By Center on Budget and Policy Priorities | Feb. 10, 2021

COVID-19 relief legislation that House committees are considering includes several vital provisions that would make comprehensive coverage more affordable and accessible for millions of people. The legislation would enhance premium tax credits available through the health insurance marketplaces for two years, boost financial incentives for additional states to rapidly expand Medicaid, and enact other proposals to improve access to health coverage during the health and economic crisis.

Consistent with a proposal President Biden outlined in January, the House bill would eliminate premiums for many low-income people who are already eligible for plans in the Affordable Care Act (ACA) marketplaces and vastly reduce premiums for others. It would extend new help with premiums to people with somewhat higher incomes who face high premium burdens. And the bill would protect marketplace enrollees who experienced income fluctuations last year from large repayments of their premium tax credits to the federal government. Additional provisions would bring down insurance costs for specific populations, such as those who receive unemployment benefits and those who lose their jobs but want to temporarily maintain their job-based health insurance.

The bill also offers a strong incentive for the 14 states that have not yet implemented the ACA’s Medicaid expansion to quickly do so by providing increased federal funds to states that newly expand. If the remaining states expanded Medicaid nearly 4 million uninsured low-income adults, including about 640,000 essential or front-line workers, could gain coverage. Also among those gaining coverage would be over 2 million people now in the so-called coverage gap — that is, people whose incomes are below the poverty line, and thus ineligible for premium tax credits for marketplace coverage, but who are ineligible for Medicaid under their state’s rules.

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