Key details about the House plan to cover poor people in states not expanding Medicaid:

ACA marketplace coverage 2022-2024 with nominal cost-sharing.

Coverage in a new federal Medicaid plan starting in 2025.

States that drop the expansion have to continue paying their share.
Here are links to the proposed legislative language from the House Energy and Commerce Committee to cover poor people in states that have not expanded Medicaid under the ACA.

energycommerce.house.gov/committee-acti…
There are 2.2 million poor adults with no health coverage because their states have not expanded Medicaid under the ACA.

Over half of them are in Texas and Florida.

kff.org/medicaid/issue…
If you're a parent in a family of three in Texas and make more than $3,733 PER YEAR, you make too much to qualify for Medicaid.

If you're an adult without kids in Texas who isn't elderly or disabled, you're ineligible, period.

kff.org/report-section…

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More from @larry_levitt

9 Sep
Under President Biden's plan, we'll see vaccination required by many employers, health care institutions, and entertainment venues.

The unvaccinated will have fewer places to work and fewer places to go.

whitehouse.gov/covidplan/
COVID vaccines are widely available and free to people whether they have insurance or not.

Now, under President Biden's plan, workers at businesses with 100+ employees will also get paid time off to get vaccinated and recover from any side effects.
It's sort of remarkable that your ability to work, attend many entertainment events, and go to certain restaurants and bars is still going to depend on proving vaccination using a flimsy, oddly-sized CDC card with no electronic verification.
Read 4 tweets
25 Aug
Delta Airlines will charge unvaccinated employees $200 per month extra for their health benefits. But, they are not mandating vaccination.

While insurers are prohibited from charging higher premiums to unvaccinated people, employers themselves can.

news.delta.com/ed-bastian-mem…
Here's more information on what employers can do to require vaccination or use financial carrots or sticks to encourage it.

kff.org/coronavirus-co…
A vaccine mandate means unvaccinated workers lose their jobs. A health insurance surcharge for unvaccinated workers is less coercive and likely less effective. It also opens up a hornet's nest of issues around whether people's behavior should affect what they pay for health care.
Read 6 tweets
9 Aug
If Democrats are able to accomplish all these goals in the budget resolution released today, it would be the biggest reform of the health care system since the Affordable Care Act passed more than a decade ago.

democrats.senate.gov/imo/media/doc/…
The policy guidelines that accompany the budget resolution are not binding. It's up to Congressional committees to match expansions with new revenues and savings to solve a complex jigsaw puzzle that matches budget targets.
The cost of these health care expansions can be dialed up or down to fit within available revenues.

One key way to lower the budgetary cost of a health care expansion: Give it an expiration date.
Read 5 tweets
25 Jun
Every time I help a family member or friend enroll in Medicaid, I come away amazed at how many people actually manage to succeed in navigating the application process.

We focus a lot on eligibility for public benefits and not nearly enough on the complexity of accessing them.
7.3 million people are uninsured but eligible for Medicaid.

More outreach and help navigating the application process could no doubt reduce that number.

kff.org/health-reform/…
In some cases, burdensome application processes for public benefits like Medicaid may simply reflect lack of thoughtful attention to the needs of applicants.

In other cases, it's a purposeful effort to reduce enrollment and costs.
Read 4 tweets
24 Jun
Possibly the biggest gap in the ACA is that there are 2.2 million poor, uninsured people who have no affordable health care options in the dozen states that have not expanded Medicaid.

kff.org/medicaid/issue…
There are two leading options being discussed to cover poor people in states that have not expanded Medicaid.

1. Make people below poverty eligible for subsidized coverage in the ACA marketplace.

2. Create a Medicaid backup plan administered by the federal government.
Using the ACA marketplace is likely the quickest and easiest approach to fill the Medicaid coverage gap, since it already exists.

It's also likely the most expensive approach, since private insurers pay higher prices for health care than Medicaid.
Read 7 tweets
13 May
Missouri is not implementing the Medicaid expansion approved by voters because the legislature has not provided the $130 million in funding for next year.

Under the American Rescue Plan, Missouri would receive $1.1 billion in extra federal funds over two years if it expands.
Here's the @KFF analysis showing the extra $1.1 billion over two years Missouri would receive if it moves forward with the Medicaid expansion approved by voters. This is in addition to the federal government covering 90% of the cost of the expansion.

kff.org/coronavirus-co…
Here is the press release from Missouri Governor Mike Parson pulling back on the Medicaid expansion approved by voters due to lack of funding by the legislature.

governor.mo.gov/press-releases…
Read 4 tweets

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