The 2020 election is now behind us, and the Democrats have won control of both the House of Representatives and the Senate. With this blue lean, the Biden administration and congressional Democrats are expected to pursue the policy agenda they campaigned on, including some, if not all, of the health care policy changes set forth in the Biden health care plan.
Below is an overview of what I view as the most meaningful health care policy changes that we can expect the new White House to put into action to strengthen the Affordable Care Act (ACA), lower the uninsured rate, and increase affordability.
1. Allow access to the ACA’s premium tax credit subsidies at higher income levels
Currently, under the ACA, an individual with a household income over 400% of the federal poverty level (FPL) is not eligible for a premium subsidy to reduce the monthly premium amount. Under the Biden health care plan, however, an individual with an income level above 400% of FPL would qualify for a premium subsidy. For example, an individual at 800% of FPL (which is around $100,000 for this individual) could receive a subsidy if they purchase an individual market ACA public exchange plan.
This change is important because while a plan may be deemed affordable on paper, in reality, many Americans are still not buying health insurance because the premiums are just too expensive.
2. Increase the premium subsidy amounts
In addition to allowing more access to subsidies, Democrats have proposed to increase the premium subsidy amounts for individuals purchasing an individual market ACA exchange plan. Subsidies today are based on the premium for the second-lowest cost silver plan. The Biden plan has proposed that subsidies be based off gold plans, which are more expensive, so the subsidy amounts available to consumers would increase.