A strong and healthy middle class is not just the backbone of any economy, but it also exhibits its real social growth. This is exactly what the healthcare provisions of the Build Back Better legislation envisage to achieve by providing a seamless care access to Americans. The Bill passed the House of Representatives test with a close margin last November and faces a tougher challenge in the Senate.
What is the Bill
The Build Back Better Bill is a $1.75 trillion social spending package having multiple provisions for healthcare along with social, climate change and revenue policies. President Joe Biden’s framework to improve public health by lowering health costs and improving access to care is tipped to be the biggest healthcare reform since the passage of the Affordable Care Act in 2010. Expanded healthcare access for children, more affordable insurance for working-age Americans and better Medicare benefits for the disabled and older Americans are highlights of the Bill.
How It Works
The legislation offers to expand access to coverage through subsidized health insurance marketplace plans by building on the Affordable Care Act to close the Medicaid coverage gap. It further proposes to raise financial assistance to those who have to buy coverage on their own through the marketplaces, leading four million uninsured people to gain coverage. The steps are estimated to bring down the number of uninsured people in the US by 3.4 million.
Key Provisions
Strengthens ACA and reduces premiums
The framework will reduce premiums for more than nine million Americans who buy insurance through the Affordable Care Act marketplace by an average of $600 per person per year. Experts predict that more than three million people who would otherwise be uninsured will gain health insurance. The Bill also proposes to expand Medicare coverage to cover hearing coverage, so that older Americans can access the affordable care they need.
Closes Medicaid coverage gap
The Bill will deliver healthcare coverage through Affordable Care Act premium tax credits to up to four million uninsured people in states that have locked them out of Medicaid. A 40-year-old in the coverage gap would have to pay $450 per month for benchmark coverage – more than half of their income in many cases. The framework provides individuals $0 premiums, finally making health care affordable and accessible.
Reduces prescription drug costs
Medicare will negotiate prices for high-cost prescription drugs. This will include drugs seniors get at the pharmacy counter as well as the ones administered in a doctor’s clinic. Drugs become eligible for negotiation once they have been on the market for a fixed number of years – years for small molecule drugs and 12 for biologics. It provides for a tax penalty if drug companies increase their prices faster than inflation.
Lower out-of-pocket costs for seniors
The absence of a cap on how much seniors and people with disabilities have to spend on drugs results in millions of seniors paying more than $6,000 a year in cost-sharing. This proposal puts an end to this burden and ensures that seniors never pay more than $2,000 a year for their drugs under Medicare. The plan will also lower insulin prices so that Americans with diabetes don’t pay more than $35 per month for their insulin.
Largest investment in childcare
The Bill permanently extends the Children’s Health Insurance Program (CHIP) to ensure children have access to quality, affordable health insurance, regardless of their family’s income. The framework will ensure that middle-class families pay no more than 7 percent of their income on childcare and will help states expand access to high-quality, affordable child care to about 20 million children per year – covering 9 out of 10 families across the country with young children.
Affordable, quality care for seniors, people with disabilities
The framework will permanently improve Medicaid coverage for home care services for seniors and people with disabilities, making the most transformative investment in access to home care in 40 years, when these services were first authorized for Medicaid.
What the Future Holds
The Bill may have passed the House hurdle but its fate still hangs in the balance given the challenge it faces in the Senate. Conservative Democrat Senator Joe Manchin, whose vote is needed to pass the bill, has declared to oppose it citing that many provisions may exacerbate high inflation.
If the Bill gets the Senate nod, the provisions for healthcare reforms will cost the government $330 billion over the next 10 years and come with compensating health savings of $325 billion, suggests an analysis of Congressional Budget Office data. For the people, it will pave the way to choose a plan depending on where they live and work, how much they earn, and how old they are.