WASHINGTON — The Democrats’ social spending and climate change bill would put the United States back on a path to reducing its persistent pool of uninsured people, with estimates ranging from 4 million to 7 million Americans gaining health coverage.
Those getting covered would include about one-third of uninsured Black Americans, according to an analysis by the Urban Institute and the Commonwealth Fund, nonpartisan research groups that support the goal of expanding health insurance. Other estimates from the Congressional Budget Office and the center-right American Action Forum project a similar overall trend.
With the legislation, the number of uninsured people under age 65 would drop from about 28 million to less than 24 million in a decade, according to the budget office, which provides nonpartisan analysis for Congress. That 28 million starting point is roughly in line with the current count of uninsured people, so the nation would see a holding pattern if lawmakers do nothing.
Even with former President Barack Obama’s Affordable Care Act, or ACA, nearly 9% of Americans remain uninsured. But now, by building on that health law, President Joe Biden is trying to drive the numbers lower, a few percentage points at a time.
Left-leaning Democrats who favor guaranteed government health insurance for all are promoting the piecemeal progress under Biden nonetheless.
“The best approach to getting universal coverage is through a single-payer system, but we should not overlook how powerfully important the provisions in the Build Back Better agenda are,” said Massachusetts Sen. Elizabeth Warren, referring to Biden’s signature legislation proposal. “We have a historic opportunity to make a real difference in people’s lives … and we should do that.”
Final specifications of Biden’s package are being worked out but numerous Democrats say the health insurance provisions have broad backing within their party. The changes include an extension of temporary financial subsidies for “Obamacare” plans in Biden’s coronavirus relief bill, coverage for low-income people in a dozen mainly Southern states where Republicans blocked Medicaid expansion, and a formula tweak for what’s deemed affordable workplace coverage.
“These policies would definitely reduce the number of uninsured in ways you could see clearly,” said economist Jessica Banthin, lead author of the Urban-Commonwealth analysis.
Republicans are trying to brand the Democrats’ plan as wasteful. Citing a budget office cost estimate of $553 billion over 10 years, House Republicans say that would work out to $14,200 per person covered, or about twice the annual premium for employee-only coverage at work.
“There’s nothing affordable about Democrats’ plan,” Rep. Kevin Brady of Texas, the top Republican on the House Ways and Means Committee, said in a statement.
But such criticism overlooks the fact that Republicans don’t agree among themselves on a strategy to continue expanding health insurance coverage.
Most believe it’s not the role of government to guarantee coverage for all, particularly for people who are able to work.
Under President Donald Trump, Republicans tried and failed to repeal the Obama health law, and that would have made more than 20 million Americans uninsured. Trump never delivered on his own promise of “insurance for everybody.”
What’s more, a good deal of the cost in the Democrats’ latest bill involves their Medicaid workaround, which would not be happening if GOP-led states such as Texas, Florida and Georgia had joined the 38 others that expanded the program under the Obama law.
