WASHINGTON – With the Biden administration set to unveil details on a series of executive ordersto reverse his predecessor’s relentless efforts to sabotage the success of the Affordable Care Act, U.S. Sen. Mark R. Warner (D-VA) will introduce the Health Care Improvement Act of 2021 to help counter the devastating effects the health and economic crisis caused by COVID-19 has had on the record high number of people lacking insurance across the country. Specifically, the Health Care Improvement Act of 2021 aims to protect health care coverage for Americans living with preexisting conditions while also expanding access to quality and affordable health care coverage for working families.

“Due to the COVID-19 pandemic, millions of Americans have lost their employer-provided insurance. Amid one of the most unprecedented health and economic health crises our country has faced where an alarming number of Americans already lack health insurance, now is the time to deploy tools to meet the demands on our health care system. As the Biden administration readies its executive orders to expand health care coverage – including reopening the enrollment period for the Affordable Care Act  – I’m also introducing legislation that would support the administration’s effort to get more families affordable health care coverage,” said Sen. Warner. 

The Health Care Improvement Act of 2021 would lower costs for working families by:

·       Capping health care costs on the ACA exchanges: The Health Care Improvement Act of 2021 will ensure no individual or family pays more than 8.5 percent of their total household income for their health insurance. Currently, no family making more than 400 percent of the federal poverty line ($51,040 for an individual in 2020) is eligible for premium assistance on the ACA exchanges. This provision – which is supported in President Biden’s American Rescue Plan – expands premium assistance to individuals making more than 400 percent of the federal poverty line and places a cap on insurance costs for all individuals and families on the ACA exchanges. 

·       Establishing a low-cost public health care option: The Health Care Improvement Act of 2021 will also require the Secretary of Health and Human Services to create a low-cost, public health care option for individuals who are eligible to enroll for health care coverage via the ACA exchanges. Establishing a public health care option will increase competition and ensure an added lower cost health care option for more American families.

·       Authorizing the federal government to negotiate prescription drug prices: Under existing federal law, the government is explicitly banned from negotiating with pharmaceutical companies for lower drug prices. The Health Care Improvement Act of 2021 will allow the federal government to leverage its purchasing power to negotiate prices and reduce drug costs for more than 37 million seniors on Medicare.

·       Allowing insurers to offer health care coverage across state boundaries:The Health Care Improvement Act of 2021 will allow insurers to offer health care coverage across state boundaries, increasing choice and competition among plans and driving down costs while maintaining quality, value and strong consumer protections.

·       Supporting state-run reinsurance programs: The Health Care Improvement Act of 2021 will create a new “State Health Insurance Affordability and Innovation Fund” to support state run reinsurance programs and additional state efforts to reduce premium costs and expand health care coverage. The non-partisan Congressional Budget Office has previously estimated such programs could reduce health care premiums by 8 percent within one year.

The Health Care Improvement Act of 2021 will increase access to affordable health care coverage by:

·       Incentivizing states to expand Medicaid: If all states were to expand their Medicaid programs, the number of uninsured Americans would decrease by more than 2 million. The Health Care Improvement Act of 2021 will provide additional incentive to states to expand their Medicaid program by temporarily increasing federal matching funds to states that expand their programs and reducing existing administrative payments to states that do not expand their programs. It would also provide retroactive payments to states like Virginia that were late to expand Medicaid and have not received their fair share of federal matching payments. 

·       Expanding Medicaid eligibility for new moms: The Health Care Improvement Act of 2021 will allow states to provide new mothers up to 12 months of postpartum Medicaid eligibility. This provision would significantly improve maternal health outcomes by ensuring mothers have access to vital health care services during the immediate months after giving birth.

·       Simplifying enrollment: There are over 7 million Americans currently eligible for cost-free Medicaid coverage, but who are not enrolled due a variety of factors including unnecessary paperwork and a confusing enrollment process. The Health Care Improvement Act of 2021 will simplify Medicaid and CHIP enrollment by permanently authorizing the successful Medicaid Express Lane Eligibility program and expanding it to include adults. The Department of Health and Human Services will also be required to conduct a study and develop recommendations to allow states to further implement Medicaid and CHIP auto-enrollment for individuals eligible for cost-free coverage. 

·       Increasing Medicaid funding for states with high levels of unemployment: The Health Care Improvement Act of 2021 will implement a counter-cyclical Medicaid matching payment from the federal government to ensure that states with high levels of unemployment receive a higher federal matching payment to appropriately account for an increase in Medicaid enrollment. This will ensure states can maintain affordable health care coverage during economic downturns and temporary periods of high unemployment.

·       Funding rural health care providers: Under current law, rural providers are unfairly compensated at a much lower rate than urban providers, making it more difficult for Virginia providers to keep their doors open in underserved communities. The Health Care Improvement Act of 2021 will create a rural floor for the Area Wage Index formula the Centers for Medicare and Medicaid use to reimburse rural providers. Fixing the Area Wage Index will boost access to affordable health care coverage in Virginia’s rural and medically underserved communities.

·       Reducing burdens on small businesses: The Health Care Improvement Act of 2021 will modernize ACA employer reporting requirements to ensure that businesses can provide comprehensive health care benefits to their employees without additional administrative costs or unnecessary paperwork.

