Biden’s Plan Does More Than Simply Tweak the ACA

It isn’t Medicare for all, but the former vice president’s “Affordable Care Act 2.0” includes provisions that Congress rejected in Obamacare.

Former Vice President Joseph Biden’s health care proposal has been derided as not going far enough by some of his opponents for the Democratic presidential nomination. But as Kaiser Health News (KHN) reports, the plan includes major changes in the health care system.

“It would do things Democrats have called for repeatedly since the ACA was passed,” KHN reports. “Among them is a provision to that would ‘uncap’ federal help to pay for health insurance premiums—assistance that is now available only to those with incomes below 400% of the poverty level, or about $50,000 for an individual.”

In addition, Biden’s plan would ensure that nobody has to pay more than 8.5% of their income for health insurance premiums, and also lowers deductibles and copayments.

Then there’s the public option, a government-sponsored plan that would compete with commercial insurers in the health care marketplace. Former President Obama tried to include that in the ACA, but Congress wouldn’t budge. It couldn’t get the 60 votes needed in the Senate even though there were 60 Democrats in the Senate at that time. The public option, as Biden sees it, would be available to many more people than the approximately 20 million people currently in the individual insurance market.

“Most controversial, though, is that the 2.5 million people ineligible for either Medicaid or private insurance subsidies because their states have chosen not to expand Medicaid would be automatically enrolled in the new public option, at no cost to them or the states where they live,” KHN reports.

Critics charge that that represents a gift to the 14 states that haven’t expanded Medicaid under the ACA because they don’t have to pay the 10% of the cost for new Medicaid enrollees that the expansion states have to.