7ILLUSTRATION
BY
JACKIE
FERRENTINO
buying individual policies. One good strategy is included in
the proposed Covid-19 relief package: replacing the existing
income ceiling for subsidies—set at 400% of the federal pov-
erty line—with a commitment to ensure that no one spends
more than 8.5% of their income on premiums.
A bare majority could also nullify a prominent lawsuit
seeking to invalidate the ACA that was filed by Republican-
led states and heard but not yet decided by the U.S. Supreme
Court. All that’s needed is to restore the individual mandate’s
tax penalty, even if it were set as low as a dollar.
Probably off the table this year, given the Democrats’ slim
advantage in Congress, are two of Biden’s signature campaign
proposals: a public insurance option and a reduction in the
Medicare age from 65 to 60. Even if those efforts have to wait,
progress through smaller steps is feasible. The administration
should do everything it can to repair and fortify the ACA. <BW>
For more commentary, go to bloomberg.com/opinion◼ BLOOMBERG OPINION March 1, 2021
Here’s some news from 2020 that seems almost good: Despite
heavy job losses during the pandemic, the proportion of
Americans without health insurance didn’t spike, as you might
have expected. Some employers maintained their coverage.
Many people who lost employer-provided policies picked up
Medicaid coverage instead. And still others bought individual
policies on the state and federal Obamacare marketplaces.
This illustrates how the 2010 Affordable Care Act broadly
improved Americans’ health security—by making it possible
to buy good-quality, often subsidized insurance and by
expanding eligibility for Medicaid.
Even so, the uninsured population in the U.S. remains unac-
ceptably large—almost 30 million people, according to the U.S.
Census Bureau’s 2019 count, and probably more now since the
number rose steadily under President Trump. His team worked
what mischief it could—shortening to six weeks the fall window
for buying insurance on the federal marketplace, for exam-
ple, and taking various steps to squeeze Medicaid enrollment.
President Biden is right to move quickly to reverse the damage.
Biden’s first move was to reopen the federal Obamacare
marketplace for three months beginning on Feb. 15—and to
boost efforts to help people figure out which policies are most
economical for them. Several states that run their own insur-
ance marketplaces have likewise provided special enrollment
windows for people who’ve lost coverage during the pandemic.
Some 4 million uninsured, low-income Americans could
take this opportunity to obtain health insurance at no cost,
because they’re entitled to federal subsidies large enough to
cover their entire premiums, according to the Kaiser Family
Foundation. An additional 4.9 million qualify for subsidies to
cover a large part of their premiums.
Biden has also told federal health agencies to review many
administrative changes that Trump made to weaken the ACA—
including an 84% cut in the budget for helping people navigate
insurance exchanges and a decision to allow substandard
“short-term” insurance policies to last as long as three years.
Also under review will be two kinds of state Medicaid
waivers floated by the Trump administration. One would
allow states to impose work rules for Medicaid beneficia-
ries, potentially knocking hundreds of thousands of people
off the program. The other would allow states to restrict
Medicaid coverage in return for limited federal funding (block
grants). Such waivers were obviously not designed to advance
Medicaid’s mission to provide health coverage for the poor
and are being challenged in court. They should be rescinded.
Biden can further buttress the ACA by working with
Congress to enlarge subsidies for low-income familiesHow to Improve
Obamacare and Get
Millions Insured
Chancellor of the Exchequer Rishi Sunak unveils the U.K.’s
budget on March 3, seeking to pull the economy out of its
pandemic- and Brexit-induced slump. Expect tax breaks for
homeowners and an extension of job retention plans.▶ On a Tight Budget
▶ The Bank of Australia
discloses its interest-
rate decision on March 2.
The central bank has
signaled that borrowing
costs won’t begin rising
for at least three years.▶ Joe Biden’s
nominees to lead the
U.S. Securities and
Exchange Commission
and the Consumer
Financial Protection
Bureau testify before
the Senate on March 2.▶ The 36th America’s
Cup sailing race
starts on March 6 in
Auckland. Team Luna
Rossa Prada Pirelli will
challenge the reigning
champion, Emirates
Team New Zealand.▶ German Chancellor
Angela Merkel meets
regional leaders on
March 3 to chart a path
out of the pandemic
lockdowns. Public
pressure is mounting to
open schools and shops.▶ Pope Francis begins
a four-day tour of Iraq
on March 5. It will be the
Roman Catholic pontiff’s
first trip to the Middle
Eastern country and his
first overseas journey in
more than a year.▶ The OPEC+ group
meets on March 4, amid
disagreements about
adding oil supply in
April. Russia favors an
increase, while Saudi
Arabia wants things to
remain steady.◼ AGENDA