Wednesday, March 10, 2021

Big health care expansion in stimulus would be bigger in Wisconsin, if GOPs get out of the way

One item that didn't get a lot of attention in the stimulus bill is that it includes a sizable expansion of access to health care.
Consider a couple of examples: A hypothetical 45-year-old making $58,000 now gets no aid under the ACA. With the bill, they’d be entitled to a $1,250 tax credit, or 20% off their premiums, according to the Congressional Budget Office. A 64-year-old making $19,300 already gets generous subsidies that reduce premiums to $800 a year. But with the bill, that person would pay no premiums for a standard plan....

Another inducement is aimed at people who have lost jobs. Those who collect unemployment this year, if even for one week, would qualify for the most generous ACA tax credits as well as its biggest reductions in copays and deductibles.

Other people who lose their jobs may want to keep their employer coverage. A federal law known as COBRA allows that, but the employee has to pay the full premium, often a prohibitive expense. The bill would provide a temporary 100% subsidy.
So what’s not to like about that and the other expansion of health access? Republicans are trying to come up with reasons, and so far, they’re not coming up with much.
Republicans cite the health insurance provisions as an example of coronavirus overreach by Democrats. Policy consultant Brian Blase, a former health care adviser in the Trump White House, says most of the additional subsidies for coverage will merely substitute for what private households would have otherwise paid. If made permanent, he predicts that over time the sweeter tax credits will have the unintended consequence of enticing small businesses to stop offering coverage to their workers.

“This subsidy expansion largely replaces private spending with government spending.” said Blase.

So small businesses won’t have to take on the extra costs of insuring their employees, and workers also pay less, and get health coverage unlocked from their jobs? THAT SOUNDS GREAT! Big win!

One other health item that directly affects Wisconsin is this one.
Democrats now are offering a new enticement for the holdout states to expand Medicaid. Already, under the ACA, the federal government would cover 90 percent of the expansion’s costs. Under the stimulus bill, newly expanding states would also receive a 5 percent bump in the federal funding match for their traditional Medicaid programs for two years. Because the traditional Medicaid population is significantly larger than the expansion population, the funding bump is projected to cover a state’s 10 percent match for expansion enrollees and then some over those two years.
That would mean the Feds would cover another 37% of costs, and extend coverage to a sizable amount of Wisconsinites whose incomes are just above the poverty line. The Evers Administration estimated that Wisconsin would save $634 million if they expanded Medicaid under the prior bill, so we would save even more under this stimulus bill.

But that means it has to get through the Legislature, and with this jag in charge, that money-saving measure is likely not to happen.
"Expanding government-run healthcare is a non-starter too." - Robin Vos
C'MON ROBBIN'! He knows as well as anyone that Medicaid is insurance that pays medical providers, most of whom are in the private sector. But Koch makes you say some dumb things, I guess.

Don’t get me wrong, - the stimulus bill doesn’t have everything we need as a country, and there are fights to be had in the future over increasing the minimum wage and installing a permanent public option (if not outright Medicare for all), which removes more influence from the for-profit insurance industry. There is still a lot of work left to be done in making this American economic system do better for most of us, and in allowing us more choices over our destiny.

But the more that this bill is examined and talked about, the more we see that there are a lot of items that move things forward in a way that is long overdue. And the more GOPs will look foolish for reflexively opposing many of these provisions, just because a Dem president backed them, and will benefit from them.

But of course, Republicans don't want things to get better in the next 2 years, either in America or in Wisconsin, because that will lessen their chances of taking power. And grabbing power and money for themselves and their donors will always be a higher priority for the 2020s GOP than in anything that might help everyday Americans.

1 comment:

  1. Now the State Journal has a story tonight saying that the LFB estimates state savings from expanding Medicaid to reach $1.6 billion over the next 2 years.

    That's because of that extra 5% coverage and higher numbers of enrollees in all forms of Medicaid (including an increase of 13,000 in February). But I bet Vos will prove too addicted to Koch to care.