The American Rescue Plan

President Joe Biden’s US$1.9-trillion stimulus bill includes several actions addressing healthcare access and affordability in the USA.

The American Rescue Plan is a multi-pronged strategy, and includes policies that would decrease health insurance premiums for more than 10 million people and reduce the ranks of the uninsured by millions more.

Two to three million people lost employer sponsored health insurance between March and September, and even families who have maintained cover may struggle to pay premiums and afford care, according to the fact sheet on Biden’s proposal.

Biden is now calling on Congress to subsidise COBRA through to the end of September. COBRA is a health care programme in which an individual who lost their job continues the same health care cover they had under their employer-based health insurance. It has higher premium payments since the employer no longer contributes.

Under Biden’s plan, the federal government would cover 100% of the premium cost, meaning the worker who lost their job would not have to pay their portion or the portion their employer previously covered.

Biden’s plan seeks to expand and increase the value of the Premium Tax Credit, a refundable credit that helps Americans cover the premiums for health insurance they got through the Health Insurance Marketplace. Biden aims to lower or eliminate premiums and make sure those who are enrolled don’t pay more than 8.5% of their income for cover.

The American Rescue Plan includes new investments in supplies for strapped hospitals, money for vaccines and testing and seeks to give front-line healthcare workers new federal protections.

A key pillar of the plan is US$20 billion for a national vaccine programme that partners with state and local governments. The plan will launch community vaccination centres around the country and mobile units for any hard-to-reach areas.

Biden will work with Congress to expand the federal matching rate to 100% for the administration of vaccines to ensure that all Medicaid enrolees get vaccinated.

Biden’s plan also calls for US$50 billion for testing and funding to purchase rapid tests and expand capacity.

The president is seeking to expand the public health workforce with money to hire 100,000 public health workers. These individuals will be hired to work in their local communities to perform vital tasks like vaccine outreach and contact tracing.

Another major boost is a directive from Biden to Congress to authorise the Occupational Safety and Health Administration (OSHA) to create a COVID-19 protection standard that shields workers from unsafe working conditions and retaliation related to the pandemic.

It remains unclear what parts of Biden’s plan could get through Congress, although money for vaccine distribution will likely have bipartisan support.

Prospects have improved for the plan since Democrats took control of the Senate. Democrats could also pass parts of the plan through a parliamentary move called reconciliation that lets budget bills pass the Senate via a simple majority.