This week, the House of Representatives passed legislation that would significantly expand the Affordable Care Act (ACA). The bill’s passage, however, is mainly symbolic in this presidential election year, intended to show the differences between the parties on affordable health care access during the COVID-19 pandemic. The legislation passed on an almost full party-line vote of 234 – 179 and is not expected to move in the Republican-controlled Senate. Following passage, the White House also announced that the President would veto the bill. Still, it is the first major expansion of the health law since it passed in 2010.

The House-passed ACA expansion bill would do the following:

• Expands federal subsidies for ACA health insurance coverage by eliminating the 400 percent of federal poverty eligibility cap for such subsidies and setting new maximum for silver health plan coverage premiums at 8.5 percent of individual or family income.
• Incentivizes the 14 states that have not accepted the ACA Medicaid expansion to do so by ensuring that the federal government would pay the full cost of the expansion for the first three years; reduces federal matching funds for traditional Medicaid programs in states that have not implemented the Medicaid expansion.
• Guarantees Medicaid coverage for one year after women give birth.
• Rescinds the Administration’s rule extending the duration of short-term health plans to 12 months, returning the duration to the original 3-month limit.
• Restores $100 million for ACA outreach and enrollment activities, funding which the Administration had eliminated.
• Ensures a permanent extension of the CHIP program, eliminating the need for program renewals every five years.
• Permits Medicare to negotiate drug prices with industry for high-cost single manufacturer drugs.

The Trump administration is seeking to invalidate the entire ACA in a lawsuit initiated by a group of Republican states, led by Texas, who contend that the entire law is unconstitutional. The Administration reiterated this position when it filed a friend of the court petition opposing the full ACA last week, which Democrats frequently pointed to during House floor debate of the bill. The Supreme Court will hear arguments in the fall of 2020 but will not issue its decision on the fate of the ACA – and the 26 million Americans insured under it – until after the 2020 elections.