🧵 Here's an updated summary of the major health provisions in Build Back Better.
It has changed from the original version, so I'll walk through the current version in this thread 🧵(1/10)
Click the link for more data on potential costs and impact: kff.org/health-reform/…
2/ Build Back Better would boost ACA Marketplace subsidies through 2025 (original version was permanent). Upper/middle income people would not be priced out of coverage and low-income people would get free platinum-like plans, thru 2025. Over a million people could gain coverage.
3/ Build Back Better would create a new Medicare hearing benefit (no longer dental/vision). Hearing aids would be available every 5 years with 20% coinsurance. There are about 36 million Medicare beneficiaries in traditional Medicare who currently lack this coverage.
4/ Build Back Better would lower Rx prices by allowing the govt to negotiate certain Medicare-covered drugs. It would also require drug companies to issue rebates if prices for certain Medicare-covered drugs rise faster than inflation. And it would limit cost sharing on insulin.
5/ Build Back Better would lower seniors' drug costs by creating a cap on out-of-pocket spending of $2,000 for Part D enrollees.
BBB also increases Medicare’s premium subsidy for drug coverage to from 74.5% to 76.5% & reduces beneficiaries' share of the cost from 25.5% to 23.5%.
6/ Build Back Better would close the Medicaid coverage gap through 2025 (not permanently).
There are now 12 states that have not expanded Medicaid. 2.2 million people in these states could receive free ($0 premium) Marketplace plans that cover 99% of a typical population’s cost.
7/ Build Back Better would extend Medicaid postpartum coverage to 12 months. Medicaid currently covers half of births but federal law only requires 60 days postpartum. There are 700-800 pregnancy-related deaths annually (Black & Native American women 2-3x higher rates than white)
8/ Build Back Better would permanently expand the Children’s Health Insurance Program. When CHIP was last reauthorized, CBO estimated it would save the federal government money because, without CHIP, other alternatives would have higher federal costs.
9/ Build Back Better would increase federal funding to state Medicaid Home and Community Based Services. Medicaid is the primary payer for long-term care services that help seniors and people with disabilities. To get extra funds, states would have to enhance these services.
10/ Build Back Better would create a universal paid family and medical leave program of 4 weeks (no longer 12 weeks).
Annual earnings up to $15k would be replaced at about 90%, plus 73% of earnings for wages between $15k -$32k, capping out at 53% of earnings for wages $32k - $62k
• • •
Missing some Tweet in this thread? You can try to
force a refresh
With new regulations on #SurpriseBills expected to drop momentarily, a reminder that about 1 in 5 emergency visits results in an out-of-network charge, putting patients at risk of surprise bills healthsystemtracker.org/brief/an-exami…
Even for childbirth -- something patients have months to prepare for, and it's common for new parents to even go on TOURS of hospitals in preparation for -- 1 in 10 in-network hospitalizations comes with an out-of-network charge healthsystemtracker.org/brief/surprise…
Soon, most surprise billing practice should stop with implementation of the No Surprises Act.
But there are holes in these protections, particularly for ground ambulance rides (which are exactly the sort of situations patients feel powerless in). healthsystemtracker.org/brief/ground-a…
2/ Under the House proposal, most of the ~14 million people buying on the individual market and the ~15 million uninsured people who could be on the ACA Marketplace would see lower ACA premiums. That savings could be used to get lower deductible plans, too.
3/ The House COVID Relief proposal would yield big savings for the older adults buying ACA Marketplace plans, particularly those above 4x the poverty rate (~$52k single income).
But the zero-premium low-deductible plans for low-income people are at least as big of a game changer
At her confirmation, #AmyConeyBarrett said the #ACA SCOTUS case is about severability.
That assumes the individual mandate is unconstitutional, and the question before the court is: 𝘾𝙖𝙣 𝙩𝙝𝙚 𝙧𝙚𝙨𝙩 𝙤𝙛 𝙩𝙝𝙚 𝘼𝘾𝘼 𝙨𝙩𝙞𝙡𝙡 𝙨𝙩𝙖𝙣𝙙?
The data shows it can... 1/9
2/ The individual mandate 𝗵𝗮𝗱 been seen as essential to the ACA’s individual market. The thought 𝗵𝗮𝗱 been, if people with #PreexistingConditons can get coverage, people would wait 'til they got sick to get insurance. This would drive up premiums and lead to a "death spiral"
3/ As anyone who has read the ACA knows, it’s a big piece of legislation. There’s a lot that has nothing to do with the individual mandate. Like calorie labeling, biosimilar approval, closing the Medicare donut hole. There was never a risk of a death spiral in Medicaid expansion.
Does Biden’s presidential win make the ACA (#Obamacare) more likely to survive tomorrow’s Supreme Court case?
Only marginally, and it would all come down to Georgia.
Here's why: (1/7)
2/ The Trump Admin is arguing in court that the ACA should be struck down. A Biden Admin would change positions to defend the law.
But the Trump admin’s exit has no effect on the plaintiffs in the case – 18 Republican-led states + two individuals – who aren’t backing out
3/ There’s nothing administrative that Biden can do unilaterally as president to reverse the course of the ACA case. Biden can’t simply issue an executive order and make it go away. This case is now up to the largely conservative SCOTUS to decide.
NEW analysis: Rather than continuing to go without insurance, *4.2 million* uninsured people could get an #ACA bronze plan for FREE
We estimate 27% of uninsured potential Marketplace shoppers are eligible for a bronze plan with $0 premiums in 2019. kff.org/health-reform/…
In #Delaware, #Iowa, #Nebraska, and #Utah, almost 1 in 2 currently uninsured people who could be buying Marketplace coverage will be able to get a $0 bronze plan in 2019.
But, will they even know this is an option?
Bronze plans have high deductibles & many ppl are better off w/ Silver
But the math is simple: $0 bronze >> uninsured
Bronze plans have $0 preventive services, often a few Dr visits pre-deductible, & make it more likely to get non-emergency care even if you can't pay deductible
[THREAD] The U.S. spends more $$$ than any other country on health care, but gets worse health outcomes than similar countries.
We live shorter lives and have more disease burden. And the gap between the U.S. and other countries has grown.
Along with Jeffrey Selberg @PetersonCHealth, my @KaiserFamFound colleagues and I took a deep dive into the health system. We examined the last 25 years of health spending and outcomes in the U.S. vs similar countries. We look at dozens of indicators from a variety of data sources
U.S. health outcomes have improved, generally, over the past generation. In the past 25 years, life expectancy in the U.S. improved 4% and disease burden improved 12% (though both recently worsened a bit). Meanwhile, the share of our economy devoted to health increased by 40%