Like a stress test on a treadmill, the COVID pandemic showed us where our systems were resilient or weak. Then Biden’s American Rescue Plan set us up for striding forward.
One system, health care, has been under significant pressure.
Where infection rates were high, hospitals filled with patients. Some resorted to holding people on gurneys in hallways for days or weeks. Nurses helped people in intensive care communicate with family members who could not visit, even when their loved ones were severely ill and near death.
Other adaptations were aimed at thwarting the disease’s spread. Going to an appointment or a blood test meant having one’s temperature taken, answering screening questions and being handed a mask.
Now that the rollout of the vaccine has ramped up, the Biden administration has already achieved its goal of 100 million vaccines administered in the first 100 days.
And what about paying for health care? The United States has a real crazy quilt of coverage — woven from a mix of employer and employee paid premiums, the Veterans Administration, Medicare, Medicaid, health care sharing groups, COBRA, health exchanges set up under the Affordable Care Act, and supplementary or main policies people buy on their own.
With so many Americans’ health insurance coverage tied to employment and unemployment soaring due to the pandemic, employer health insurance fell. Somewhere around 10 million lost coverage in 2020. Many were able to shift their coverage to private insurance bought on or off the health exchanges or, if they lived in one of the majority of states that expanded Medicaid, to Medicaid.
New, bold steps have just been taken on health coverage. The $1.9 trillion COVID bill signed by President Biden has gotten the most attention for its payments to individuals and families — and its stark contrast to the $1.9 trillion Trump tax bill that gave the most and longest lasting benefits to people with high incomes. Instead, the Biden bill’s benefits are mostly going to low and middle income Americans.
But a key part of the bill involves health coverage. That’s one reason why it was so odd that Rep. Jared Golden said he voted against it because he thought it could undermine “fixing our broken and unaffordable health care system.”
Americans get big boosts in affordable coverage through the American Rescue Plan.
One is by boosting subsidies for people buying health insurance through the exchanges. When the ACA was passed, Democrats tried to keep the total price tag down to get 60 votes to pass it in the Senate and to try to attract Republican support. One result was lower subsidies, which meant higher costs for patients. Although then-President Barack Obama made those concessions, no Republicans backed it. Now working class and middle class people can pay less, because of the rescue plan. How much less? Four out of five Americans can pay $10 a month or less and 50 percent can get a Silver plan for $10 or under monthly.
COBRA is a way unemployed people can continue with the health insurance they had through an employer, but it is often very expensive. From April through September 2021, 100 percent of these costs will be covered for those who lost their jobs or had their hours cut.
And the bill tackles a shameful, damaging reality — our country’s high rate of maternal mortality, the worst in the industrialized world. New mothers can have a gap in coverage, especially since 40 percent give birth when covered by Medicaid but the coverage only lasts 60 days afterward. As journalist Sarah Kliff explains, “The American Rescue Plan will let states extend Medicaid coverage for a full year, and provides federal funding to do so.”
As we move beyond the pandemic and our economy recovers, the health provisions in the COVID relief bill provide a strong foundation for another round of health reform. As always there are many possibilities, perhaps adopting a public option, which Biden supported and which is very popular, or passing other policies.
After what we’ve been through, this is a great time to take further steps.
Amy Fried is chair of the Department of Political Science at the University of Maine. Her views are her own and do not represent those of any group with which she is affiliated.