President Biden reprised his role as Obamacare salesman Tuesday in a bid to reach people who have been left in the cold by the durable yet faulty law, extending a special enrollment period by three months and betting that enhanced subsidies will chip away at the roughly 30 million Americans who remain uninsured.
Traveling in Ohio, the president said people can select plans on the federal HealthCare.gov enrollment portal until Aug. 15, instead of May 15, as part of his bid to boost sign-ups amid the COVID-19 pandemic and promote his $1.9 trillion relief package.
“Thanks to this law, there’s an Obamacare plan that most folks can get with zero-dollar premiums,” Mr. Biden, donning a mask, said at the James Cancer Hospital and Solove Research Institute at Ohio State University.
Mr. Biden used off-the-cuff profanity to describe the importance of the Affordable Care Act at its signing with President Obama 11 years ago.
The landmark program insures about 20 million people through federally subsidized private insurance and expanded Medicaid eligibility. Yet many Americans have been priced out of coverage or are ineligible for government-funded insurance in states that have refused to expand their Medicaid rolls under Obamacare, leaving the program far short of its goal of universal coverage.
Mr. Biden is hoping beefed-up subsidies from his massive American Rescue Plan will plug affordability gaps in Obamacare and burnish its legacy, even as Republicans push for free market reforms and liberals campaign for a government-run, single-payer insurance plan that has more than 100 co-sponsors in the House.
“When I ran for president, I promised I would build on the foundation of the Affordable Care Act. And just 50 days into my administration, we’ve delivered on that promise with the American Rescue Plan,” Mr. Biden said in Columbus, where the university’s radiation care facility was built with a $100 million grant from Obamacare.
Mr. Biden’s relief plan expanded Obamacare subsidies across the board for two years, making lower-income people suddenly eligible for plans with no premiums to pay. It also made people earning over 400% above the poverty line eligible for subsidies for the first time by removing the income cap and offering financial help if “benchmark” premiums exceed 8.5% of income.
“If you’re enrolled in Obamacare, you’re going to save an average of $50 a month, $600 a year by the reduction in payments,” Mr. Biden said.
Enrollees need to do some work to take advantage of the subsidy structure, which could become permanent if lawmakers feel pressure to extend the benefits.
The administration says people enrolled in coverage should log on to HealthCare.gov starting April 1 to review their information and lock in the higher subsidy. They also can shop for a different plan if they find a better deal with more robust coverage.
“Getting the word out is going to be important. I think that’s part of why they are doing these tours,” Karen Pollitz, a senior fellow at the Kaiser Family Foundation, said of the Biden administration.
People also can claim the bigger subsidy at tax filing time next year. Yet one of the reasons the administration is asking people to return to HealthCare.gov, the sign-up portal serving 36 states, is to make sure income aligns with subsidies under Obamacare’s complicated framework.
“If they automatically increased people’s subsidies based on the 2021 income they estimated at the end of 2020, it would increase the chances the people would owe money back on taxes if their income is higher than their original estimate,” said Myra Simon, a principal at Avalere Health, a Washington-based consultancy.
Uninsured people enticed by the enhanced subsidy can shop now as part of Mr. Biden’s special open enrollment period that began Feb. 15. They can sign up or lock in the bigger subsidies after April 1.
Another set of people will qualify for higher subsidies because they received unemployment benefits at some point this year. They can shop now, but the ability to lock in the enhanced help won’t be available until early July, after federal officials work through the web coding and technical details.
Democrats are characterizing it as a continuing effort to improve their 2010 law. They also point to the pandemic to justify long-desired changes that were impossible under a divided government.
“For 11 years, the landmark Affordable Care Act has expanded coverage, lowered costs and secured lifesaving protections for hardworking families. Today, the ACA stands as a great pillar of economic and health security for the American people, alongside Social Security, Medicare and Medicaid,” said House Speaker Nancy Pelosi, California Democrat. “In the middle of a deadly pandemic, access to quality, affordable health coverage is more important than ever.”
More than 200,000 people have signed up for Obamacare coverage during Mr. Biden’s special enrollment period, and Alabama and Wyoming are considering a Medicaid funding boost designed to entice them into expanding eligibility to those earning over the federal poverty level. Other holdout states have balked at the plan, which offers enhanced federal funding for traditional Medicaid that would exceed the state’s costs from expanding the insurance program.
Budget analyses suggest Mr. Biden’s subsidy plan is a pricey way to try to herd people into the exchanges. About $35 billion would be needed to get 1.3 million people newly insured. Republicans say Democrats are continuing to throw taxpayer money at a flawed system.
“Democrats have chosen to address it by pumping more money into the ACA and limiting state flexibility instead of addressing the real problem: the high cost of health care,” Rep. S. Brett Guthrie, Kentucky Republican, told the House Energy and Commerce Committee.
President Trump and his Republican allies zeroed out Obamacare’s “individual mandate” penalty for shirking insurance in 2017, though only after failing to replace the law with another plan.
Rep. Jim Banks, Indiana Republican and chairman of the Republican Study Committee, said his party needs to offer concrete solutions if it wants to win on the issue.
“The Republican Party must be the party of health care. Over the next two years, conservatives can’t shy away from an issue that American voters consistently rate as one of their top priorities,” he wrote in a recent op-ed for The Daily Signal. “We must coalesce around a set of clearly defined and articulatable policies, we must develop a plan to make those policies law, and we must convince the public that those policies deserve to be law. Until and unless conservatives do this, our nation will continue its quickening descent toward full-scale socialized medicine.”