Healthcare is the most important issue in this election, tied with the economy, and the Biden/Harris healthcare plan hasn’t been discussed in detail. We know from the Democratic debates that Biden favors the Affordable Care Act, while Harris promoted Medicare For All. So, what is their healthcare plan and how do they reconcile their differing views?
The main principle of the Biden/Harris plan is to ensure that more than 97% of Americans are insured under the ACA. To achieve increased enrollment, the Biden/Harris plan proposes implementing a public option, increasing subsidies for ACA plans, and expanding Medicaid by giving access to the public option for free to 4.9 million Americans, in essence creating a lite version of Medicare For All. In addition, Biden’s plan tackles healthcare costs.
A critical element of their healthcare plan will be funding the free public option and increased subsidies, which is not discussed on the website or in other materials. However, the campaign website notes that the website will roll out Biden’s detailed proposals over the next months and does provide an overview of his plan.
Let’s take a deeper dive on each aspect of the plan as it’s presented today.
Biden’s public option would be available to all Americans to purchase the plan. The Biden plan proposes that similarly to Medicare, the public option will negotiate with hospitals and healthcare providers to provide care a lower cost. In addition, the public option will provide primary care without any copays. The public option is designed to appeal to those who are dissatisfied by the cost sharing elements of their employer plan, those who are seeking an individual plan, or for those who are uninsured.
Increase ACA Subsidies
Today, the ACA reviews family incomes and subsidizes the cost of an ACA plan for families that make up to 400% of the federal poverty limit. Biden’s plan proposes to eliminate the 400% income cap and replacing it with simply a calculation of 8.5% of the family’s total income. What this means is no family would spend more than 8.5% of their income on health insurance. And Biden’s plan would make the calculation based on the gold plan, which has lower deductibles and out-of-pocket costs, so that families could have richer plans than they do today.
Free Public Option
Biden proposes to offer free access to the public option for 4.9 million people in the 14 state that did not enact Medicaid expansion. Under the ACA, states were allowed to expand their Medicaid plans to more of their population; all states but 14 expanded their Medicaid plans. The Biden healthcare plan asserts that 4.9 million people in those 14 states are uninsured because Medicaid expansion was not implemented. As a result, Biden proposes to offer free access to the public option for those individuals. In addition, Biden proposes to auto-enroll those who make less than 138% of the federal poverty level into the free public option by automatically enrolling them when they interact with other government programs such as public schools or welfare.
Reduce Healthcare Costs
In addition to adjusting the current framework of the ACA, Biden is also tackling the underlying problem of rising healthcare costs by implementing cost savings measures. First, Biden proposes to end surprise billing by barring healthcare providers from charging patients out-of-network rates when the patient does not have control over which provider the patient sees. Next, Biden will reduce costs in the healthcare system by aggressively using antitrust authority to increase competition. And Biden plans to reduce prescription costs by allowing consumers to buy prescriptions from other countries, terminating tax breaks for pharmaceutical company advertising, and by accelerating the development of safe generic medications.
The Biden healthcare plan seeks to insure 97% of Americans by implementing a Medicare For All Lite strategy that expands the ACA to include a public option, increase ACA subsidies and create a free public option for 4.9 million Americans.
Jan Dubauskas is a healthcare expert, enthusiastic insurance pro, attorney and mom serving as vice president of healthinsurance.com.
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