With all the focus on spending to recover from a coronavirus-induced depression, Senate Democrats on Friday floated their proposals to deal with the most basic part of the crisis -- people's health.
The plan echoes some of what Democrats in the House passed recently in their $3 trillion rescue package, and can be seen as what Senate Democrats will try to insist on in whatever new COVID-19 package emerges from talks with Senate Republicans and the White House.
Among other things, the package includes bills that would cover all costs for anyone to get coronavirus treatment; provide subsidies for people who lose jobs to cover COBRA premiums; open the Affordable Care Act for signups with expanded tax credits; create incentives for hold-out states to expand Medicaid, and ban the sale of junk insurance plans that cost less but provide little coverage.
“Access to health care has never been more important,” said Sen. Jeanne Shaheen (D-N.H.), who coordinated proposals. “As our country faces the worst public health crisis in a century, millions are facing furloughs and job losses that make affordable health care coverage an even greater struggle."
While the plan is about healthcare, the senators involved also clearly signaled that it is a political document designed to put pressure on Republicans.
“For families in need, access to quality, affordable health care isn’t a partisan issue -- it’s a life and death one," said Sen. Patty Murray (D-Wash.), the tom Democrat on the Health, Education, Labor and Pensions Committee. "It shouldn’t take a historic global pandemic for Republicans to understand that, but for them to continue ignoring the health care needs of families in the middle of this crisis would be truly inexcusable.”
“The absolute least we can do in the middle of an unprecedented public health crisis is help people get the health care they need -- and Republicans have no excuse to continue playing politics or dragging their feet on getting these common-sense steps done," Murray added.
Perhaps the most ambitious part of the plan is Shaheen's legislation to expand subsidies and tax credits available in the ACA's marketplace insurance plans.
Tax credits are limited now to people earning under 400 percent of the federal poverty rate, or at about $51,000 and down for an individual. Shaheen's bill would extend tax credits to people earning up to 800% of the poverty rate, on a sliding scale. It would also allow the tax credits to be more generous, coving a greater percentage of the premiums people pay than under current law.
Republicans have shown little appetite for expanding access to healthcare, or footing the related costs. In this case, estimates run around the $18 billion range, though that could be on the low side in the current pandemic. The White House has refused even to open up enrollment in the Affordable Care Act at a time when uninsured people might be tempted to sign up in fear of contracting COVID-19.
But the costs of confronting the pandemic have been so high (with close to $3 trillion already appropriated, and much more likely needed), that Shaheen's proposal would be a drop in the bucket.
So, the question of which of these smaller items -- relatively speaking, of course -- get included will come down to the politics Murray and Shaheen both referenced. If Republicans want to secure larger payouts and liability protections for corporations, they'll have to relent on something Democrats want. Perhaps it could be helping more people get healthcare.
The while paper detailing the proposals is here: