited prescription drug coverage.
Not allowing states to get waivers for certain aspects of Obamacare by demonstrating that a comparable number of residents will have access to comprehensive coverage if part of the law is waived.
It would also restore funding for several Obamacare initiatives that were reduced by the Trump administration, including:
Funding the navigators program, through which community-based organizations provide people seeking coverage information about coverage options on the federal insurance marketplace, with $100 million per year.
Funding marketing and outreach for the federal marketplace with $100 million per year.
Additionally, this part of the bill would establish a state-based reinsurance program that’d give states a choice of setting up their own reinsurance programs or using funds to provide premium subsidies or cost-sharing support to consumers. It’d also provide a federal default reinsurance program for states that decline to set up their own reinsurance programs.
“State Innovation & Transparency”
This section of the bill would fund state health insurance education programs for consumers, including $100 million in Consumer Assistance Program grants for states to support educational activities about health insurance (like filing complaints, assisting with enrollment, or getting premium tax credits).
From 2020 to 2022, $200 million in funding per year would be provided for states to conduct feasibility studies, pilot programs, technology upgrades, or other efforts to promote enrollment in health insurance plans in the individual and small group markets (including implementing a state version of the individual mandate to buy health insurance).
States that haven’t set up a health insurance marketplace of their own would be permitted to establish such a marketplace and receive federal funding for planning and implementation. Under current law states were cut off from getting federal funds to set up a marketplace after January 1, 2015.
Additionally, the Dept. of Health and Human Services (HHS) would required to provide Congress with an annual report detailing its spending on outreach and enrollment, navigators, maintenance of Healthcare.gov, and operation of the Healthcare.gov call centers.
Argument in favor
This bill would reverse the Trump administrations efforts to sabotage the Affordable Care Act and weaken protections for pre-existing conditions. It’d also expand Obamacare’s premium assistance tax credits so that they make getting coverage more affordable for all Americans.
Argument opposed
This bill would reduce the health insurance options available to consumers by cutting off access to short-term, limited duration plans or those that cover less and are relatively inexpensive. Not only that, it’d also waste millions of tax dollars on the inefficient navigators program.
Impact
American consumers of health insurance; state governments; health insurers; and relevant federal agencies, particularly HHS.
Cost of H.R. 1884
A CBO cost estimate is unavailable.
Additional Info
In-Depth: House Energy & Commerce Committee Chairman Frank Pallone (D-NJ) introduced this bill to strengthen Obamacare and reverse the Trump administration’s efforts to undermine it:
“This comprehensive proposal follows through on our commitment to make healthcare more affordable and to defend critical protections for the more than 133 million Americans living with pre-existing conditions. It’s time for Congress to take action to lower the soaring costs of healthcare, rein in the Trump Administration’s efforts to sabotage the ACA and ensure that insurance companies cannot discriminate against people with pre-existing conditions.”
House Speaker Nancy Pelosi (D-CA) added:
“While the Trump Administration broadens its monstrous ambitions from destroying protections for pre-existing conditions to tearing down every last benefit and protection the Affordable Care Act provides, Democrats are putting forward new legislation to lower health insurance premiums and strengthen protections for America’s families. Today, with the Protecting Pre-existing Conditions & Making Health Care More Affordable Act, we are taking another bold step to deliver more affordable health care.”
House Republicans are expected to oppose this bill in committee and on the floor, while the GOP-controlled Senate is highly unlikely to take up the bill if it were to pass. The Trump administration will also oppose the bill because it seeks to undo actions it has taken.
Centers for Medicare and Medicaid Services Administrator Seema Verma explained cuts to the Obamacare navigators program by noting that they helped with fewer than 1% of enrollments in 2017. And the administration has opposed a legal challenge to the executive action regarding association health plans.
This legislation has the support of 132 cosponsors, all of whom are Democrats, and has been endorsed by a group of 26 healthcare organizations.
Media:
Kaiser Health News (Context)
American Hospital Association (In Favor)
Center on Budget and Policy Priorities (In Favor)
Summary by Eric Revell
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