Pros & Cons of the Biden Healthcare Plan

Yesterday I posted the Pros & Cons of the health care plan that was proposed in 2017 and subsequently failed to be passed by Congress.  While much of the information from that post was taken from Trump’s 2017 plan, I was not able to find any type of revised plan by Trump that doesn’t hold the same pros and cons. 

Today, I am going to provide the pros and cons of the Biden Plan.  While much of his plan simply builds off of the already in-effect Affordable Care Act (ObamaCare), there are a few major points that actually revise Obamacare into a better plan than originally passed. 

Pros:

• Adding a Public Option to the ACA that will provide insurance coverage for approximately 97% of all Americans.  Despite the arguments put out by the Republican party, this is NOT “Coverage for All” but rather an option made available on top of the private options for individuals to PURCHASE from the government.  Biden’s public option is not part of Medicare, but rather more like an expansion of Medicaid.
• Because of the Government’s large bargaining power, the rates on a public insurance option would likely be more in tune with the rates of Medicare policies.
• Separately, Biden’s plan includes a proposal to expand the existing Medicare program by lowering the eligibility age from 65 to 60. This makes millions of Americans eligible for coverage sooner. 
• The current ACA caps the amount of income that a family can make in order to receive a tax credit toward the purchase of their health coverage.  Biden’s plan removes that income cap which would allow all American’s who purchase their coverage through the ACA Marketplace to receive help from the government.
• Tax credits would be calculated based on “Gold” plans instead of “Silver” plans; this should help bring down the out-of-pocket costs.
• It will allow Medicare to negotiate lower drug prices with the pharmaceutical companies in turn saving Seniors money on their drug costs.
• The Biden plan allows Americans to purchase their medications from other countries, such as Canada, which in turn promotes competition in the pharmaceutical industry making prices trend down
• Tax loopholes that only benefit that super-wealthy through Capitol Gains tax law would be eliminated, making the “playing field” when it comes to taxation between the poor & the wealthy a little bit more even. 
• A cap of 8.5% of the individual purchaser’s income would go into effect, meaning that insurance companies could no longer “gouge” consumers with high premiums that are unaffordable.
• Since some states did not expand their state Medicaid system under the ACA of the Obama Administration, Biden’s plan would provide a Federal Program that would allow low-income families in the non-expansion states to be covered.
• The new plan will ban “surprise bills” for insureds that require “out-of-network” hospital care.
• Mandate the coverage of pre-existing conditions. (the ACA includes this component as well, however, the Trump administration has worked throughout his first-term to remove this requirement & no longer require insurance providers to cover individuals with pre-existing conditions.)
• An Independent Review Board would be established to review the value of all new drugs being launched by pharmaceutical companies. This board would have the power to set prices for these new drugs and would try got stop Pharmaceutical companies from abusively pricing new drugs.
• Premium increases would be limited to the rate of inflation.  Drugmakers would incur a tax penalty if they raise prices more than this rate.
• End tax breaks to Pharmaceutical companies for advertising.
• The government would take a more active stance on the enforcement of Antitrust laws against mergers of companies within the medical industry.
• A long-needed overhaul to the caregiving infrastructure that would create jobs, improve working conditions & create/invest in new models on long-term care outside of the nursing home setting.
• Restore funding to organizations like Planned Parenthood.
• Double funding for community health centers.
• Support & encourage the expansion of funding for mental health services by enforcing the Mental Health Parity Law.

Cons:

• Biden’s plan would cost taxpayers $750 billion over 10 years.  This would paid for by ending the Trump tax cuts which in turn could effect the amount of taxes paid by lower-income workers.
• A shift of more Americans being covered under the Medicare system would mean lower reimbursements to the medical providers.  While this would not be a con to the majority of Americans, it is a downside for anyone in the medical profession who’s income is, in part, dependent upon Medicare reimbursement.
• The plan does not address the overall costs of medical care in the United States.  While lower insurance premiums help working-class Americans and Lower Income citizens; there are still no regulations on how much a person would have to pay out of pocket for services.  There is no plan limiting the deductibles that Americans will have to pay, the amount of “co-insurance” required by insurers or the overall costs in general for medical treatment. 
• I was unable to locate anything in Biden’s plan that discusses the “mandate” which was included in the Affordable Care Act.  Though the Trump Administration and the Republican-led Congress have made it clear they would like to get rid of the mandate, it is not entirely clear if the mandate is or isn’t still in effect. In either case, Biden makes no promise that if removed by the Trump Administration that he would not “add it back in” if elected President.  But, he also does not address if he would leave it out.  This is a big negative for anyone who feels they should not be “forced” into having medical care or be fined.  In my opinion, I don’t understand why anyone would not want to have health insurance (besides cost), however, without insurance, should a person fall victim to illness, the costs out of pocket are astronomical. 
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So, is the Biden Plan enough?  If you are looking for my opinion, no it is not enough, however, is a HUGE leap forward as opposed to the plan offered by the Trump Administration.  As health care costs continue to rise, Health Insurance Companies are banking record profits year after year after year.  How?  Because of their unscrupulous increases of insurance premiums to consumers and the way insurance companies like to deny coverage for procedures or medications that they “deem” to be “unnecessary.  It doesn’t matter if those procedures or medications may cure someone of whatever ails them.  Americans are expected to pay a monthly premium, then on top of that, they are required to pay for medical care & services until a deductible is met.  Often times this deductible is more than a monthly house or rent payment.  After that is paid, while continuing to pay a monthly premium, they then have to pay a co-insurance or a percentage of the total bill.  For example, let’s say Suzy pays $450 per month for her coverage.  The plan she has purchased requires her to pay the first $1000 of care.  This is automatically an expense of $6400 per year.  Let’s say Suzy meets her $1000 deductible which now means her insurance company will pay 75% of all of her care with In-Network providers.  But, her coverage requires her to pay a co-insurance of $4000 more (a total of $5000 w/the $1000 deductible)  before they will provide 100% coverage.  This means that Suzy is required to pay $10,400 per year of her income just for medical coverage.  The problem is that Suzy only brings home about $25,000 a year.  This means that, not including any medications or over-the-counter medical costs she may incur, nearly 42% of her income is paying for her medical care.  This is more than most financial experts recommend a person pays for their housing!