An expansion of health coverage.
The legislation would patch numerous holes in the Affordable Care Act, bringing the nation closer to the Democrats’ goal of universal health coverage. The bill would extend generous subsidies that have lowered the cost of premiums for Americans who buy their own insurance. It would permanently extend a program that insures millions of children from low-income families, and would guarantee a year of Medicaid coverage for eligible women in the year after they have a child.
In a provision aimed at vulnerable people without health coverage, it would offer comprehensive health coverage to poor adults who live in 12 states that have declined to expand their Medicaid programs, giving them subsidized access to private Obamacare plans. Several of these changes would expire after 2025, but millions more Americans would gain health coverage in the next few years.
Older Americans would receive a number of new benefits. Medicare would begin covering hearing aids and audiology services in 2023. Medicare’s drug benefit would become more robust, lowering the total amount any patient would be asked to pay to $2,000 a year. And patients who need long-term care services would see new funding to enable them to receive that care at home, instead of a nursing home.
The funding for home-based care is smaller than the president’s initial plan, however, and lawmakers jettisoned popular provisions that would have also added Medicare coverage for eyeglasses and dental care.
For the first time, the government would be given the power to regulate the prices of certain prescription drugs. Medicare would be allowed to negotiate directly with drug makers over a subset of expensive drugs in the coming years. And drugmakers would be barred from raising the prices of their medicines by more than the rate of inflation. The drug price provisions are less aggressive than an original House proposal, but still expected to have substantial effects over time.
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Addressing immigration issues.
The legislation would expand the homeland security secretary’s authority to grant a temporary status known as parole to undocumented immigrants who have lived in the country for a decade, providing them with work permits and shielding them from deportation. The work permits would last five years, and then would need to be renewed.
The proposal would include most undocumented immigrants who have lived continuously in the United States since before Jan. 1, 2011, and could help between 7 million and 8 million people. But significantly, the proposal does not create a new pathway to citizenship after such plans were disqualified under Senate rules.