Discover and read the best of Twitter Threads about #ACA2
Most recents (24)
Short version: The expanded subsidies in the #AmRescuePlan are fantastic, but are only for 2 yrs & only reduce premiums, not deductibles/co-pays. if @SenatorShaheen's #S499 becomes law, not only would that expansion be made *permanent*...
đź“Ł NEW: PREPARE THYSELF: It may be in fits & starts, but #ACA2.0 *is* happening:
acasignups.net/21/03/15/prepa…
acasignups.net/21/03/15/prepa…
Four years ago I posted my (now sorely outdated) list of 20 changes to the #ACA I'd make If I Ran The Zoo (yes, I understand how awkward that title is at the moment): acasignups.net/18/02/12/updat…
In January, Sen. @MarkWarner introduced his Health Care Improvement Act which includes many of the same provisions: warner.senate.gov/public/index.c…
đź“Ł THREAD: @JoeBiden is rolling 2 major #ACA2.0 provisions into the #AmericanRescuePlan! 1/
acasignups.net/21/01/15/joe-b…
acasignups.net/21/01/15/joe-b…
Along with a whole mess of other important stuff, the #AmericanRescuePlan also includes two key parts of Biden's larger healthcare plan (with the remainder to be included in a later bill after he, you know, actually takes office):
1. #KillTheCliff
2. #BeefUpTheSubs 2/
1. #KillTheCliff
2. #BeefUpTheSubs 2/
Currently, #ACA enrollees pay between 2-10% of their income in premiums up to 400% of the federal poverty line (FPL)...but if you earn more than that (around $51K/yr if you're single; around $105K/yr for a family of four), you receive *no* assistance & have to pay full price. 3/
AGAIN: I'm not a huge fan of the guy, but like it or not, ANY federal legislation will almost certainly require Joe Manchin's blessing to get signed into law whether Dems flip the GA Senate seats or not.
Posting posting photos of him being glared at isn't going to change that.
Posting posting photos of him being glared at isn't going to change that.
Manchin has already stated that killing the filibuster is a non-starter. He's proposing a different rule in which any legislation which has bipartisan Senate support (via a committee) would have to be given a floor vote, which would at least be a partial improvement, I suppose.
This, again, is why I'm guessing the full #BidenCare proposal is unlikely to make it through. The #ACA2.0 part probably would, however.
A full PO is unlikely. Lowering the Medicare buy-in age to 60 is a possibility (which I suspect is why Biden included it in the first place).
A full PO is unlikely. Lowering the Medicare buy-in age to 60 is a possibility (which I suspect is why Biden included it in the first place).
This is something I've caught some heat from other healthcare advocates over.
I *hate* #ShortAssPlans & would prefer to ban them...but only *after* we #KillTheCliff & beef up the APTC formula. Until then they're a necessary evil, though they should be strongly discouraged.
I *hate* #ShortAssPlans & would prefer to ban them...but only *after* we #KillTheCliff & beef up the APTC formula. Until then they're a necessary evil, though they should be strongly discouraged.
ACA plans are affordable for those earning up to 200% FPL & for most earning 200-400% FPL, but are unaffordable for many earning >400% FPL due to the subsidy cut-off.
#ShortAssPlans suck, but until the 400% cut-off is removed, they're a kinda/sorta viable option for those folks.
#ShortAssPlans suck, but until the 400% cut-off is removed, they're a kinda/sorta viable option for those folks.
The ACTUAL solution is to #KillTheCliff, which @HouseDemocrats did in July & which is a core provision of #BidenCare...@dylanlscott's point is that if killing the 400% cut-off isn't doable, #ShortAssPlans may continue to be a necessary evil for some people.
THREAD: The other day @paulkrugman correctly noted that assuming the Trump/GOP lawsuit to strike down the #ACA fails, @JoeBiden's healthcare proposal (which basically amounts to #ACA2wPO) would be a Big F*cking Deal: nytimes.com/2020/10/05/opi… 1/
Krugman notes that most of the #BidenCare focus has been on the Public Option which "in the near term would be much less important than other aspects of the plan."
