House Democrats Introduce Healthcare Bill Aimed at Boosting ACA Features

Three House Democratic leaders introduced a healthcare bill aimed at reversing some of the actions taken by the Trump administration regarding the Affordable Care Act (ACA). Because Republicans currently control Congress, however, the legislation may largely be moot for now.

The legislation was introduced by Energy and Commerce Ranking Member Frank Pallone Jr, D-New Jersey, Ways and Means Ranking Member Richard Neal, D-Massachusetts, and Education and the Workforce Ranking Member Bobby Scott, D-Virginia.

The bill would:

• Prevent the expansion of association health plans (AHPs) from going into effect. The plans would be exempt from ACA regulations, including those guaranteeing 10 essential health benefits and prohibiting insurers from using preexisting conditions as a reason not to offer benefits. A recent analysis found that AHPs would increase choices and lower premium costs, as the administration promised, but for less coverage and more risk, while making the ACA markets more expensive.
• Prevent the administration from moving forward on a rule proposed last month that would allow insurance companies to offer short-term limited-duration health plans that provide limited benefits and little financial protection from healthcare costs. Short-term plans are allowed to choose whether to sell insurance coverage to consumers based on preexisting conditions. The Congressional Budget Office does not consider the short-term plans private insurance.
• Create a national reinsurance program to help stabilize the ACA market and alleviate potential premium increases.
• Prevent the administration from weakening protections for essential health benefits, which would leave patients with less comprehensive plans that may not cover needed services, such as prescription drugs, maternity care, and substance use disorder treatment.
• Lower healthcare premiums for some consumers by eliminating the cap on eligibility for premium tax credits, which are currently set at 400% of the federal poverty line (FPL), and increase the size of the tax credit for all income brackets.
• Provide additional support for out-of-pocket costs by expanding eligibility for cost-sharing subsidies from 250% of the FPL to 400% and making cost-sharing subsidies more generous for those below 250% of the FPL. In October, President Trump stopped paying cost-sharing subsidies to insurers.
• Restore marketing and outreach funds that were cut by 90% during the 2018 ACA open enrollment period. Specifically, the bill requires HHS to conduct marketing and outreach and provides $100 million per year from 2019 through 2021. It also allocates $100 million in grants for states, which provides funding for them to conduct educational activities regarding health insurance and creates a state innovation fund to empower states to implement new approaches to increasing enrollment.