House passes $1.9T COVID-19 relief package that temporarily boosts ACA subsidies, expands Medicaid

The House passed an enormous $1.9 trillion COVID-19 relief package that boosts subsidies for Affordable Care Act plans and gives money for vaccine distribution.

The 219 to 212 vote early Saturday morning now sends the package to the Senate. While the package includes some key healthcare items, it does not include any new money for a provider relief fund created by the CARES Act to help plug financial holes caused by the pandemic.

Hospital groups are already lobbying the Senate in hopes of changing that. The American Hospital Association (AHA) is pressing to get $35 billion added to the package.

A key part of the package is a temporary two-year increase in the subsidies for plans sold on the ACA’s exchanges.

If signed into law, individuals making income 400% above the federal poverty level would pay 8.5% of their income on healthcare. Currently, consumers making above 400% are not eligible for any subsidies.

RELATED: Hospitals could lose between $53B and $122B this year due to pandemic

Lower-income customers who also make 150% above the poverty level can now get fully subsidized coverage. Currently those eligible customers pay no more than 4.3% of their income on healthcare.

The legislation also gives premium assistance to cover 85% of the COBRA continuous coverage for eligible individuals and families through Sept. 31. The boost comes as the pandemic has caused major job losses.

There are also several provisions aimed at expanding Medicaid coverage.

It would add a five percentage point increase for two years to the state’s base federal matching rate if the state expands Medicaid under the ACA. So far there are 12 states that have not expanded Medicaid.

The legislation would get rid of a cap on Medicaid drug rebates starting in 2023.

The Centers for Disease Control and Prevention would also get $7.5 billion to promote and administer COVID-19 vaccines.

Democrats are using a parliamentary procedure called reconciliation that lets a budget bill pass the Senate with a simple majority and avoid garnering 60 votes needed to break a filibuster.

Hospital and other provider groups are directing their lobbying efforts to the Senate to add more money to a $178 billion relief fund. The AHA estimated on a call earlier this week that the fund has about $4.4 billion left to give out to providers, who have faced lower revenue due to dropping patient volumes.