Ayyyeee… What’s Goodie Everyone. So I got some tea and it involves the Democrats on the House of Representatives and The Affordable Care Act a.k.a Obamacare.
House of Representatives on Monday passed the first significant expansion of the Affordable Care Act providing Democrats a high wattage platform to derail President Trump for his efforts to overturn the landmark law during a pandemic and an election year.
There was a 234-179 vote, almost entirely along party lines, was a hollow exercise in terms of any chance the bill would become law and reshape federal health policy. Moments after the debate began, the White House announced the president would veto the legislation if it reached his desk, though a wall of Senate Republican opposition to the measure makes that a moot point.
The vote carried political implications. Less than five months before presidential and congressional elections, it forced Republicans to go on the record about the ACA and showed anew the parties’ highly charged ideological differences on health care an issue that consistently polls as a prime concern among U.S. voters while Democrats portrayed themselves as champions of access to affordable care at a critical time. Republicans characterized the opposing party as authors of a failed law and proponents of tax increases.
Monday’s vote supposedly symbolized that House Democrats have a path to make health insurance and treatment more accessible at a moment when the novel coronavirus and the jobs the pandemic has cost has strained the U.S. health system, robbed millions of Americans of health benefits and caused nearly 125,000 deaths nationwide.
The legislation would add to some of the ACA’s central elements by expanding eligibility for insurance subsidies to those at higher incomes and pressuring more than a dozen states to expand Medicaid. It also would blunt some of the ways the Trump administration has watered down the law. According to The Washington Post;
And the hours of debate before the vote allowed Democrats to point out, again and again, that the Trump administration is seeking to invalidate the ACA in a lawsuit before the Supreme Court that was initiated by a group of Republican attorneys general who contend the entire law is unconstitutional.
Under the law, federal insurance marketplaces and similar state ones opened in 2014 for individuals and families who cannot get affordable health benefits through a job. The law provides federal subsidies for insurance premiums for those with incomes up to 400 percent of the federal poverty level about $51,000 for an individual and nearly $105,000 for a family of four.
The bill would eliminate the 400 percent threshold, saying for the first time that no one would be required to pay more than 8.5 percent of their income on the most popular tier of marketplace health plans.
The legislation would also place financial pressure on states that have not expanded Medicaid, the insurance program for low income Americans run jointly by the federal government and states. The ACA originally expanded Medicaid nationwide, but a 2012 Supreme Court ruling, in which justices upheld the law’s constitutionality, gave each state the choice of whether to expand Medicaid.
For 14 states that have not expanded the program, the bill would reduce federal funding for traditional Medicaid. It would also add an inducement, paying for the entire initial cost of an expansion as the law did when expansions first were allowed in 2014.
Medicaid also would guarantee that all women in the program would stay eligible for coverage for a year after they give birth a step to address the nation’s high rates of medical problems and deaths among new mothers.
Among reversals of changes the administration has made to the ACA, the bill would undo a rule that allows skimpy insurance plans to be sold for up to 12 months, returning them to a three month maximum.
It would provide $100 million a year for outreach and enrollment assistance to encourage consumers to sign up for ACA health plans activities the administration has slashed.
The bill also includes a longtime Democratic goal of allowing federal health officials to negotiate the price of drugs under Medicare, the vast federal insurance program for older and disabled Americans. Trump used to support that idea but turned against it.