On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (the ARP), a wide-ranging package of health care and economic measures responding to the coronavirus pandemic. The ARP includes a broad expansion of the Affordable Care Act’s (ACA) main health insurance subsidy, the premium tax credit (PTC), the first major expansion of the health care reform law since its passage. This piece highlights the policymaking considerations that states must account for in light of the PTC expansion and uncertainty about future federal action. A key theme that emerges is that states will benefit from approaches that give them the flexibility to adjust policies year by year as the federal landscape develops.
Understanding the Graham-Cassidy Proposal: Implications for States
In a final effort to pass a bill to repeal and replace the Affordable Care Act before reconciliation instructions expire on September 30th, Senators Graham and Cassidy are advancing a proposal that would retain many key provisions of the Better Care Reconciliation Act (BCRA) – including per capita caps for Medicaid non-expansion populations – and replace federal funding for tax credits, cost sharing reductions, Medicaid expansion, and the Basic Health Program with a capped allotment that would be distributed to states in the form of a block grant. Continuing our webinar series on the impacts of repeal and replace proposals for states, the Robert Wood Johnson Foundation’s State Health and Values Strategies (SHVS) program, together with technical assistance experts from Manatt Health, hosted a webinar on Friday September 22nd that provided an overview of the Graham-Cassidy proposal and discussed implications for states, including the impact of federal funding for Medicaid and Marketplace subsidies.