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Charles Ghoul-ba 👻 Profile picture
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28 Oct, 8 tweets, 3 min read
This is just a quick overview for my readers; I don't see the point of doing a deep dive until I know whether this is the final cut or not:
acasignups.net/21/10/28/biden…
UPDATE: The text of the updated House version of the bill is already out! That was fast...
rules.house.gov/sites/democrat…

Re. healthcare stuff, here's some of the relevant portions:

1. ACA Subsidy Cliff killed for another 3 years: Image
2. Extension of the more generous #AmRescuePlan subsidy table for another 3 years: Image
3. Oh good...the reduction in the group plan affordability test from 9.5% to 8.5% is still there...but only through 2025 as well. Glad to see this survived, though; small but important to those it impacts: Image
4. This one I had missed before--lump-sum social security benefits would no longer be counted towards household income for purposes of determining ACA subsidies.

Again, sounds like a minor thing but probably a Big Deal to those it impacts: Image
5. HEY HEALTHCARE TWITTER: Want to help me with this one? (page 1462-1463) Does this mean the Family Glitch wouldn't apply for enrollees <138% FPL (which basically means the Medicaid Gap + 100-138% folks in nonexpansion states)?? Or is it something else? Image
6. Oh good! The ARP's Unemployment Benefit would be extended thru 2025 as well! I honestly figured that was a one-time thing but it sounds like it's a hit so, sure! Image
7. Huh. Not sure what this bit is about. Image

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More from @charles_gaba

Charles Ghoul-ba 👻 Profile picture
30 Oct
In 2018, Bernie acolyte Paula Swearengin ran against Manchin in the primary & was crushed by 40 points.

In 2020, Swearengin ran against Caputo in the general and was crushed by 43 points.

Oh, and I personally raised over $50,000 for Paula Jean Swearengin last cycle.
(For those wondering: I raised money for EVERY federal race last cycle, no matter how absurd of a long shot it was.)
Swearengin is a perfect test case for Our Revolution's "We need to run far-left progressives instead of moderate/centrist Dems in deep red areas to win" theory.

1st time she was crushed by one in the primary.

2nd time she won the primary & was then crushed by the Republican.
Read 6 tweets
Charles Ghoul-ba 👻 Profile picture
30 Oct
📣📣📣
QUESTION: What healthcare policies are included in the #BuildBackBetter framework?

ANSWER: A hell of a lot more than you probably thought!

There's *77* sections on healthcare policy improvements. Here's an overview of all of them.
acasignups.net/21/10/30/detai…
There's 4 sections devoted to closing the Medicaid Gap; 9 sections on expanding/extending ACA health insurance subsidies & affordability; 6 on Home & Community-Based Services; 1 which adds Hearing Aid coverage to Medicare; 5 on various Hospice/Palliative Care programs...
...3 sections re. beefing up the CDC, FDA & other departments to head off the NEXT global pandemic; 18 sections (!) on prenatal, perinatal, maternal & postpartum health programs; 4 sections funding SAMHSA programs; 3 devoted to Native Hawaiian health programs...
Read 4 tweets
Charles Ghoul-ba 👻 Profile picture
29 Oct
📣 THE 2022 #ACA OPEN ENROLLMENT PERIOD STARTS ON MONDAY.

Once again, the #ACA can be best described as a #3LeggedStool:

1. Insurer Responsibilities
2. Government Responsibilities
3. Enrollee Responsibilities

Let's review, shall we?
1st Leg: INSURER RESPONSIBILITIES:
--Guaranteed Issue
--Community Rating
--Essential Health Benefits
--Minimum Actuarial Value
--No Annual/Lifetime Limits
--Maximum Out of Pocket Costs
--Free Preventative Services
--Can Stay on Parents Plan until Age 26
2nd Leg: ENROLLEE RESPONSIBILITIES:
--Limited-Time Open Enrollment Period
--Shared Responsibility Penalty*
*(no longer applies in 46 states...replaced by the World's Most Expensive Shim®)
Read 5 tweets
Charles Ghoul-ba 👻 Profile picture
28 Oct
We’ll have to see what actually passes (if anything) of course, but it’s a fuckload more than “scraps” even now.
Universal Pre-K isn’t “scraps.”

Affordable childcare isn’t “scraps.”

Another full year of expanded child tax credits isn’t “scraps.”

$550 Billion in climate change/green energy development isn’t “scraps.”

Closing the Medicaid Gap for 2.2 million Americans isn’t “scraps.”
Extending the #AmRescuePlan’s expanded ACA tax credits another 3 years isn’t “scraps.”

There’s a whole mess of other stuff still included. It’s not perfect and I’m pissed as hell at Manchinema for dragging it down & the ENTIRE GOP for rejecting ALL of it, but it’s not “scraps.”
Read 4 tweets
Charles Ghoul-ba 👻 Profile picture
28 Oct
Deleted a tweet about the BBB ACA subsidy extension provision until I get more clarity, because the figures cited didn’t make much sense to me if taken literally.
OK, here's the official (for the moment, anyway) "framework" via the White House itself:
whitehouse.gov/briefing-room/…
The healthcare provisions would include:
--Extend expanded #AmRescuePlan subsidies thru 2025 (3 more years)
--Close Medicaid Gap via expanding ACA subsidies <100% FPL thru 2025 (4 yrs)
--Add hearing aid coverage to Medicare
--Repeal Trump Admin prescription drug rebate rule Image
Read 10 tweets
Charles Ghoul-ba 👻 Profile picture
25 Oct
Deleted a tweet because some folks who should know better thought I was *siding* with Manchin on this.

To be clear: Yes, it *could* technically end up "rewarding" the non-expansion states *depending on how it's done* by letting them off the hook for their share. HOWEVER...
1. The way the bill is currently written, those states would be required to pay the same 10% of the cost as if they expanded Medicaid anyway, making it moot--the only way they'd be "rewarded" is, ironically, if the "Fedicaid" portion is removed by, say, MANCHIN;
2. Even if it does "reward" them, as @FishmanEliot correctly notes, it's STILL far more important to get those caught in the Medicaid Gap covered than to "refuse to cave" to non-expansion state GOP leadership.
Read 5 tweets

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