100 Million Stimulus Checks

By Yuval Rosenberg

How Biden Is Expanding Obamacare as the Law Turns 11

President Obama signed the Patient Protection and Affordable
Care Act into law 11 years ago. President Biden and Democrats
marked the anniversary Tuesday by celebrating the law — even as
they look to continue to expand it and defend it against a
challenge in the Supreme Court.

After years of Republican attacks and Trump administration
efforts to undercut the law, Obamacare is now expanding.

“On this anniversary, we should remember just how close we have
come to losing that act that we fought so hard for, and we have a
duty not just to protect it but to make it better and keep becoming
a nation where health care is a right for all and not a privilege
for a few,” Biden said in a speech Tuesday in Ohio.

Biden’s Covid-19 rescue act temporarily raised Obamacare premium
subsidies for two years to help better deliver on the ACA’s titular
promise of making insurance coverage more affordable. “The
provision in the $1.9 trillion ‘American Rescue Plan’ is the first
major change to the health law since its passage,” Sheryl Gay
Stolberg writes at
The New York Times. “The
new subsidies last for only two years, and it will
take some time for the full emergency aid to reach people. Even so,
nearly everyone who buys insurance will be eligible to do so at a
discount.”

On top of that, at least two red states, Alabama and Wyoming,
are also considering whether to expand Medicaid under the ACA now
that the Covid-relief package sweetened the incentives for doing
so.

And a special enrollment period opened by the Biden
administration last month to allow more people to get ACA plans in
the midst of the coronavirus pandemic has seen more than 206,000
people sign up in its first two weeks. Biden, who memorably told
Obama that the health reform law was a “big f---ing deal,”
announced Tuesday that the special enrollment period, which had
been slated to run until May 15, will now be extended through
August 15.

“The ACA is over a decade old and this is literally the first
time that Democrats have been successful at improving it,” analyst
Larry Levitt of the nonpartisan Kaiser Family Foundation told the

Associated Press. “Democrats have succeeded
politically by selling the ACA’s protections for preexisting
conditions, but affordability has always been a challenge. And now
Democrats have successfully improved the premium help available
under the law.”

Pandemic puts the ACA to the test: “We still have
millions of people walking around without insurance,” Jonathan
Cohn, the author of a new history of the enactment of the ACA, told

The Washington Post. “The pandemic was a reminder
that we still have huge gaps in our health care system, with
immense human consequences.”

Obamacare may have helped close some of those gaps, though. The
Kaiser Family Foundation estimated late last year that some 2
million to 3 million people may have lost employer-based coverage
as the pandemic raged between March and September. But it added
that many of those who lost coverage through their jobs were
eligible for Medicaid or subsidized ACA plans.

“This is really the first true test of the A.C.A.,” the
foundation’s Cynthia Cox told the Times. “In past recessions, you
usually see the uninsured rate increase significantly. We don’t
know for sure yet, but all indications are that the uninsured rate
has not gone up by much, likely in large part thanks to the
A.C.A.”

KFF’s Levitt added in a
tweet: “The right still views the ACA as a government
overreach. The left sees it as not going far enough in guaranteeing
universal coverage and getting profit out of health care. But,
imagine this pandemic and economic crisis without the ACA there as
a safety net.”

More tests ahead: Biden may have scored relatively easy
wins via both executive action and legislation, but advancing other
elements of his health care agenda — the creation of a public
option to compete with private insurers on the ACA exchanges,
expanding Medicare eligibility and lowering prescription drug
prices — likely will prove much more challenging. “These mainly
require the support of Congress, where Democrats hold only slim
majorities in both houses -- and some in the party are still
pushing for more dramatic changes, including enacting ‘Medicare for
All,’” CNN’s Tami Luhby
says.

The Biden administration is reportedly considering a push to
allow Medicare to negotiate drug prices as a way to help pay for
some
$3 trillion in new spending it plans to propose.
“We’ve got to address the sector’s pricing abuses, and that’s
fundamentally the big question the administration and Congress are
facing,” Frederick Isasi, executive director of Families U.S.A., a
consumer advocacy group, told the Times. “Are they going to have
the political will to do that?”

Politico
reports that that the answer may well be yes (see
more on this below).

As for the public option, Biden still faces pressure from within
his own party to go further. Progressives recently introduced
another Medicare for All bill, an approach to health care reform
that Biden has rejected.

