Health provisions in federal relief law increased enrollments, but expire this year
A Nevada Health Link table at an event to promote open enrollment in 2019. (Courtesy photo)
The passage of a federal American Rescue Plan relief bill last year, which expanded health care subsidies within the Affordable Care Act, resulted in a 25% increase in enrollment in Nevada, officials said.
However, subsidies are set to expire at the end of 2022.
U.S. Rep. Susie Lee and state Sen. Fabian Doñate joined health advocacy group Protect Our Care in a virtual town hall last week to discuss the provisions within the American Rescue Plan, which passed in March 2021, that expanded health care coverage.
“We had millions of people across this country who were facing unemployment and were on the brink of financial collapse,” Lee said. “We were able to extend the subsidies of the Affordable Care Act and open up access to millions of Americans. What that did is you saw an average of savings of $2,400 per family per year.”
Efforts to keep current provisions in place, along with components to rein in costly prescription drug prices, were included in the Build Back Better bill, which is stalled in the Senate.
In addition to sending $6.7 billion in funding to Nevada and expanding the child tax credit, the American Rescue Plan made Nevadans making more than 400% of the federal poverty level who were previously left to pay for insurance on their own eligible for plans.
The entire Democratic Congressional delegation voted for the bill while Republican U.S. Rep. Mark Amodei, along with every other Republican in both the House and the Senate, voted against the legislation.
The package also reduced ACA health care premiums and offered zero cost plans for Nevadans who received unemployment insurance.
Janel Davis, a spokeswoman with the Silver State Health Insurance Exchange, said the legislation had positive results for Nevada.
“The exchange has worked diligently to offer more plans, more options, more assistance and most importantly, ensure Nevadans are aware of their potential cost savings available by getting covered on the exchange,” she said. “Most of the consumers have qualified for some amount of federal subsidy to lower monthly costs, and almost half enrolled in plans with a premium under $100. ”
Efforts to extend those subsidies beyond 2022 face an uphill battle since West Virginia Democratic U.S. Sen Joe Manchin said in late December he wouldn’t support the Build Back Better as written.
Manchin along with Arizona U.S. Sen. Kyrsten Sinema, another Democrat, balked at the size of the legislation, which makes investments in climate change and social policy.
With zero Republican support for the nearly $2 trillion package, which also includes extending the child tax credit and investments in housing, child care and paid family and medical leave, Democrats have to use a procedure known as reconciliation to shield the bill from a Republican filibuster.
Another component of the legislation talked about during the town hall was provisions to rein in high prescription drug costs.
Kristine Schachinger, who spoke alongside Lee and Doñate on Friday, spends around $16,000 every year on health care costs, which includes insurance and especially prescription drugs.
“It’s an albatross around my neck I can’t ever get rid of,” she said. “My whole life circles around how I’m going to get insurance, how am I going to pay for insurance, how am I going to get medications, how am I going to pay for them? I don’t have a lot of savings because of it. I can’t buy a house because I can’t save up because I’m spending all this money on health care.”
Along with previously dealing with congestive heart failure, a few years ago she was diagnosed with diabetes. When she got Covid in 2020, she began experiencing long hauler symptoms.
“So along with the two medications I was already taking, the doctor wanted me to take two more,” Schachinger said. “The problem was the insurance refused to cover one of the medications I was told to take. The medication that was not covered costs $625 a month.”
She said at one point her insurance, United Healthcare, informed her they would cover the costs. When she finally went to a Walmart pharmacy, the price was $565 – only $60 was covered.
Instead, she has a friend drive to Mexico to pick up the medication, which costs $60.
“Prescription drug pricing is an economic issue for this country,” Lee said. “You’re unable to plan to purchase a house, it consumes your every waking hour. We have a fight on our hands.”
The prescription drug provisions included in the Build Back Better bill passed by Lee and her Democratic House colleagues in November proposed giving Medicare the ability to negotiate drug prices starting in 2023 with price caps beginning 2025. It would have capped out-of-pocket expenses at $2,000 and set insulin, for which prices have skyrocketed, at $35 per month.
“These are key provisions that really get to the heart of what we’re seeing with respect to the affordability of prescription drugs,” Lee said. “For too long congress has failed to act and taken the side of pharmaceutical companies.”
Lee didn’t say if there were efforts to address prescription drug costs outside of Build Back Better.
She added any effort to tackle costs should be bipartisan,and “we have to reach across the aisle and have to find a common ground.”
“I know it’s frustrating to know we were on the brink of having this legislation and not seeing it get past the finish line, but do not give up,” Lee said. “We gotta keep up the fight.”
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