Following passage in the Senate on March 6, 2021, the House of Representatives passed the $1.9 trillion American Rescue Plan Act of 2021 on March 10, and President Biden signed the bill into law on March 11. The Center for Medicare Advocacy applauds the passage of this landmark bill that will provide wide-ranging relief to people struggling with the ongoing global pandemic.
According to the New York Times, the bill is “one of the most far-reaching federal relief efforts ever to pass Congress” and “is estimated to cut poverty by a third this year and […] would potentially cut child poverty in half”. The Rescue Act, which is the sixth major COVID relief bill passed in the last year in which the pandemic has gripped the nation, includes a range of economic stimulus provisions and an expansion of federal safety net programs (some of which is temporary), including: child tax benefits; extension of unemployment benefits; stimulus checks; additional funding for COVID testing and contract tracing and vaccine distribution; aid to state and local governments; housing assistance; funding to support the opening of schools; support for child care providers; relief for multi-employer pension plans; and a number of health care related provisions, discussed below. (For summaries of the bill, see, e.g., this Senate Title-by-Title summary; the Center on Budget and Policy Priorities (CBPP) issue brief “American Rescue Plan Act Will Help Millions and Bolster the Economy”; also see this Washington Post summary and NPR summary.)
Health care specific provisions of the Rescue Act include:
- Expansion of marketplace coverage – according to CBPP, “the Act eliminates or vastly reduces premiums for many people with low or moderate incomes who enroll in plans through the Affordable Care Act (ACA) marketplaces and provides new help to people with somewhat higher incomes who face high premiums.” The Kaiser Family Foundation has updated its 2021 Health Insurance Marketplace Calculator to reflect these changes, which will be in effect for two years. In addition, there are protections for marketplace enrollees with fluctuating income over the last year from having to repay significant portions of their federal premium tax credits.
- Expansion of COBRA coverage – per the Senate summary, the “bill subsidizes 100 percent of COBRA premiums for six months for individuals who lost employment or had reduced hours.”
- Medicaid – provisions include:
- Increased financial incentives for the states that have not implemented the ACA’s Medicaid expansion to do so
- Increased federal portion of Medicaid funding for Home and Community Based Services (HCBS)
- According to the Senate summary referenced above, “The bill also includes numerous investments to reduce health disparities, including an option for states to provide one-year of postpartum Medicaid coverage, […] and resources for COVID-19 response in nursing homes.”
The American Rescue Plan will provide much needed relief to a nation seeking to emerge from the pandemic, but the work is not done. The Center for Medicare Advocacy now urges Congress and the Administration to address additional health care and Medicare issues. This includes: confronting long-standing problems faced by those who reside in nursing homes, including addressing staffing, infection control, and management problems; filling the gaps in Medicare coverage, including adding oral health coverage; and ensuring that all Medicare-eligible individuals can access their earned Medicare benefits during the COVID-19 pandemic and beyond, including reinstating enrollment flexibilities and addressing hospital observation status. See the Center’s legislative priorities outlined in our Medicare Platform, our Transition Memo to the Department of Health and Human Services, and our joint letter with the Medicare Rights Center outlining our organizations’ priorities for immediate administration actions.