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Lawmakers Urge Support for Expanded Healthcare Tax Credit

APR. 19, 2022

Lawmakers Urge Support for Expanded Healthcare Tax Credit

DATED APR. 19, 2022
DOCUMENT ATTRIBUTES
  • Authors
    Underwood, Rep. Lauren
    Williams, Rep. Nikema
    Adams, Rep. Alma
    Allred, Rep. Colin
    Axne, Rep. Cynthia "Cindy"
    Barragán, Rep. Nanette
    Bishop, Rep. Sanford D., Jr.
    Rochester, Rep. Lisa Blunt
    Bonamici, Rep. Suzanne
    Bourdeaux, Rep. Carolyn
    Brown, Anthony G.
    Cárdenas, Rep. Tony
    Castor, Rep. Kathy
    Castro, Rep. Joaquin
    Cherfilus-McCormick, Rep. Shelia
    Chu, Rep. Judy
    Cicilline, Rep. David N.
    Clarke, Rep. Yvette D.
    Connolly, Rep. Gerald E.
    Cooper, Rep. Jim
    Craig, Rep. Angie Dawn
    Crow, Rep. Jason
    Dean, Rep. Madeleine
    DeFazio, Rep. Peter A.
    DeGette, Rep. Diana
    DeSaulnier, Rep. Mark
    Dingell, Rep. Debbie
    Doggett, Rep. Lloyd
    Espaillat, Rep. Adriano
    Gallego, Rep. Ruben
    Grijalva, Rep. Raúl M.
    Hayes, Rep. Jahana
    Horsford, Rep. Steven
    Johnson, Rep. Eddie Bernice
    Johnson, Rep. Henry C., Jr.
    Brownley, Rep. Julia
    Kildee, Rep. Daniel T.
    Kilmer, Rep. Derek
    Larson, Rep. John B.
    Lawrence, Rep. Brenda L.
    Lawson, Rep. Al, Jr.
    Levin, Rep. Andy
    Malinowski, Rep. Tom
    Maloney, Rep. Carolyn B.
    Manning, Rep. Kathy E.
    Matsui, Rep. Doris O.
    McBath, Rep. Lucy
    McNerney, Rep. Jerry
    Moore, Rep. Gwen
    Norton, Del. Eleanor Holmes
    Pappas, Rep. Chris
    Porter, Rep. Katie
    Price, Rep. David E.
    Quigley, Rep. Mike
    Raskin, Rep. Jamie
    Ross, Rep. Deborah K.
    Ruiz, Rep. Raul
    Sánchez, Rep. Linda T.
    Sarbanes, Rep. John P.
    Schneider, Rep. Bradley Scott
    Schrier, Rep. Kim
    Scott, Rep. David
    Sewell, Rep. Terri A.
    Stevens, Rep. Haley M.
    Thompson, Rep. Mike
    Thompson, Rep. Bennie G.
    Tlaib, Rep. Rashida
    Torres, Rep. Ritchie
    Trahan, Rep. Lori
    Trone, Rep. David J.
    Veasey, Rep. Marc A.
    Welch, Sen. Peter
    Nadler, Rep. Jerrold
    Newman, Rep. Marie
  • Institutional Authors
    U.S. House of Representatives
  • Subject Area/Tax Topics
  • Industry Groups
    Health care
    Insurance
  • Jurisdictions
  • Tax Analysts Document Number
    2022-12921
  • Tax Analysts Electronic Citation
    2022 TNTF 76-9

UNDERWOOD, WILLIAMS LEAD EFFORT TO PERMANENTLY LOWER HEALTH CARE COSTS

April 19, 2022

WASHINGTON — Today, Congresswomen Lauren Underwood (IL-14) and Nikema Williams (GA-05) led a group of more than 70 Members of Congress in urging Senate Majority Leader Charles Schumer (D-NY) to include provisions in reconciliation legislation to permanently lower out-of-pocket health premium costs and extend Medicaid coverage to people in states that have refused to expand the program. These provisions would lower health care costs at a time when families are experiencing increased costs of living due to inflation and prevent premium increases at the end of this year when expanded tax credits are set to expire.

“As negotiations continue around reconciliation legislation, we write to express our support for critical provisions to permanently lower out-of-pocket health care premium costs and ensure that low-income Americans in every state have health care coverage . . . We have a once-in-a-generation opportunity to make high-quality care affordable and accessible for all,” the Members wrote.

In the letter, the Members called on the Senate to include two permanent health care provisions in a reconciliation package. The first provision, Underwood's Health Care Affordability Act, was included on a temporary basis in the American Rescue Plan and has saved families an average of $2,400 per year on Marketplace health care premiums, leading to a record 14.5 million people signing up for Marketplace plans during the 2022 Open Enrollment period.

