A bill championed by Iowa Congresswoman Cindy Axne to lower the cost of health insurance premiums for people purchasing coverage on the federal exchange was advanced this week as part of a larger effort by Democrats to shore up the Affordable Care Act.
The U.S. House of Representatives advanced the Patient Protection and Affordable Care Enhancement Act to help meet the health care needs of Americans impacted by the recession and coronavirus pandemic. The bill’s chief goal is to increase federal subsidies on the health care exchange so insurance premiums are more affordable. No individual or family would pay more than 8.5% of their income for a standard “silver” plan in the Affordable Care Act marketplace, resulting in half-priced premiums in some cases.
Pillars of the legislation, such as government intervention in negotiating prescription drug costs, expanding enhanced Medicaid availability to more states and curtailing the promotion of substandard health insurance plans long have been priorities for Democrats when discussing how to provide people in the United States more affordable coverage. Given the coronavirus pandemic and ensuing layoffs, however, advancing fast-acting legislation became necessary.
“When we see a situation right now with what’s happening in the country and people barely being able to afford their health care, we’ve got to do something to address it,” Axne told Starting Line. “I know it’s more of a short-term solution, but it’s a solution nonetheless.”
Included in the health care package is Axne’s Fair Indexing for Health Care Affordability Act. Axne’s bill reverses a Trump Administration decision to change the formula that calculates eligibility for ACA premium tax credits (also known as subsidies) and out-of-pocket costs. The rule, implemented by the Trump Administration in 2019, allows for up to $400 more per year in out-of-pocket costs and increased premiums for more than 80% of Americans who purchase subsidized coverage on the health care exchanges.
“The change is not required by the ACA or any other statute,” the Center on Budget and Policy Priorities wrote in April 2019. “The Administration is making an entirely discretionary choice to raise costs for millions of people … Moreover, the Administration chose to move forward with finalizing the rule change despite the fact that, as the final rule itself notes, ‘all commenters on this topic [of the proposed rule] expressed opposition to or concerns about the proposed change.'”
If Democrats’ legislation is implemented and the administration’s rule change is reversed, some of the top-line benefits are lower premiums and lower out-of-pocket costs.
The Republican-controlled Senate has taken up few pieces of legislation this year and typically balks at the idea of considering any measures to bolster the ACA, but Axne was hopeful Republicans “understand that families are suffering, people are losing coverage and people are sick.”
“We’ve got to protect them,” the 3rd District congresswoman said.
In May, the Kaiser Family Foundation estimated 27 million people were at risk of losing their employer-provided health insurance due to the economic downturn caused by the pandemic.
Protecting health insurance coverage for people with preexisting conditions and working to lower the cost of prescription drugs was “the biggest reason I ran” for Congress, said Axne, who flipped a Republican-held seat in 2018.
“I get what families are going through,” Axne said, as she recalled selling personal possessions in order to cover the cost of her pregnancy and delivery, back before the ACA when private insurance companies considered pregnancy a preexisting condition. “They’re struggling through times like this.”
In addition to Axne, Iowa representatives Abby Finkenauer and Dave Loebsack joined more than 200 of their colleagues (all but two of them Democrats) in supporting the Patient Protection and Affordable Care Enhancement Act.
Finkenauer’s bill, the CARING for Kids Act, also was included in the health care package. The legislation permanently funds the Children’s Health Insurance Program, which provides insurance to 10 million children of lower-income families who do not qualify for Medicaid. In Iowa, CHIP is offered through the Healthy and Well Kids in Iowa program (Hawki), which covers about 75,000 children.
“For too long, D.C. politicians have used kids’ health care as a bargaining chip in their political games,” Finkenauer said in a statement. “No more. This program must be permanently funded so that gamesmanship never threatens our children’s health.”
By Elizabeth Meyer
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