Feb 17, 2021 - Health

Democrats' very pricey, very small health care coverage expansion

Picture of House Speaker Nancy Pelosi

House Speaker Nancy Pelosi. Photo: Anna Moneymaker/Bloomberg via Getty Images

The Congressional Budget Office doesn't expect much from House Democrats' plan to temporarily expand health care coverage through the Affordable Care Act.

The big picture: According to CBO's estimates, Democrats' proposals would cover fewer than 2 million uninsured Americans — at a cumulative cost of over $50 billion.

Details: Democrats on the House Ways and Means Committee want to make more people eligible for the ACA's premium subsidies and increase the value of those subsidies for people who already get them. Both changes would be temporary.

  • Those changes would cover about 1.3 million uninsured people next year, CBO projects, and would end up costing the federal government about $34 billion.
  • Offering full subsidies to people receiving unemployment benefits would cost another $4.5 billion. And people wouldn't have to pay back excess subsidies from last year, adding another $6.3 billion.
  • Separately, Democrats' plan to subsidize COBRA benefits would cover about 600,000 otherwise uninsured Americans, along with over 1.6 million more who would have otherwise had some other form of coverage, at a cost of $7.8 billion.

By the numbers: That comes out to nearly $53 billion, for a set of policies that would, per CBO's estimates, cover 800,000 uninsured Americans this year, 1.3 million in 2022 and 400,000 in 2023, before phasing out.

Our thought bubble ... This does not seem like a particularly efficient, or even effective, way to achieve Democrats' primary goal: Offering a bridge to the millions of people who lost their health insurance when they or their family members lost their jobs amid the pandemic.

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