The second provision Members advocated for would ensure that low-income people living in states that have refused to expand Medicaid can finally gain coverage. Since the enactment of the Affordable Care Act, states have had the power to expand Medicaid eligibility to individuals who have incomes up to 133 percent of the Federal Poverty Level. However, 12 states have continued to deny millions of Americans Medicaid coverage, 60% of whom are people of color. Making this provision permanent would help close the coverage gap and ensure low-income residents achieve affordable, quality coverage.

Along with Underwood and Williams; Alma S. Adams, Ph.D. (NC-12); Colin Allred (TX-32); Cindy Axne (IA-03); Nanette Diaz Barragán (CA-44); Sanford D. Bishop, Jr. (GA-02); Lisa Blunt Rochester (DE-At Large); Suzanne Bonamici (OR-01); Carolyn Bourdeaux (GA-07); Anthony G. Brown (MD-04); Tony Cárdenas (CA-29); Kathy Castor (FL-14); Joaquin Castro (TX -20); Sheila Cherfilus-McCormick (FL-20); Judy Chu (CA-27); David N. Cicilline (RI-01); Yvette D. Clarke (NY-09); Gerald E. Connolly (VA-11); Jim Cooper (TN-05); Angie Craig (MN-02); Jason Crow (CO-06); Madeleine Dean (PA-04); Peter A. DeFazio (OR-04); Diana DeGette (CO-01); Mark DeSaulnier (CA-11); Debbie Dingell (MI-12); Lloyd Doggett (TX-35); Adriano Espaillat (NY-13); Ruben Gallego (AZ-07); Raúl M. Grijalva (AZ-03); Jahana Hayes (CT-05); Steven Horsford (NV-04); Eddie Bernice Johnson (TX-30); Henry C. "Hank" Johnson, Jr. (GA-04); Julia Brownley (CA-26); Daniel T. Kildee (MI-05); Derek Kilmer (WA-06); John B. Larson (CT-01); Brenda L. Lawrence (MI-14); Al Lawson (FL-05); Andy Levin (MI-09); Tom Malinowski (NJ-07); Carolyn B. Maloney (NY-12); Kathy Manning (NC-06); Doris Matsui (CA-06); Lucy McBath (GA-06); Jerry McNerney (CA-09); Gwen Moore (WI-04); Jerrold Nadler (NY-10); Marie Newman (IL-03); Eleanor Holmes Norton (DC-At Large); Chris Pappas (NH-01); Katie Porter (CA-45); David E. Price (NC-04); Mike Quigley (IL-05); Jamie Raskin (MD-08); Deborah K. Ross (NC-02); Raul Ruiz, M.D. (CA-36); Linda T. Sánchez (CA-38); John Sarbanes (MD-03); Brad Schneider (IL-10); Kim Schrier, M.D. (WA-08); David Scott (GA-13); Terri A. Sewell (AL-07); Haley Stevens (MI-11); Mike Thompson (CA-02); Bennie Thompson (MS-02); Rashida Tlaib (MI-13); Ritchie Torres (NY-15); Lori Trahan (MA-03); David Trone (MD-06); Marc Veasey (TX-33); and Peter Welch (VT-At Large) joined the letter.

Full text of the letter can be found here and below.

April 19, 2022

The Honorable Charles E. Schumer
Majority Leader
United States Senate
Washington, DC 20510

Dear Majority Leader Schumer,

We are grateful for your ongoing commitment to ensuring that every American has access to high-quality, affordable health care. As negotiations continue around reconciliation legislation, we write to express our support for critical provisions to permanently lower out-of-pocket health care premium costs and ensure that low-income Americans in every state have health care coverage. Specifically, we write to express our strong support for Sections 137301 and 30601 of H.R. 5376, which passed the House of Representatives on November 19, 2021, and to encourage you to pursue opportunities to make the historic coverage and affordability gains in these sections permanent.

Section 137301 would extend the advance premium tax credit expansion included in the American Rescue Plan Act, which is currently set to expire at the end of this year, leading consumers to face higher out-of-pocket premium costs starting in 2023. The expansion of these tax credits is essential to lower health care costs and implement the largest expansion of coverage since the Affordable Care Act was signed into law more than a decade ago.

Thanks to the enhanced advance premium tax credits in the American Rescue Plan Act, individuals and families have seen their health care costs decrease substantially. Monthly premiums for Marketplace plans have decreased by $50 per person on average, four out of five enrollees can find a plan for $10 or less per month, and an average of three out of five uninsured eligible adults may be able to enroll in a zero-premium plan.1

These lower costs have led to historic coverage gains across the country: a record 14.5 million people signed up for Marketplace plans during the Open Enrollment period for 2022 coverage and more than 9 in 10 enrollees will receive premium tax credits.2 Families are saving an average of $2,400 per year on their health care premiums.3

