U.S. Sen. Mark R. Warner (D-VA) has introduced the Health Care Improvement Act, legislation that builds on the progress of the Affordable Care Act to expand health care coverage, reduce costs, and protect Americans with preexisting conditions.
“Ten years ago, I was proud to vote for the Affordable Care Act. Since that time, despite relentless attacks by the Trump Administration and Republicans trying to dismantle the law, our country has made enormous strides in making health care coverage affordable, accessible, and available to more Americans,” said Sen. Warner. “But in spite of our progress, too many families are still struggling to deal with spiraling health care costs and a shortage of affordable options in their area. I’m proud to introduce this legislation to reduce health care costs for working families and increase access to care for uninsured Virginians while continuing to protect all Americans with preexisting conditions.”
The Health Care Improvement Act will reduce costs for working families by:
- Eliminating the existing premium subsidy cliff on the ACA exchanges: The Health Care Improvement Act will ensure no individual or families pays more than 8.5 percent of their total household income for their health insurance. Currently, no family making more than 400 percent of the federal poverty line ($51,040 for an individual in 2020) is eligible for premium assistance on the ACA exchanges. This provision expands premium assistance to individuals making more than 400 percent of the federal poverty line and places a cap on insurance costs for all individuals and families on the ACA exchanges.
- Establishing a low-cost public health care option:The Health Care Improvement Act will also require the Secretary of Health and Human Services to create a low-cost, public health care option for individuals who are eligible to enroll for health care coverage via the ACA exchanges. Establishing a public health care option will increase competition and ensure an added lower cost health care option for more American families.
- Enacting a federal ban on surprise medical bills:Nearly 60 percent of Americans have received a surprise medical bill for services they thought would be covered by their insurance. The Health Care Improvement Act will create additional federal protections to ensure Americans no longer receive surprise medical bills.
- Authorizing the federal government to negotiate prescription drug prices: Under existing federal law, the government is explicitly banned from negotiating with pharmaceutical companies for lower drug prices. The Health Care Improvement Act will allow the federal government to leverage its purchasing power to negotiate prices and reduce drug costs for more than 37 million seniors on Medicare.
- Allowing insurers to offer health care coverage across state boundaries: The Health Care Improvement Act will allow insurers to offer health care coverage across state boundaries, increasing choice and competition among plans and driving down costs while maintaining quality, value and strong consumer protections.
- Supporting state-run reinsurance programs: The Health Care Improvement Act will will create a new “State Health Insurance Affordability and Innovation Fund” to support state run reinsurance programs and additional state efforts to reduce premium costs and expand health care coverage. The non-partisan Congressional Budget Office has previously estimated such programs could reduce health care premiums by 8 percent within one year.
The Health Care Improvement Act will increase access to affordable health care coverage by:
- Incentivizing states to expand Medicaid: If all states were to expand their Medicaid programs, the number of uninsured Americans would decrease by more than 2 million. The Health Care Improvement Act will provide additional incentive to states to expand their Medicaid program by temporarily increasing federal matching funds to states that expand their programs and reducing existing administrative payments to states that do not expand their programs. It would also provide retroactive payments to states like Virginia that were late to expand Medicaid and have not received their fair share of federal matching payments.
- Expanding Medicaid eligibility for new moms: The Health Care Improvement Act will allow states to provide new mothers up to 12 months of postpartum Medicaid eligibility. This provision would significantly improve maternal health outcomes by ensuring mothers have access to vital health care services during the immediate months after giving birth.
- Simplifying enrollment: There are over 7 million Americans currently eligible for cost-free Medicaid coverage, but who are not enrolled due a variety of factors including unnecessary paperwork and a confusing enrollment process. The Health Care Improvement Act will simplify Medicaid and CHIP enrollment by permanently authorizing the successful Medicaid Express Lane Eligibility program and expanding it to include adults. The Department of Health and Human Services will also be required to conduct a study and develop recommendation to allow states to further implement Medicaid and CHIP auto-enrollment for individuals eligible for cost-free coverage.
- Increasing Medicaid funding for states with high levels of unemployment: The Health Care Improvement Act will implement a counter-cyclical Medicaid matching payment from the federal government to ensure that states with high levels of unemployment receive a higher federal matching payment to appropriately account for an increase in Medicaid enrollment. This will ensure states can maintain affordable health care coverage during economic downturns and temporary periods of high unemployment.
- Funding rural health care providers: Under current law, rural providers are unfairly compensated at a much lower rate than urban providers, making it more difficult for Virginia providers to keep their doors open in underserved communities. The Health Care Improvement Act will create a rural floor for the Area Wage Index formula the Centers for Medicare and Medicaid use to reimburse rural providers. Fixing the Area Wage Index will boost access to affordable health care coverage in Virginia’s rural and medically underserved communities.
- Reducing burdens on small businesses: The Health Care Improvement Act will modernize ACA employer reporting requirements to ensure that businesses can provide comprehensive health care benefits to their employees without additional administrative costs or unnecessary paperwork.