Stimulus bill would make 'remarkable strides' for health care, but some goals would be left unmet

Adriana Belmonte
·Senior Editor
·5 min read

An amended version of President Biden’s American Rescue Plan passed the House and Senate, pushing the U.S. one step closer toward more economic relief amid the coronavirus pandemic.

Along with provisions for taxes, unemployment, and small businesses, the $1.9-trillion stimulus bill also addresses gaps in the current U.S. health care system.

“The bill makes remarkable strides in the case of people who need coverage, who are lower- to moderate-income people and can’t possibly afford their coverage and depend on the marketplace,” Sara Rosenbaum, a professor of law at the Milken Institute School of Public Health at Georgetown University, told Yahoo Money. "We see extraordinary improvement."

The bill passed the House of Representatives on Wednesday after passage in the Senate on Saturday. It will be sent to the president for his signature this week.

US President-elect Joe Biden removes his facemask before delivering remarks on the public health and economic crises at The Queen theater in Wilmington, Delaware on January 14, 2021. - President-elect Joe Biden will propose injecting $1.9 trillion into the US economy when he takes office next week, as evidence mounts that the recovery from the sharp downturn caused by Covid-19 is flagging. (Photo by JIM WATSON / AFP) (Photo by JIM WATSON/AFP via Getty Images)
Biden removes his facemask before delivering remarks on the public health and economic crises at The Queen theater in Wilmington, Del. on January 14, 2021. (Photo by JIM WATSON/AFP via Getty Images)

The good news

Many of these strides involve expanding parts of the Affordable Care Act (ACA), commonly known as Obamacare.

The stimulus bill expands health insurance coverage subsidies under the ACA, expands ACA cost-sharing support for the unemployed, increases Medicare reimbursement for select hospitals, and approves the continuation of COBRA coverage without premiums.

It also provides financial relief to rural hospitals and facilities, and ambulances, and increases support for medical care for veterans and for those working in nursing home facilities. Additionally, it directs mental health service spending to two key areas: the Pediatric Mental Health Care Access Program and Community Behavioral Health Clinics.

Nursing home residents receive a shot of the coronavirus disease (COVID-19) vaccine at King David Center for Nursing and Rehabilitation, a nursing home facility, in Brooklyn's Bath Beach neighborhood in New York City, U.S. January 6, 2021.  REUTERS/Yuki Iwamura
Nursing home residents receive a shot of the COVID-19 vaccine at King David Center for Nursing and Rehabilitation in Brooklyn's Bath Beach neighborhood in New York City, January 6, 2021. REUTERS/Yuki Iwamura

This is the “biggest investment in affordable coverage since the ACA,” Christina Cousart, a senior policy associate at the National Academy for State Health Policy, told Yahoo Money.

Those who earn an income above 400% of the poverty level will qualify for subsidies, but the subsidies will still increase for anyone eligible across all income ranges. States also now have the option to expand the postpartum period for women in Medicaid.

For those who are incarcerated, the bill gives them Medicaid eligibility 30 days before their release from prison for the next five years. And for those eligible for COBRA coverage, the bill provides temporary funding for the program.

“The changes that states need to make to their systems will require significant infrastructure investments from both the federal and state governments, but the short-term relief is critical for individuals,” Cousart said.

MIAMI, FLORIDA - JANUARY 28: A pedestrian walks past the Leading Insurance Agency, which offers plans under the Affordable Care Act (also known as Obamacare) on January 28, 2021 in Miami, Florida. President Joe Biden signed an executive order to reopen the Affordable Care Act’s federal insurance marketplaces from February 15 to May 15 . (Photo by Joe Raedle/Getty Images)
A pedestrian walks past the Leading Insurance Agency, which offers plans under the Affordable Care Act on January 28, 2021 in Miami, Florida. (Photo by Joe Raedle/Getty Images)

The caveats

While Rosenbaum praised the health care provisions of this bill, there were some caveats and part of it has to do with the duration of these provisions.

“When it comes to the very poorest Americans, the bill continues to use an incentives approach when it would have been, in my view, quite possible to say — as they’ve done for a lot of things — that at least for the next year or two during the pandemic and its aftermath, in the case of any state that hasn’t expanded Medicaid, we’re not going to leave the poorest people without any coverage,” she said.

Rosenbaum continued: “I would have thought they would have done — realizing it’s a larger debate, whether you have a default for non-expansion states — an emergency provision just to help those people out in non-expansion states, and there’s nothing for them.”

Oklahoma and Missouri recently approved ballot measures to expand Medicaid. (Graphic: David Foster/Yahoo Finance)
Oklahoma and Missouri recently approved ballot measures to expand Medicaid. (Graphic: David Foster/Yahoo Finance)

Building upon Obamacare and improving the U.S. health care system were key parts of Biden’s presidential campaign. His health care vision, which some have dubbed Bidencare, includes creating a public option, which would automatically enroll those who normally would qualify for Medicaid, but don’t because of their state’s guidelines.

Though the Biden administration has tried for a bipartisan approach due to the equally split Senate between Democrats and Republicans, Rosenbaum is skeptical that health care will be brought back to the conversation any time soon.

Her concern, she said, is that the renewed incentives created by the American Rescue Plan will “quietly” become the permanent policy, “and then that means that’s all we’ve got.”

“If you look at the landscape of legislative priorities, starting with voting rights — which is really the end of the measure of our time — and then immigration reform and the infrastructure bill, I do not see this bigger debate about a huge policy question," Rosenbaum said, "but one that arguably can be put off a little bit because now so many more Americans will have relief under the marketplace.”

WASHINGTON, DC - FEBRUARY 01: U.S. President Joe Biden (Center R) and Vice President Kamala Harris (Center L) meet with 10 Republican senators, including Mitt Romney (R-UT), Bill Cassidy (R-LA) and Susan Collins (R-ME), in the Oval Office at the White House February 01, 2021 in Washington, DC. The senators requested a meeting with Biden to propose a scaled-back $618 billion stimulus plan in response to the $1.9 trillion coronavirus relief package Biden is currently pushing in Congress. (Photo by Doug Mills-Pool/Getty Images)
President Biden and Vice President Harris meet with 10 Republican senators, including Mitt Romney, Bill Cassidy, and Susan Collins in the Oval Office February 01, 2021. (Photo by Doug Mills-Pool/Getty Images)

Some have criticized the bill, going so far as to call it a win for the private insurance industry due to the fact that it doesn't include lowering the age of Medicare eligibility or creating a public option, two goals Biden proposed during his campaign.

“I don’t see that we’re going to come back to this big debate because there are so many important issues, it can’t be all about health care all the time,” Rosenbaum said. “Once they made a decision to do so much to improve health care in the context of this bill, I think quietly the dye has been cast to, in fact, not come back to health care as a next round issue. It’s a philosophically important issue, but it’s not a front-burner issue.”

Adriana Belmonte is a reporter and editor covering politics and health care policy for Yahoo Finance. You can follow her on Twitter @adrianambells and reach her at adriana@yahoofinance.com.

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