Democrats' COVID relief plan 'most significant expansion of health care' in 10 years

Beyond the immediate economic relief it affords, the $1.9 trillion COVID relief bill passed by House and Senate Democrats and signed into law on Thursday by President Joe Biden stands to advance health care — and Americans’ access to it — in unprecedented ways.

Not a single congressional Republican voted for the bill, which expands health insurance coverage during the pandemic, rolls out funding for vaccination efforts, and protects some of groups most vulnerable to the coronavirus.

The legislation will expand federal subsidies that lower or eliminate premiums for health insurance plans acquired through the federal marketplace to more Americans.

The Kaiser Family Foundation’s vice president for public health policy, Larry Levitt, told ABC News that American families with incomes ranging from $12,880 to $19,320 will be able to obtain plans without paying premiums out of pocket.

Levitt said, “These provisions go a long way towards putting plans within reach of people who have struggled to pay premiums.” He predicted that “tens of millions” of Americans would be helped by these Obamacare enhancements.

The bill also offers an incentive to states that have not yet passed Medicaid expansions, offering federal matching funds for two years if they enact legislation to do so. And for Americans who have recently lost their jobs, the legislation will subsidize premiums to enable them to stay on employer-provided health care.

“The American Rescue Plan is the most significant expansion of health care in over a decade,” Anne Shoup, communications director of Protect Our Care, told the American Independent Foundation. “This bill will lower health care costs, expand coverage, and address inequities in care. The Affordable Care Act has been a lifeline for so many Americans during this pandemic, and there has never been a more critical time to build on its successes.”

Dr. Thomas Russo, chief of the division of infectious diseases at the University at Buffalo’s Jacobs School of Medicine and Biomedical Sciences, said that expanding health care coverage is particularly vital during the pandemic, when it might enable Americans who are otherwise “hesitant or unaware” about the COVID-19 vaccine to see a doctor and learn more about the necessity of vaccination.

“If there’s more people in the health care system, that’s an opportunity for them to be vaccinated, if they haven’t reached out but are suddenly eligible,” Russo said.  “[They’re] now plugged into the health care system, [and] that’s an opportunity to get them vaccinated, either by informing them that vaccines are safe and effective [or] expediting the process of getting vaccinated.”

The American Rescue Plan legislation also offers health care protections to new mothers after labor and delivery, giving states the option of expanding Medicaid to cover mothers for up to one year after delivery. Previously, state requirements only mandated coverage for up to 60 days.

The provision also cuts approval time required for mothers to obtain state Medicaid coverage during a vulnerable time: Researchers say postpartum mothers in the United States remain at risk of serious health consequences for up to a year after giving birth — particularly non-Hispanic Black women, who are three times more likely to die as a result of childbirth than white women are.

“As we fought the coronavirus, it was clearer than ever that far too many people don’t have access to the same health care in our country,” Shoup told the American Independent Foundation. “The American Rescue Plan works to reduce racial inequities in our health care system, including letting states expand Medicaid coverage to new mothers so we can reduce the skyrocketing rates of maternal mortality in underserved communities.”

Nan Strauss, the managing director of policy, advocacy, and grant-making at the organization Every Mother Counts, told the American Independent Foundation, “Extended support for mothers and childbearing people is long overdue,” since nearly 1 in 4 maternal deaths occurs between six weeks and one year after birth. “The American Rescue Plan’s Medicaid coverage extension for the full postpartum year paves the way to ensuring access to quality, respectful, and equitable maternity care for all families,” she said.

Moreover, the bill offers support for mental health care services, directing spending toward behavioral health resources, such as $80 million in funds to the Pediatric Mental Health Care Access Program and $420 million to community behavioral health clinics. Additionally, the bill directs almost $14.5 billion in funding to Department of Veterans Affairs health care for veterans of the U.S. Armed Services.

Support for widespread vaccination, too, is on the horizon. The $1.9 trillion COVID relief bill allocates $7.5 billion to the Centers for Disease Control and Prevention for preparing for, administering, and tracking the COVID-19 vaccination, and $1 billion to the U.S. Department of Health and Human Services for “vaccine confidence programs” that would encourage more people to be vaccinated. It also allocates billions for COVID-19 testing, tracing, and surveillance and $7.6 billion to community health centers for vaccine education and administration.

This is critical, Dr. Russo said, since although the United States is poised to hit herd immunity rates of 70%-80% by May — when counting those with natural immunity along with those who have received vaccines — it’s vaccination that affords the most reliable immunity. Ideally, he said, 70%-80% of the American population would be vaccinated to achieve the best possible results, and the new funding would help achieve this by the fall.

“The heavy lift isn’t vaccine development and production,” Russo added. “It’s going to be getting the shots in the arms. We know that’s going to take a while … funding that can go for tracking variants, funding that can go for encouraging vaccination, that’s all going to be critical to help putting this to bed and/or prepare us if some ugly variant arises.”

He added that the American Rescue Plan funding could help support informational campaigns, resource and vaccination sites, and other “creative endeavors” to help vulnerable populations obtain access to the vaccine.

Published with permission of The American Independent Foundation.