Then there’s the Supreme Court challenge. The Biden
administration last month urged to court to uphold the law in the
face of a Republican-led lawsuit seeking to invalidate it. The
court heard arguments in the case last November and is expected to
hand down a ruling by July.

Can Democrats Finally Bring Down Drug Prices?

Democratic lawmakers are getting behind a plan to enable the
Department of Health and Human Services to negotiate the prices of
some drugs covered by Medicare, potentially saving the federal
government billions of dollars, but they face serious resistance
from two key players: Republicans and the major pharmaceutical
firms.

No Republican lawmakers are expected to back the drug price
proposal, all but eliminating the possibility that it could pass
through Congress under normal rules. But Democrats are now
reportedly considering adding the proposal to their next budget
reconciliation bill, allowing them to pass it with a simple
majority — and greatly increasing the odds that substantial drug
pricing reform could occur in the coming months.

Looking for offsets: The idea of allowing the federal
government to negotiate drug prices isn’t new, but it’s taken on
new prominence as Democrats look for ways to pay for their next big
economic package, which is expected to contain roughly $3 trillion
in new spending on things like infrastructure, education and green
energy.

Lowering drug prices is particularly attractive, since it would
be appealing to voters while freeing up money that would have been
spent on medicine to be used elsewhere.

“The huge difference between drug prices and literally
everything else out there: Everything else costs money, and this
one saves money,” Alex Lawson, executive director of Social
Security Works,
told Politico.

Sanders takes aim: Holding the first hearing of the new
Congress on drug prices Tuesday, Sen. Bernie Sanders (I-VT) asked,
“Why does the U.S. pay the highest prices in the world for
prescription drugs?” Answering his own question, Sanders charged
that the drug companies are in control on Capitol Hill. “I think
it’s fair to say that it’s not Congress which regulates the drug
companies but the drug companies which regulate Congress, and that
has got to change,” Sanders said.

Along with more than two dozen Democratic lawmakers, Sanders is
reintroducing a package of bills that aims to reduce drug prices.
The Medicare Drug Price Negotiation Act (summary
here) would remove the current prohibition on the head
of HHS from negotiating drug prices, empowering that agency to
lower the cost of many name-brand drugs covered by Medicare.
According to one study, the federal government could save more than
$15 billion a year if Medicare could negotiate the same prices paid
by Medicaid and the Veterans Administration.

The package also includes the Prescription Drug Price Relief
Act, which would tie the price of prescription drugs in the U.S. to
the median price in Canada, the United Kingdom, France, Germany and
Japan; and the Affordable and Safe Prescription Drug Importation
Act, which would permit the importation of drugs from Canada and
other major countries.

Drugmakers take notice: Tuesday’s hearing, which was
announced abruptly, was greeted with some alarm by pharmaceutical
firms and their powerful lobbyists. One lobbyist told Politico that
there is now concern that the drug industry could be seen as a
“piggy bank” that could be tapped to help pay for the next economic
package.

“Something is coming. We’re just not sure when,” one drug
industry source said.

The outcome of the effort is far from guaranteed, however. Even
without the need to win bipartisan support, it’s not clear that
centrist Democrats are willing to back aggressive plans to rein in
drug prices. Drug lobbyists are reportedly targeting Sen. Kyrsten
Sinema (D-AZ) in an effort to break up the 50 Democratic votes in
the Senate. And while Sen. Joe Manchin (D-WV) has indicated that he
would back the plan to negotiate drug prices in Medicare, he hasn’t
said if he is willing to pass it through reconciliation.

Number of the Day: 100 Million

Biden said Tuesday that his administration will have
distributed 100 million relief payments by Wednesday. The economic
impact payments, worth up to $1,400 per person for those who
qualify, are part of the $1.9 trillion coronavirus relief package
the president signed into law earlier this month.

Quote of the Day

“If all eligible US residents are vaccinated in 2021, we
project that the pandemic will effectively be over by the fall.
With a vaccine take-up rate of 100 percent, effective population
immunity would be attained at some point this summer, depending on
the pace of vaccination.”

– Alex Arnon and John Ricco of the Penn Wharton Budget
Model,
writing Monday about the economic effects of the
Covid-19 vaccine. The researchers warn that if 25% of those
eligible refuse to take a vaccine and social activities return to
close to their pre-pandemic levels, “the epidemiological outlook
for the spring and summer worsens considerably,” with millions of
additional Covid-19 cases this year.

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