The "other parts" he's referring to are primarily the "ACA 2.0" parts which I've been calling for for years. 2/
The "other parts" he's referring to are primarily the "ACA 2.0" parts which I've been calling for for years. 2/
As I noted in my updated analysis of #BidenCare, while there's a LOT going on in his plan, the parts Krugman refers to include killing the subsidy cliff, beefing up the subsidies, upgrading from silver to gold & autoenrolling low-income folks: 3/
acasignups.net/20/07/23/biden…
acasignups.net/20/07/23/biden…
This is disgusting, bald-faced gaslighting bullshit. Gardner is utter garbage.
Here's my write-up on the 62-word bill @CoryGardner refers to. It's laughable for multiple reasons:
acasignups.net/20/08/20/color…
acasignups.net/20/08/20/color…
đź“Ł In light of both @thehowie & @pbump's comments: A couple of years back I crated a video explainer re. how the #ACA's 3-legged stool works and why covering pre-existing conditions w/out the rest of the ACA in place is a recipe for disaster. 1/
It's a bit out of date (it predates the mandate penalty actually being zeroed out by the GOP), but it's still a good overview:
Here's what the #ACA's 3-legged stool was originally supposed to look like. When people talk about "protections for coverage of pre-existing conditions", they're basically talking about the Blue Leg on the left: 
đź“Ł THREAD: As I'm typing this, the U.S. House is debating #HR1425, aka the House #ACA2.0 bill (#ACEA). What does it include? LET'S DIVE IN! 1/
Here's my deep dive into #HR1425, the Patient Protection & Affordable Care *Enhancement* Act (#ACEA), which I've dubbed simply "#ACA2.0": 2/ acasignups.net/20/06/24/aca20…
đź“Ł THREAD: Since Bernie's "Who the hell knows how much #M4All would cost" clip on #60Minutes is causing such a stir, here's why his answer, while terrible, is actually accurate. Let's look at the much-discussed "Mercatus Analysis" which received so much attention in July 2018: 1/
Back in July 2018, Charles Blahous of the @Mercatus Center, a *right-wing* think tank which isn't a fan of #M4All, came out with a 10-year projection about how much Bernie's #M4All bill would cost *assuming it was implemented exactly as worded* 2/
mercatus.org/system/files/b…
mercatus.org/system/files/b…
There were a TON of headlines screaming about how Bernie's #M4All proposal "would cost $32 Trillion!", which isn't surprising..but there were *other* headlines, including from Bernie himself, noting that the same analysis projected M4All "would *save* $2 Trillion!". Huh?? 3/
Again: The ACA succeeded where "HillaryCare" failed in large part because the Obama Administration learned not to try and take on EVERY PART of the health insurance industry SIMULTANEOUSLY. This led to a law which is far from perfect but which still made major improvements. 1/
The ACA took on and won SOME battles, but not so many as to guarantee that it would go down in flames...and even then it BARELY squeaked by, and only in a watered-down way. If they had insisted on going after EVERY player at once, it would never have happened at all.
The insurance lobby had mixed feelings about the ACA. It stopped most (not all) of their ugliest practices, forced them to stop discriminating against "undesirable" enrollees, and put a cap on their profits. On the other hand, it also provided a flood of enrollees & subsidies.
