Thread by @charles_gaba

📣 Ahead of tonight’s big speech: I have no idea if he’ll give an update on ACA enrollment, but if he does, I’m guessing he’ll announce over 1.0 million ADDITIONAL exchange enrollees via HealthCare.Gov alone since the relaunched enrollment period started on 2/15.

According to @JStein_WaPo, it sounds like Biden will be proposing $200B to make the expanded #ACA subsidies permanent, but no other major healthcare provisions *at the moment*. This actually makes more sense than you may think given this poll: acasignups.net/21/04/27/huh-s…

Having said that, the WH resistance to going bigger in healthcare *at the moment* seems to center around passing #HR3 to pay for other stuff, which is fiercely opposed by #PhRMA.

The thing is, assuming the CBO scores the various provisions close to the estimates I list here, there should be enough funding available for ACA 2.0 *and* significant Medicare improvements.
acasignups.net/21/04/25/updat…

Even so, making the expanded #ACA subsidies permanent would still be a HUGE upgrade for ~20 million people. The @urbaninstitute estimates it will reduce the number of uninsured Americans by 4.2 million AND lower individual market premiums by 15%: acasignups.net/21/04/16/urban…

It’s also worth noting that there’s nothing stopping the @HouseDemocrats & @SenateDems from simply...passing #HR3 and other healthcare upgrades anyway. I know that’s understating the WH’s influence but I hardly think Biden would VETO a larger bill if it came down to that!

Annnnd here it is: The #AmFamiliesPlan: whitehouse.gov/briefing-room/…

It’s important to note that THIS IS *NOT* THE END OF BIDEN’S HEALTHCARE PLAN. He’s still stressing #HR3, expanding Medicare etc. but wants the rest of it done in a separate legislative package. Most healthcare advocates want everything baked in HERE, but that might be feasible.

Biden seems to be saying that he wants to lock in the expanded ACA subsidies along with all of the other major policies (child care, education, unemployment etc) NOW, (which I certainly support!), and then have a larger healthcare upgrade debate this fall (or next year).

My guess is he also doesn’t want to risk the entire larger bill being targeted by #PhRMA and the hospital industry (remember, it’s supposed to include BOTH the #AmJobsPlan AND the #AmFamiliesPlan). Limiting the healthcare provision to this avoids the wrath of both for now.

It’s also important to keep perspective: I’ve spent the past 3 yrs working my butt off to #KillTheCliff and #UpTheSubs. I even had over a dozen in-person meetings with Congressional staffers just before COVID hit to pass exactly what Biden’s proposing: acasignups.net/20/06/09/aca-2…

Both of those are now reality through the end of next year, and Biden’s proposal to make them permanent would scratch them both off my “to do” list. There’s a bunch of other important stuff of course but this would still be a #BFD by itself and shouldn’t be understated.

Also, the Biden Admin (thru @SecBecerra) appears to be attempting to fix the #FamilyGlitch via regulatory changes at the IRS, which wouldn’t require legislation and which would make 2-6million MORE Americans eligible for #ACA subsidies: acasignups.net/21/04/05/good-…

UPDATE: As noted upthread, CONGRESS ultimately decides what's included in legislation, not the President or the White House staff.

Sounds like @HouseDemocrats are very happy with most of the #AmFamPlan but still plan on passing #HR3 as part of it whether Biden approves or not.

Worth noting that all this talk about how "expensive" the bill is is pretty disingenuous since IT'S ALL PAID FOR AS PART OF THE BILL ITSELF.

If you trade two $10,000 motorcycles for a $20,000 car and someone asks how much you paid, the answer isn't $20K.