“As Americans continue to face a once in a century public health crisis, Senator Warner is working to make health care more accessible and affordable for the American people. Senator Warner’s bill would take bold steps to reduce costs, expand coverage, and strengthen protections for people with pre-existing conditions at a time when access to affordable health care has never been more critical. Mitch McConnell and Senate Republicans should work with Senate leadership to prioritize the health and well-being of Americans by building on the success of the Affordable Care and abandoning their health care sabotage agenda,” said Brad Woodhouse, Executive Director of Protect Our Care.

“The pandemic has exacerbated the deep, structural problems in our health care system: namely, cost is far too big of a burden and not enough people have adequate protection. We must make real reforms to health care, and Third Way applauds Senator Mark Warner for the leadership he has shown in the Health Care Improvement Act of 2020,” said Gabe Horwitz, Senior Vice President for the Economic Program at Third Way. “Among its very important provisions, this legislation would expand coverage by making enrollment in Medicaid automatic whenever a low-income uninsured patient accesses health care. As Third Way has long called for, automatic enrollment makes health care easier for people to navigate and is an important step to achieve universal coverage. The Warner legislation also builds on the Affordable Care Act and makes coverage affordable for millions of middle-class families who currently fall through gaps in the program. And it provides financial relief to states during economic downturns like the one we’re experiencing now by increasing the federal share of Medicaid payments to the states. Americans need far more security and stability in their health care, and we are excited about the vision shown in Senator Warner’s bill.”

“The Virginia Community Healthcare Association represents more than 150 health center sites, serving over 350,000 individuals across the Commonwealth with the goal of ensuring access to primary care for all Virginians. The COVID-19 pandemic has made the need for quality health care coverage more critical than ever. Senator Warner’s Health Care Improvement Act will advance our shared goal of reducing health care costs and expanding quality health care coverage to more Virginians. We thank him for introducing this legislation and look forward to working with him on this important effort,” said Rick Shinn, Director of Government Affairs for the Virginia Community Healthcare Association.

“Rising health care costs have increasingly become a burden for too many Virginians – making it more difficult to access quality and affordable health care coverage. The COVID-19 pandemic has demonstrated the importance of ensuring every American has access to quality health care coverage, and also highlighted significant gaps in access to health care coverage for communities of color and people with low-incomes. Senator Warner’s legislation will improve access to quality health care by closing existing coverage gaps and reducing premiums costs for people who already have health care coverage. We look forward to working with Senator Warner to advance these important priorities,” said Freddy Mejia, Health Policy Analyst, The Commonwealth Institute for Fiscal Analysis.

“The Virginia Poverty Law Center applauds Senator Warner’s introduction of comprehensive legislation on health care. The improvements in this bill address a wide range of critical issues that will reduce costs and expand access to care for consumers in Virginia and across the country. Specifically, we strongly support the Senator’s proposals that improve ACA health plan affordability, enhance premium assistance, provide additional incentives for states to expand their Medicaid programs, ensure continuity of health care for new mothers and reduce Medicare drug prices. We encourage Congress to move quickly on this vital legislation that will help so many consumers during and after the COVID pandemic,” said Jill Hanken, Health Attorney, the Virginia Poverty Law Center.

“We at the American Medical Student Association (AMSA) believe that access to quality health care is a right, not a privilege, and that access to comprehensive health services must be recognized and protected as a basic human right. Especially in light of this ongoing pandemic, we continue our commitment to ensuring health care for all. To that end, we support this effort to expand health care coverage in the U.S. AMSA especially supports Medicaid eligibility expansion, the simplification of enrollment procedures for Medicaid and SCHIP programs, and the expansion of federal financing. Moreover, we are excited to see efforts that work to reduce prescription drug prices and fight against surprise medical billing. AMSA applauds Senator Warner and the Health Care Improvement Act,” said Dr. Ali Bokhari, President of American Medical Student Association 

“The Association of University Centers on Disabilities (AUCD) is aware of how access challenges and high costs in our health care system disproportionally affect people with disabilities. We appreciate Senator Warner’s commitment to work closely with the disability community as he leads efforts to ensure Americans have access to the care and coverage they need.  AUCD supports the Health Care Improvement Act and its commitment to address the pressing needs of reducing health care costs and protecting the rights of people with disabilities,” said Rylin Rodgers, Policy Director of the Association of University Centers on Disabilities. 

This legislation also boasts the support of The Arc of Northern Virginia, The Autism Society of Northern Virginia, Healthcare for All Virginians Coalition, First Focus Campaign for Children, and the Infectious Diseases Society of America.

Bill text is available here. A bill summary is available here. A section-by-section explainer on the bill is available here.

With President Biden’s expected executive order announcement later today and the introduction of his American Rescue Plan, the Biden administration is set to act on additional priorities Sen. Warner has long called for to improve our nation’s health care system such as re-opening theAffordable Care Act exchanges so that more uninsured individuals can enroll in health care coverage. During the COVID-19 health crisis, Sen. Warner called on the Trump Administration and Congress to make this important change to address the health care coverage crisis we now face. 

In line with the forthcoming announcement by the Biden administration, Sen. Warner’s Health Care Improvement Act provides $100,000,000 in funding to support the administration’s effort to fully fund programs to help more Americans enroll in affordable health care coverage. Additionally, President Biden plans to roll back the Trump administration’s actions to sabotage the Affordable Care Act which has undermined our preparedness for and ability to respond to COVID-19 and protect health care coverage for millions of Americans. In 2019, Sen. Warner led the entire Senate Democratic Caucus in a legislative maneuver to protect health coverage  for Americans with preexisting conditions from the Trump Administration’s attempts to undermine those safeguards.

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