đź“Ł OK FOLKS, with Trump's latest whopper, time to dust off the #3LeggedStool one more time. Again, this is what the ACA's 3-legged stool looked like when it originally passed. The blue leg on the left = the Pre-Existing Condition protections (& other consumer protections): 1/
Unfortunately, as with any major piece of legislation impacting millions of people and billions of dollars, there were some legitimate problems with the original structure which have never been addressed due to political resistance. 5 major ones in my view are shown here. 2/
Basically, subsidies aren't robust enough and cut off too low on the income scale; high deductibles are still a big problem; the mandate penalty wasn't robust enough to be fully effective; and the minimum network requirement isn't strong enough. All of these COULD be fixed... 3/
📣 ⚠️ MAJOR UPDATE: How much will @CoveredCA’s expanded/enhanced #ACA subsidies reduce YOUR premiums? THREAD:
acasignups.net/19/11/27/major…
acasignups.net/19/11/27/major…
@CoveredCA In October, I posted an analysis of @CoveredCA’s expanded subsidies, showing how they’ll reduce 2020 premiums for both those who didn’t previously qualify for subsidies *and* those already receiving them. However, I was using the wrong table for my calculations! 2/
@CoveredCA The ACTUAL expanded subsidy formula is even MORE generous! Therefore, w/apologies to @CoveredCA, @aewright & @healthaccess, I’ve re-run the numbers & graphs to show how much different households in Sacramento, CA will save if they #GetCovered for 2020! 3/
acasignups.net/19/11/27/major…
acasignups.net/19/11/27/major…
đź“Ł IMPORTANT: The Dem POTUS candidates seem to be bogged down in a #M4All vs. #PublicOption debate...but EITHER of those would take several years to get passed, signed, implemented & ramped up. In the meantime, the #ACA itself desperately needs to be protected & strengthened. 1/
Robust #ACA2.0 bills have been introduced by both @HouseDemocrats (#HR1868 / #HR1884) *and* @SenateDems (#S1213, aka #CHIPA), and either of them could be implemented almost immediately upon signing.
Yet there's been little movement on either of these since last spring. 2/
Yet there's been little movement on either of these since last spring. 2/
📣 HEADS UP: House @EnergyCommerce Committee to grill @SeemaCMS on #ACASabotage this morning starting at 10am: acasignups.net/19/10/23/house…
Here we go: Opening statement by @RepDianaDeGette; overview of Trump Admin actions attempting to sabotage the #ACA. Ironically, it sounds like she might have a bit of a cold herself.
Opening statement by GOP ranking member @RepGuthrie; needless to say he's gushing with praise for Verma. As I explained yesterday, the "4% drop in premiums" for 2020 is a) misleading and b) is basically just a correction of carriers overestimating costs in 2017 & 2018.
It is. It basically splits the difference between Biden/Buttigieg's plans and Bernie/Warren's plan. Similar to Harris' plan, but phased in more quickly because it deals with the "union contract" issue differently.
FWIW, here's my deep dive into #Med4America (warning: it gets wonky...on the other hand, it also includes colorful psychedelic donuts!):
acasignups.net/19/05/16/reall…
acasignups.net/19/05/16/reall…
OK, here's the visuals to give a sense of how it'd be phased in:
Here's the current healthcare coverage situation for the entire U.S. population...the "Psychedelic Donut®" as I've dubbed it:
Here's the current healthcare coverage situation for the entire U.S. population...the "Psychedelic Donut®" as I've dubbed it:
ONCE AGAIN: @BernieSanders co-sponsored @ewarren's robust #ACA2.0 bill until less than a year ago before stripping his name off of it and crapping all over it even in the short term.
Also, @ewarren is cosponsoring a *Medicaid* buy-in bill by @brianschatz. And @KamalaHarris has cosponsored various other major healthcare expansion bills. And @JoeBiden's "#ACA2wPO" proposal is a cross between Warren's #ACA2.0 & @SenJeffMerkley/@ChrisMurphyCT's "Choose Medicare".
Point being, THERE'S NOTHING WRONG WITH COSPONSORING MULTIPLE BILLS ON THE SAME ISSUE. Whatever the final bill ends up being, it will hopefully take the best elements of each and mush them together into something like...oh, say, @BetoORourke's #MedicareForAmerica? :)
Hmmm…according to @daveweigel’s piece in the WaPo yesterday, this is where the Dems currently fall (Sanders made it clear in recent statements that he’s not interested in strengthening the ACA even in the short term):
washingtonpost.com/politics/palom…
washingtonpost.com/politics/palom…
@daveweigel Of course it's still confusing, because Booker, Harris & Gillibrand are co-sponsors of Bernie's #M4AllBILL, and Booker, Harris, GIllibrand and Klobuchar are co-sponsors of Warren's #ACA2.0 bill...which she seems to have abandoned (or at least hasn't been talking about lately).
