Joe Biden's plan to make the Affordable Care Act more affordable

Joe Biden speaks at an event about affordable health care. Photo: Jim Watson/AFP via Getty Images

Joe Biden's proposal to increase Affordable Care Act subsidies and open the marketplace to people with employer insurance could save millions of people hundreds of dollars a month, according to a new Kaiser Family Foundation analysis.

Why it matters: Biden's plan to build on the ACA — making it more affordable and drawing more people onto its exchanges — sets up a stark contrast with President Trump's vision, which is to tear the entire law down.

The big picture: Biden's proposal for a public option got a lot more attention during the primary, as it was contrasted against Medicare for All.

  • While less flashy, expanding ACA subsidies could enormously benefit middle-class people — particularly older people who live in more rural areas — who don't qualify for subsidies and so spend a large portion of their income on premiums each month.
  • It could also be helpful for people who spend a lot on employer insurance, but are barred from choosing a subsidized plan on the individual market.

Driving the news: Affordable coverage options have become even more important during the pandemic, as millions of Americans lose their jobs and their insurance.

  • Employers looking to reduce expenses are increasingly opting out of providing health coverage, a problem that is likely to get worse, the NYT reported yesterday.

By the numbers: Biden has proposed to limit what anyone pays in premiums to 8.5% of their income, and to change the way subsidies are calculated.

  • This would lower the cost of coverage for nearly everyone who is already enrolled in an ACA plan, as well as for those who can't afford this coverage, per KFF.
  • A 40-year-old making $50,000 a year — which is just above the subsidy threshold — would save 32% a month on premiums for a lower-deductible ACA plan. A 60-year-old with the same income would pay 66% less a month.
  • More than 12 million people with employer insurance would spend less on premiums if they switched to an ACA plan subject to premium caps.

Yes, but: "Any health reform plan involves trade-offs. In the case of Biden's, it's primarily the budgetary cost — an estimated $750 billion over 10 years, according to the campaign," KFF's Larry Levitt tweeted.

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