04.01.2019

Don’t Destroy the ACA; Improve It

The Trump Administration’s move last week to eliminate the Affordable Care Act (ACA) was countered by House Democrats who introduced a series of bills to do just the opposite – strengthen the ACA and expand its reach. While countering ACA opponents, the Democratic package that House Speaker Nancy Pelosi and committee chairs put forward is also an alternative to the various “Medicare for All” bills that Democrats have introduced.
 
The ACA legislative package would, among other things, increase tax credits and cost-sharing to allow more people to buy insurance; that is, raise the income level above which people are ineligible for tax credits to purchase insurance. The bills would also restore the funding that President Trump cut from programs to inform people about their insurance options and subsidies available to them. 
  
The Democratic bills would force the low-cost, limited-benefit plans that the Trump Administration allowed last year to conform to the ACA’s minimal coverage requirements. That means they would now have to cover prescription drugs, maternity care, drug abuse treatment, and pre-existing conditions.

Many of the elements of the new bills are carry-over ideas from a previous bill drafted by Reps. Richard Neal (D-Mass.), Frank Pallone (D-N.J.), and Bobby Scott (D-Va.).
 
There are approximately 2.5 million Massachusetts residents with pre-existing health conditions who benefit from the ACA; more than 300,000 Massachusetts residents have received coverage through the ACA’s Medicaid expansion; more than 283,000 individuals purchased insurance through the state’s health exchange as of February 2019, including more than 224,000 with the support of ACA advanced premium tax credits that the current proposed bills would expand.