@daveweigel ...all of which goes back to my question for each of the top contenders: acasignups.net/19/07/16/heres…
📣 Thanks to @paulkrugman for reminding me that I completely forgot to address @JoeBiden’s scaremongering factor in my write-up of his (pretty good) #ACA2.0 healthcare proposal: acasignups.net/19/07/19/joe-b…
@paulkrugman @JoeBiden Something really important to keep in mind re. the #ACA2.0 / #M4All battle: The #ACA *itself* allows for individual states to go Single Payer if they want to, via the 1332 Waiver provision. Vermont and Colorado both attempted to do this. Both ended up failing...
@paulkrugman @JoeBiden ...but let's suppose both had been successful, and the other 48 states had followed suit. Now you'd have 50 states with Single Payer healthcare systems. Would that be considered "eliminating Obamacare"? Depends on your POV.
Ok, I’ve been stuck at the Apple store for four hours waiting for my iCloud update to complete, so I’ve had time to read over Biden’s healthcare proposal. Sure enough, it’s basically @ewarren’s #ACA2.0 plus a robust public option, which is just fine.
I still can’t fathom why @ewarren has shifted gears to jump completely into the BernieCare pool when she already gave a perfect response back in March. Still hoping she’ll shift back to that stance.
Biden, Warren and the @HouseDemocrats all base their #ACA2.0 proposal subsidy formula on the @urbaninstitute’s “Healthy America”. The House version sticks with Silver for the benchmark, Warren & Biden upgrade to Gold.
I'm glad to see @RepUnderwood's #HR1868 back in the news. Here, again, is my explainer of how much it'd save #ACA enrollees...and, just as importantly, how MILLIONS OF PEOPLE not *currently* eligible for tax credits would become eligible: acasignups.net/19/07/11/how-m… #ACA2.0
#HR1868 is a remarkably simple bill which solves the single biggest complaint people have about the #ACA, by opening up tax credits to millions of *middle class* Americans while also strengthening the formula for those currently receiving them. Here's what the bill does. #ACA2.0
How much would this save? Well, right now, on average, a single adult earning $49,960/yr pays no more than 9.86% of their income for premiums, while the same person earning $49,961 (just $1 more) has to pay full price...which could be as much as *three times* as much.
đź“Ł THREAD, WITH TABLES & GRAPHS! 1/
A Really Deep Dive into #MedicareForAmerica: acasignups.net/19/05/02/reall…
A Really Deep Dive into #MedicareForAmerica: acasignups.net/19/05/02/reall…
So yesterday, @RosaDelauro & @RepSchakowsky re-introduced their #Med4America universal healthcare coverage bill. It’s important to note that BOTH of them are members of the Congressional Progressive Caucus, and Schakowsky is also a co-sponsor of the House #MFA bill. 2/
@rosadelauro @RepSchakowsky In other words, this is NOT a battle between “progressives” and “centrists”. #Med4America is *very* progressive…while also, in my view, simply being more practical than the “pure” #MFA bills. It starts out as a robust Public Option for 2 yrs, but then becomes MUCH more. 3/
CORRECTED HEADLINE:
“Nurse and freshman member of Congress introduces important bill to significantly improve ACA until universal coverage can be passed in the future”
#ACA2 isn’t an *alternative* to MFA, it’s an important stopgap to improve things in the short term.
“Nurse and freshman member of Congress introduces important bill to significantly improve ACA until universal coverage can be passed in the future”
#ACA2 isn’t an *alternative* to MFA, it’s an important stopgap to improve things in the short term.
#ACA2 is desperately needed for the next few years REGARDLESS of whether we eventually move to MFA, Med4Am or some other universal coverage program.
ACA2 could be fully implemented pretty much immediately, possibly even retroactively for some provisions. MFA or even Med4Am (which I support) will take several years to ramp up, so at least some ACA2 provisions would still be needed in the meantime.
