The $1.9 trillion COVID relief bill signed into law on March 11 is offering lowered health insurance premiums — the monthly payments associated with insurance plans — for as many as 29 million Americans, drastically relieving the burden of medical costs.
Prof. Sean Nicholson, policy analysis and management and director of the Sloan Program in Health Administration, discussed the health care components of the coronavirus relief package in a March 26 talk — dissecting the relief bill as part of a speaker series organized by the student-run publication the Cornell Healthcare Review.
While the relief bill largely focuses on aid outside of health care, like direct stimulus payments and extended unemployment benefits, Nicholson explained that in a bill this size, even a relatively small proportion dedicated to health care matters.
According to the Congressional Budget Office, the bill will reduce the number of uninsured individuals by approximately 1.3 million. The substantial health care provisions outlined in the bill will expire after 2022, but Democratic lawmakers may try to make some reforms permanent, according to Nicholson.
One provision will subsidize 100 percent of the monthly premiums until September for unemployed individuals who want to stay on their company health plan. Previously, those unemployed could have been required to pay their entire premium.
Nicholson also discussed how anyone receiving unemployment benefits this year will qualify for a zero-premium Marketplace plan. Established through the Affordable Care Act, the Marketplace serves as a shopping service for individuals in search of low-cost medical insurance.
“The nice thing is someone’s going to be getting income through unemployment benefits but also won’t have to worry about how they’re going to pay for their medical bills,” Nicholson said.
Anyone currently enrolled in health care through Marketplace will also see markedly lower premiums.
As the threshold for Marketplace subsidies increases to include those earning over $51,040 each year, more people will be able to qualify for subsidies and better access the health care they need.
Nicholson also highlighted the bill’s financial incentives for states to expand Medicaid. The Affordable Care Act, a program run jointly by federal and state governments, currently grants states with the power to decide whether they will expand Medicaid eligibility.
However, as families continue to grapple with the high cost of care amid increased COVID-19 health burdens, 12 states have not passed the Affordable Care Act’s 2014 Medicaid expansion, despite its benefits such as mitigating racial disparities in insurance coverage.
Nicholson said the federal government is covering 90 percent of the costs associated with the Medicaid expansion. Now, under the COVID relief bill, the federal government will cover an additional 5 percent of the costs associated with traditional Medicaid plans for states that pass the expansion.
This reduced cost makes the Medicaid expansion a more attractive option for the states who have not yet passed it, Nicholson said.
Still, it remains to be seen whether Republican governors and legislators in these holdout states will accept the fiscal benefits and expand Medicaid, or refuse due to ideological opposition to the Affordable Care Act.
While these policy changes are slated to significantly expand access to health care, Nicholson stressed that they will expire at the end of 2022. However, Democratic lawmakers have hopes for making some of the changes introduced by the bill permanent, especially given that many of the provisions — such as expanding Medicaid and lowering premiums — are ones that the Biden administration had initially promised as permanent changes during his 2020 presidential campaign.
The pandemic has transformed the U.S. healthcare system, even before the latest relief bill passed. One of these changes occurred last December, when the Center for Medicare and Medicaid Services made coverage of telehealth services permanent.
Understanding how these changes will benefit people is part of what drew Nicholson to the field of health care policy. In addition to his research that includes studying regional variations in medical spending and biotechnology, Nicholson also teaches the popular undergraduate course Policy Analysis and Management 2350: The U.S. Health Care System.
“[The industry] changes so quickly… You’re always trying to figure out where it’s headed next,” Nicholson said.