Thread by @charles_gaba

This is something I've caught some heat from other healthcare advocates over.

I *hate* #ShortAssPlans & would prefer to ban them...but only *after* we #KillTheCliff & beef up the APTC formula. Until then they're a necessary evil, though they should be strongly discouraged.

https://twitter.com/xpostfactoid/status/1328727601486180354

ACA plans are affordable for those earning up to 200% FPL & for most earning 200-400% FPL, but are unaffordable for many earning >400% FPL due to the subsidy cut-off.

#ShortAssPlans suck, but until the 400% cut-off is removed, they're a kinda/sorta viable option for those folks.

The ACTUAL solution is to #KillTheCliff, which @HouseDemocrats did in July & which is a core provision of #BidenCare...@dylanlscott's point is that if killing the 400% cut-off isn't doable, #ShortAssPlans may continue to be a necessary evil for some people.

California has *partly* done this on their own, by the way: They banned #ShortAssPlans outright but *also* added their own supplemental #ACA subsidies on top of the federal tax credits for those earning 400-600% FPL.

This partly resolves the issue, but only partly.

Here's an illustration of how much a single 64-yr old Sacramento, CA resident pays in premiums with federal #ACA subsidies, supplemental CA subsidies & how much they'd pay under the #ACA2.0 bill passed by the House back in July at different income levels in % of income:

Up to 138% FPL, they qualify for Medi-Cal.

From 138 - 400% FPL, they qualify for #ACA subsidies + nominal state subsidies.

From 400-600% FPL, they qualify for state subsidies only...which help a lot, but which would still leave them paying up to 18% of their income.

The #ACA2.0 bill passed by @HouseDemocrats & proposed by @JoeBiden would limit premiums to no more than 8.5% of income, period (the graph shows it at 8.0%; I think that was a slightly different version of the bill). Subsidies would still taper off at higher income levels.

Next year, I believe Washington State is supposed to start offering similar supplemental subsidies to those earning >400% FPL; instead of 400-600% FPL w/an 18% cap, WA is supposed to offer them to those earning 400-500% FPL with a 10% cap.

VT & MA offer supplemental subsidies to lower-income enrollees (<300% FPL), and New Jersey is starting their own supplemental subsidy program this year as well...but again, these are only band-aids to the larger problem, since state budgets are tight (especially now).

Here's a similar example of the dilemma for a 60-yr old couple in Detroit, MI (where we don't have supplemental subsidies). Again, under the #ACA, they're fine up to 400% FPL...but once their income hits ~$70K, they have to pay up to 24% of their income.
acasignups.net/20/02/17/aca-2…

From 400% FPL (~$69K) up to ~700% FPL (~120K), this couple has to choose between paying a huge chunk for premiums *or* paying low premiums for a junk plan.

#SophiesChoice, basically.

Again, the solution is to pass #ACA2.0 which caps premiums at no more than 8.5% of income.

A. Trump/GOP "solution": Throw cheap junk plans at middle-income people.

B. Biden/Dem *actual* solution: #KillTheCliff & offer #ACA-compliant policies at a reasonable price for all.

If Dems don't flip *both* GA seats (& possibly even if they do), we'll be stuck with A.