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Dems take the Senate: What does it mean for health care?

Dems Take The Senate: What Does It Mean For Health Care?

民主黨拿下參議院: 這對醫療保健意味著什麼

Victories by Democrats Raphael Warnock and John Ossoff in Georgia’s Senate runoffs Tuesday have changed the dynamics for health-care legislation. However, experts believe that small changes are more likely than major structural overhauls, according to the New York Times.


A series of tweaks bolstering the Affordable Care Act stands the best chance of passage. Legislators could make insurance subsidies more generous, get coverage to low-income Americans in states that haven’t expanded Medicaid, and render moot a pending Supreme Court lawsuit that aims to overturn the entire law.


But structural overhauls such as Medicare for All, which would move all Americans to a government-run health plan, face a much tougher road. So would elements of Joe Biden’s health agenda, such as a public option, which would give Americans a choice between a new public plan and private insurance.


There are several areas of health policy where congressional aides and health policy experts could see Democrats focusing their efforts this year. Smaller policy reforms are expected to be easier, both legally and politically, while more ambitious policies may not easily slot into strict parliamentary rules — or the political preferences of enough Democratic lawmakers.


ACA expansion


Congress is most likely to act on a set of changes meant to expand the ACA and make health coverage less expensive for those who buy their own plans. One priority is raising the income ceiling for those who receive subsidies, which would expand the number of people who qualify for help. Another is rewriting formulas to peg the size of the subsidy to a more generous health insurance plan, a way to increase the amount of assistance.


Closing the Medicaid gap


In the 12 states that do not participate in the health law’s Medicaid expansion, millions of low-income Americans are left without affordable coverage options. Many Democrats are eager to change this but have so far been stymied by states’ decisions to decline the program. One option that has been floated is to extend the ACA’s tax credits to this population. They wouldn’t get to enroll in Medicaid, but they would have access to a highly subsidized private plan on the health law’s marketplace.

在12個不參與健康法聯邦醫療補助擴大的州中,數百萬低收入的美國人沒有負擔得起的醫保選擇。許多民主黨人急於改變這種狀況,但迄今為止,各州決定拒絕該計劃,阻礙了這一計畫。已提出的一個選擇是將 ACA 的稅收抵免擴展到此類人口。他們無法參加聯邦醫療補助計劃,但他們可以在醫療市場上獲得一個高度補貼的私人計劃。

Reducing drug prices


Lowering drug prices has been a Democratic policy priority for many years, and one that Biden endorses, at least in general. Experts believed that certain drug pricing controls might be possible with reconciliation since they have clear budgetary effects. But the politics of passage could be difficult with narrow majorities in both the House and Senate and such strong opposition from the drug industry.


Public option


Biden included a public health insurance option, available to all Americans, in his 2020 campaign platform. The slim majority in the Senate, however, may make it hard to move this type of plan forward.


Medicare for All


The obstacle to such a plan is more likely political than procedural. Currently, a majority of House Democrats back Medicare for all, but that would not be nearly enough votes to pass such a bill. An even smaller share of senators backs the plan.



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