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New York Times

Finally, Democrats have a chance to get Engineer Obamacare 2.0

Since the Affordable Care Act became law in 2010 (in the words of Vice President Joe Biden (sterilized)), this is a big thing, and Democrats have been working hard to correct its shortcomings. But Republicans united against the law, and in the next ten years, almost all efforts aimed at supporting the law or making technical corrections that were common in the years following a major piece of legislation were blocked. Now, the Biden administration and the Democratic Congress hope to design and expand the scope of the first major repair work since the passage of the Affordable Care Act. They plan to reformulate regulations and spend billions of dollars through stimulus packages to make Obamacare̵

7;s changes simpler, more generous, and closer to what many of its architects originally wanted. Subscribe to the “Morning News” of the “New York Times”. “This is the largest expansion we have made since the passage of the ACA,” said New Jersey Representative Frank Pallone, who helped draft the health law more than a decade ago and led the House Energy and Commerce Committee. “It is conceivable that we will perform this operation on a regular basis, but we don’t think we have to wait that long.” The Affordable Care Act has expanded the coverage to more than 20 million Americans, reducing the uninsured rate from 17.8% in 2010 to 2019. 10.9%. It expands Medicaid to cover low-income groups and provides private insurance subsidies for higher incomes for people suffering from diseases. However, some families still feel that the insurance cost is too high and the deductible is too high, especially for those whose income is too high to get help. The stimulus bill passed by the House of Representatives earlier on Saturday contained a series of clauses that would make private plans more affordable, at least in the short term. This legislation is largely based on a bill passed by the House of Representatives last year. It will enable mid- to high-income Americans who are newly eligible for financial assistance to purchase plans in the Obamacare market and will increase the amount already available to low-income enrollees. Subsidies. According to data from the Congressional Budget Office, this change will last for two years, benefit another 1.3 million Americans, and cost approximately $34 billion. For some Americans, the difference in premium prices is huge: The U.S. Congressional Budget Office estimates that a 64-year-old person with an annual salary of $58,000 will have a monthly income that will drop from $1,075 under the current law to the new subsidy. 412 dollars under. When the Supreme Court allowed states to refuse to expand Medicaid, it was a blow to the authors of Obamacare. In recent years, multiple states have joined this expansion plan, some of which were initiated through voting initiatives, but some Republican governors firmly rejected the plan, resulting in 2 million uninsured Americans in 12 states. The stimulus package aims to fill this loophole by increasing economic incentives for states to join the plan. Although the Democrats are offering more payments to reserved states than expected in the past, it is unclear whether this is enough to attract state governments that have left billionaires. According to the current law, the federal government pays 90% of the fees for new enrollees. Republican critics of the law believe that Democrats are seeking to adopt a temporary stimulus plan to develop long-seeking permanent policies. Senator Bill Cassidy of Louisiana said: “This is enough to show that this is not COVID relief.” In 2017, he wrote the famous Obamacare repeal bill. Cassidy is worried that the short-term increase in Obamacare spending will be difficult to eliminate. He quoted former President Ronald Reagan as saying: “Nothing lasts longer than the interim government plan.” The White House and the Department of Health and Human Services (HHS) have begun to promote insurance options and make It is easier to obtain. On February 15th, the Biden government announced a special enrollment deadline so that those who are not covered can immediately sign up for insurance and conduct extensive publicity. Officials have also begun to reduce the Trump-era job requirements in the Medicaid program. Other regulatory changes are also planned. Biden’s choice to lead HHS, Xavier Becerra, testified on February 24th of his ambitions on Capitol Hill. Officials want to solve the “family breakdown” problem, which makes Obamacare insurance an expensive job for children or spouses of workers who are only insured. Officials plan to tighten the rules for private short-term insurance plans, which do not need to cover all benefits. They are considering a long list of technical changes aimed at making the plan more comprehensive. “Any changes in the ten years are moderate, but stacking up one after the other, you will greatly benefit from the Affordable Care Act,” said Jonathan Cohn, author of The Ten Years War. . “This will not change the structure