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House Democrats to consider measure to strengthen Obamacare

Party is once again making health care a top election priority

Nurses demonstrate in Lafayette Square in Washington in April, calling for better PPE for health care workers. Democrats believe the pandemic has put health care on the fall ballot.
Nurses demonstrate in Lafayette Square in Washington in April, calling for better PPE for health care workers. Democrats believe the pandemic has put health care on the fall ballot. (Tom Williams/CQ Roll Call file photo)

House Democrats on Monday released legislation to bolster the 2010 health care law, which the Rules Committee plans to consider this week.

The measure, which is expected to get a floor vote as soon as this month, comes as Democrats are betting that focusing on health care — a top priority for voters — will be to their advantage in the November elections. 

New provisions are being incorporated into a bill to provide funds for states to set up reinsurance programs for the exchanges set up by the 2010 law. The Energy and Commerce Committee approved that bill last year. The Rules Committee will meet Wednesday to approve a rule, which may not allow amendments, for the new version. 

The panel on Monday released the new text, which includes provisions to increase premium assistance for eligible consumers, incentivize states to expand Medicaid eligibility and reverse Trump administration rules that Democrats say weaken the health care law, among other things.

The measure would make the law’s premium subsidies more generous and allow more people to get them.

It would do so by increasing the insurance premium subsidies for people whose household income is above 150 percent of the federal poverty line. And it would allow for people whose household income is more than 400 percent above the poverty line to receive those tax credit subsidies. Under the 2010 law, those consumers don’t qualify for financial assistance and have borne the brunt of large premium increases in past years.

The bill would also rescind regulations the Trump administration put forward to allow for short-term health insurance plans to be more available. It would revoke an administration guidance for states to allow them more flexibility to seek waivers for their insurance marketplaces.

The measure would also require the administration to conduct outreach and educational activities about the marketplaces, which the Trump administration scaled back compared to the Obama administration. It would also require the administration to set enrollment targets, which the Trump administration has not done publicly.

The measure would also seek to encourage states to expand Medicaid eligibility by enhancing federal payments to provide the same benefits that states that expanded initially under the health care law enjoyed in 2014, 2015 and 2016. It would also reduce the amount of federal payments for certain administrative costs to states that don’t expand eligibility and would increase reporting requirements for those states. More than a dozen states have not expanded Medicaid, while some are in the process of implementing expansion.

It would provide permanent funding for the Children’s Health Insurance Program. It would offer 12 months of eligibility for Medicaid or CHIP and extend Medicaid and CHIP eligibility to 12 months postpartum for new mothers and their children.

The measure also includes provisions to allow for the Health and Human Services secretary to negotiate drug prices. That was in House Democrats’ measure to lower drug prices, which the chamber passed last year.

Democratic campaign committees have said in recent weeks that health care is on the ballot in the midst of the COVID-19 pandemic. The groups issued a joint memo last month explaining how a focus on health care would draw comparisons with Republicans up and down the ballot.

The vote on the House measure will come around the same time as the Trump administration and Republican attorneys general seeking to overturn the health care law are set to file their opening briefs to the Supreme Court in Texas v. California. Those states are set to file their opening briefs on Friday.

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