Health news coverage in the Democrats’ big social spending bill focused on policies that have been cut: things like sweeping restrictions on prescription drug prices and dental benefits for those using Medicare. But the law as it stands still includes many changes that will expand health coverage, expand benefits, and lower costs for all ages.
These changes are not a major overhaul of the health care system in the United States, as Medicare would be for everyone. Instead, Democrats in Congress have crafted smaller solutions to fill gaps in the current system.
“These are all kind of small pieces,” said Christine Eibner, senior economist at RAND Corporation. “We have a whole bunch of little niches that need to be filled.”
As the bill is still under debate in Congress, details may change – or the law may fail altogether. But the current package represents a concrete vision of how to overhaul the system.
During the 2020 presidential primaries, I described the Democratic healthcare debate as a metaphorical struggle over home options. Some candidates, such as Bernie Sanders, considered the strange old home of the US health care system to be destroyed; others, like Joe Biden, saw him as bogus. The authors of the Build Back Better Act are aiming at renovations.
Here’s what the proposals of the health care bill would suggest to the various groups.
If the current law is passed, more than 25 million Medicare patients with hearing loss will be eligible for hearing aid coverage. The drug benefit review will also reduce the amount patients pay for drugs, including a $ 35 monthly limit for insulin and an annual drug spending limit of $ 2,000. About 2.5 million Medicare patients now pay more, and those who pay may face huge bills for life-saving treatment.
For the first time, legislation will allow Medicare to regulate the price of prescription drugs, which could lower the cost of pharmacies for some patients. The details of this plan have been the subject of intense negotiations and remain the subject of intense lobbying. But the current version still represents a significant change in how Medicare pays for drugs.
Another part of the bill will expand funding for home health care. This could help some of the 800,000 queuing elderly and disabled Americans get health care in their neighborhood rather than nursing homes.
Working age adults
The bill will fix a long-standing hole in the Affordable Care Act by offering affordable health insurance options to low-income adults in 12 states that have not accepted extended Medicaid programs. The bill will give these people access to free Obamacare plans with additional benefits that will eliminate most of the co-payment and offer additional services.
People who buy their own health insurance will be able to continue to collect tax breaks that were created in March under President Biden’s pandemic stimulus bill. These subsidies reduce the cost of health insurance for almost everyone who buys their own plan. Low-income adults will be able to sign up for free plans, and higher-income people will be able to receive new financial assistance that was not available in Obamacare’s first ten years.
The increase was intended to alert Democratic researchers and legislators that the Affordable Care Act did not make insurance affordable enough. Combined with a large number of members, these changes prompted an additional 2.8 million Americans to sign up for insurance this year.
The new rules in the bill will limit how much pharmaceutical companies can raise drug prices annually. This could help reduce premiums and co-payments for two-thirds of Americans with private health insurance. (Although, as Politico recently reported, pharmaceutical companies are lobbying hard to weaken the proposal.)
The bill will permanently expand the Child Health Insurance Program, which provides affordable health care to nearly 10 million low-income children.
It will also introduce technical changes to Medicaid that experts say will help children keep their health insurance longer. The change requires children to be allowed to keep insurance for a year after enrollment, even if their family’s income changes. Frequent eligibility checks in some states have resulted in the loss of coverage for over a million children in recent years.
The sum of these parts is much less than dismantlers would prefer. America’s health insurance system remains fragmented. Some groups, such as undocumented immigrants, are left on the sidelines. Other people may still struggle to afford coverage or may not have coverage for benefits such as dental care. Price regulation will not greatly affect the profits of the pharmaceutical industry. And some of the key outreach expansions will expire after 2025 unless Congress renews them.
But for a legislative package that is not primarily health care and faces monetary constraints, Democrats are targeting many cracks in the system. They are aimed at protecting key populations of uninsured Americans and addressing shortcomings in existing programs, at least temporarily.
“This is a short-term big deal,” said Cynthia Cox, director of the ACA program at the Kaiser Family Foundation. “We will see that almost every American citizen will be eligible for affordable health insurance, but only for the next three years or so.”
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ART & IDEAS
Can Halo speed up Microsoft again?
Twenty years ago, Halo made the Microsoft Xbox console a must-have for gamers. The futuristic space shooter series has sold over 81 million copies of games, transformed into a universe of novels and comics, and grossed over $ 6 billion.
Halo Infinite, the next game in the franchise, is due out next month on Microsoft’s new consoles, the Xbox Series X and Series S. This comes at a time when the company can use blockbusters, Kellen Browning wrote in The Times.
During the pandemic, the main competitors Microsoft, Nintendo and Sony, made great strides with Animal Crossing and The Last of Us Part II. “Microsoft really didn’t have a product to get the attention of a home-sitting, Covid-wary gamer,” Adam Sessler, a video game journalist, told The Times.
But it’s been two decades since Halo was first released and six years since its last major installment. Will people care?
“The Halo franchise is old, and its new game faces a lot more competition for the eyeballs of gamers than it did during its heyday,” Kellen told us. “But don’t underestimate the nostalgia factor. So far, gamers seem to be treating this as a fun throwback rather than a tedious reboot. ” – Tom Wright-Piersanti, Morning Editor
PLAY, WATCH, IS
What to cook
The pangram from yesterday’s Spelling Bee was cleverly… Here’s today’s puzzle – or you can play it online.