of the law, but it does make it more generous.” Those who spare no effort say that its ambitions and limitations reflect the preferences of leaders. Biden once participated in the passage and promotion of Obamacare as President Obama’s vice president. His idea is expansion rather than turmoil. The congressional leaders who wrote “Obamacare” have been observing in the wild for ten years and are slowly enacting laws to address the gaps and shortcomings they believe. Many people believe that their work is a continuous, gradual process in which legislators should make adjustments, evaluate their effects and make adjustments again. “When you think about the direction of the ACA four years ago and compare it to where we are now, at the pinnacle of a massive expansion of affordability, it’s really exciting,” said Christen Linke Young, the agency’s deputy director of the White House. Domestic Policy Committee on Health and Veterans Affairs. But Bob Kocher, an economic adviser to the Obama administration, is now a partner in the venture capital firm Venrock. He said that in addition to the current changes, Biden’s mission to Obamacare seems to be more humble, more like “don’t destroy it.” He said: “I don’t think he has any ambitions other than management.” To help this work, President Joe Biden recruited many aides from the former Obama administration. He has participated in the first round of Obamacare policy for the top positions selected in the key representatives of the Medicare and Medicaid Services Center, the Office of Management and Budget, and HHS. Now, many important congressional aides who work in health care have also helped write the Affordable Care Act. The Affordable Care Act, which was born in the Great Depression, was drafted with a focus on cost. Political compromises and concerns about losing control of the deficit have kept the law’s 10-year total price of no more than $1 trillion, which includes sufficient cuts in expenditures and tax increases to cover the costs. These restrictions have caused its architects to reduce the financial help Americans have to buy their own insurance. The employees who wrote the formula said they ran hundreds of simulations to figure out how to reach the most people within their budget. Those who wrote statutes that interpret the laws also recalled drafting statutes that were wrong in reducing expenses to avoid backlash or litigation. Republicans spent ten years repealing this law, but prevented any policy that expanded its influence. Even if the law was not that divided politically, the fiscal politics of the Obama era could have eliminated the subsidy expansion that is currently being discussed. Now, as Democrats regain control of Congress and the White House, there is a new enthusiasm for expanding medical coverage. In the context of the pandemic and the changing views of many economists on federal debt, legislators have paid less attention to fiscal deficit spending than ever. But Biden’s medical project still faces challenges, which may disappoint his allies. The new proposed expenditure is temporary, and it will align the subsidy of the law with the earlier draft of the Affordable Care Act. If these changes are to be maintained forever, it may cost hundreds of billions of dollars in ten years. Once economic conditions improve, this sum may scare moderate Democrats. For many Democrats, the reforms did not go as they wanted. Biden not only relied on the expansion of subsidies and technical repairs, but also lowered the applicable age of medical insurance, and formulated the so-called public choice plan, that is, government insurance that people can choose to replace private insurance. Members of Congress have proposed health insurance expansion and public choice bills, but neither proposal seems to move soon. Becerra previously supported a single payer system. He faced questions from Senator Bernie Sanders, who repeatedly proposed “Medicare for All” legislation, and Republican senators who opposed the idea, about his commitment to the idea. In each case, his response is similar: The Affordable Care Act is the President’s priority and also the President’s priority. Becerra said: “It is an honor for the President of the United States to be here.” “He knows his position very well-he wants to build on the foundation of ACA. That will be my task.” Leading Biden during the Biden presidential campaign -The Democratic Rep. Pramila Jayapar (D.Wash.) of the Sanders Joint Policy Working Group said she is encouraged by the measures the government is taking-but worried that current efforts have not yet met the promises in the campaign. Targeting progressive people during the period. She said she will continue to strive for more generous medical plans and expand medical insurance coverage to more Americans, among other measures. She said: “I believe we will do a lot of things in this package. I do think it is a good package.” “But I believe we have not done enough to help all those who are in trouble.” Published in the “New York Times”. ©2021 The New York Times Company

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