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Advancing the ACA

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The Obama administration was essentially a transition between where the Democratic Party was in the 90s and where it was headed in the 2021. A lot of the ACA — most notably the historic expansion of Medicaid and its tough regulations of the insurance industry — was in the New Deal tradition. But the bill was a compromise with what was still a large moderate-to-conservative wing, and the exchanges in general and the dramatic subsidy cliff in particular showed remnants of the too-clever-by-half neoliberalism and austerity politics of the 90s.

Tellingly and importantly, the ARA addresses some of the major flaws of the act:

Currently under the ACA, people who earn 400% of the federal poverty level aren’t eligible for the tax credits, also known as subsidies, that help offset the cost of buying health plans. That means a single person who earns more than about $51,000 isn’t eligible, nor is a family of three that makes about $87,000.

The legislation would eliminate an income cap that limits who is eligible for ACA tax credits to reduce monthly insurance premiums. It would also limit the amount households pay to only 8.5% of their income on healthcare, and it would boost subsidies to lower-income consumers.

With the increased subsidies, costs would come down for many who buy ACA-compliant plans. For a 60-year-old with a $55,000 income, premiums would drop by around 50% to 80% depending on the plan, according to a Kaiser Family Foundation analysis.

The subsidy boost for the ACA plans has been a long-held goal of Democrats who say expanding the tax credits would allow more people to benefit from the coverage.

Democrats have praised the subsidy expansion as a way to improve upon the ACA by ending its so-called subsidy cliff, saying it will benefit low- and middle-income families, and reduce health-insurance expenses for lower-income people. They are expected to press to make it permanent during the 2022 midterm elections.

Better than pressing to make it permanent during the midterms, they should eliminate the filibuster, make the changes permanent, and let Republicans try to defend voting against it. I’m confident that another midterm fought on healthcare would look a lot more like 2018 than 2010.

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