Closing the Medicaid Coverage Gap – InsuranceNewsNet

After months of doing nothing, Democrats in Congress finally seem on the verge of achieving something – or rather, several things, from protections for same-sex marriage to tens of billions of dollars for computer chips to, finally, an economic package passed through reconciliation. There’s still room for the majority to make the latter something as good as possible.

Senate Majority Leader Charles E. Schumer (DN.Y.) seems to have hit it off with Senator Swing-voting. Joe Manchin III (DW.Va.) primarily involves a grassroots bill allowing Medicare to negotiate prices for a select set of drugs, reducing costs. The legislation is both a political and political victory for the party. Even better, it saves money that can be directed to other programs so that, with the blessing of the house parliamentarian, the arrangements made together can circumvent a filibuster. So far, Democrats look likely to extend the Affordable Care Act’s enhanced subsidies for at least two years, preventing a spike in health insurance premiums that could drive millions away from trade.

All this is more than welcome: it is essential. The only problem is that while the ACA’s extended grants will help lower-to-middle-income Americans stay insured, the poorest could find themselves left behind. Indeed, in 12 states that refused to enact the landmark law’s Medicaid expansion, an estimated 2.2 million people, mostly of color, languish in the so-called coverage gap: eligible for neither Medicaid nor subsidies. in the ACA market. Build Back Better, as originally envisioned, sought to address this problem by allowing residents of non-expanding states to enroll in subsidized plans after all, but the provision was dropped. This means that the reconcile package Democrats continue to help those above the poverty line buy coverage, but those below the poverty line with an impossible bill.

Congress can still solve the problem. The numbers must add up to satisfy Mr. Manchin, which wants to dedicate a large portion of the savings from pharmacare to deficit reduction. Another provision of the old Build Back Better to reinforce the Internal Revenue Service auditing capabilities could generate revenue without the inflationary backlash that the West Virginia senator so worries about pushing the wealthy to pay legally owed taxes — and worth it on the merits, too. But proponents argue the math could work even without the extra dollars of such a reform.

This is likely the last chance lawmakers have to prevent what is already a tragedy from causing more damage and more casualties. Democratsunder the direction of a White House who says it’s dedicated to the country’s most vulnerable, can’t afford to miss it. The country’s poorest citizens can afford it even less.

An editorial by The Washington Post.

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