The expanded advance premium tax credits in the American Rescue Plan are also essential for promoting equity. Given that the uninsured rate for Black adults is 1.6 times higher than the rate for white adults, and the rate for Hispanic adults is 3.2 times higher,4 coverage gains will help to address the persistent disparities that can be seen in a wide range of financial and health outcomes, from chronic disease incidence5 to maternal mortality.6 Uninsured rates are also higher in rural areas than urban areas,7 threatening to worsen health outcomes in rural communities already facing lower life expectancies8 and increased risk for death from heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke.9

According to the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services, thanks to the American Rescue Plan Act, approximately 65.5 percent of Black adults are now able to access a zero-premium plan and 75.5 percent can find a plan for $50 or less per month. Among Hispanic adults, approximately 68.7 percent now have access to a zero-premium plan and 79.9 percent can now find a plan for $50 or less per month.10 The American Rescue Plan Act advance premium tax credit expansion is expected to make zero-and low-premium health plans available to 78.7 percent and 88.4 percent, respectively, of current HealthCare.gov enrollees in rural counties.11 By permanently extending the expanded advance premium tax credit through reconciliation, we can continue these transformational health equity gains in communities of color and rural communities across the country.

As the COVID-19 pandemic has demonstrated, every American must be able to access quality, affordable health care. Thanks to the American Rescue Plan Act, more individuals and families have been able to find affordable coverage than ever before. However, there is more work to do, particularly in states that chose not to expand Medicaid under the Affordable Care Act.

Since the enactment of the Affordable Care Act, states have had the power to expand Medicaid eligibility to individuals who have incomes up to 133 percent of the Federal Poverty Line. While 38 states and D.C. have since expanded Medicaid to these residents, 12 states continue to deny their expansion populations access to Medicaid due to continued partisan opposition to the Affordable Care Act. Meanwhile, millions of Americans — 60 percent of whom are people of color — continue to be ineligible for affordable, high-quality health care simply because of their ZIP code.

In the American Rescue Plan Act, Congress and President Biden addressed this inequity by providing financial incentives to non-expansion states to finally extend Medicaid, but not a single additional state took advantage of this opportunity to expand coverage. Building on the Affordable Care Act and fulfilling the promise of universal health coverage requires us to close the coverage gap and ensure lower-income residents in Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, and Wyoming can finally get the affordable, quality coverage they have long awaited. We must ensure the language in Section 30601 of H.R. 5376 is signed into law as we work to achieve our vision of Building a Better America, and we must work to make the language in this section permanent.

We have a once-in-a-generation opportunity to make high-quality care affordable and accessible for all. We stand ready to join you in working to pass this critical legislation through Congress and get it signed into law swiftly. Thank you for your leadership in this urgent work to extend the economic security and health protections of health care coverage to every American.

Sincerely,

Lauren Underwood
Member of Congress

Nikema Williams
Member of Congress

Alma S. Adams, Ph.D.
Member of Congress

Colin Allred
Member of Congress

Cindy Axne
Member of Congress

Nanette Diaz Barragán
Member of Congress

Sanford D. Bishop, Jr.
Member of Congress

Lisa Blunt Rochester
Member of Congress

Suzanne Bonamici
Member of Congress

Carolyn Bourdeaux
Member of Congress

Anthony G. Brown
Member of Congress

Tony Cárdenas
Member of Congress

Kathy Castor
Member of Congress

Joaquin Castro
Member of Congress

Sheila Cherfilus-McCormick
Member of Congress

Judy Chu
Member of Congress

David N. Cicilline
Member of Congress

Yvette D. Clarke
Member of Congress

Gerald E. Connolly
Member of Congress

Jim Cooper
Member of Congress

Angie Craig
Member of Congress

Jason Crow
Member of Congress

Madeleine Dean
Member of Congress

Peter A. DeFazio
Member of Congress

Diana DeGette
Member of Congress

Mark DeSaulnier
Member of Congress

Debbie Dingell
Member of Congress

Lloyd Doggett
Member of Congress

Adriano Espaillat
Member of Congress

Ruben Gallego
Member of Congress

Raúl M. Grijalva
Member of Congress

Jahana Hayes
Member of Congress

Steven Horsford
Member of Congress

Eddie Bernice Johnson
Member of Congress

Henry C. "Hank" Johnson, Jr.
Member of Congress

Julia Brownley
Member of Congress

Daniel T. Kildee
Member of Congress

Derek Kilmer
Member of Congress

John B. Larson
Member of Congress

Brenda L. Lawrence
Member of Congress

Al Lawson
Member of Congress

Andy Levin
Member of Congress

Tom Malinowski
Member of Congress

Carolyn B. Maloney
Member of Congress

Kathy Manning
Member of Congress

Doris Matsui
Member of Congress

Lucy McBath
Member of Congress

Jerry McNerney
Member of Congress

Gwen Moore
Member of Congress

Jerrold Nadler
Member of Congress

Marie Newman
Member of Congress

Eleanor Holmes Norton
Member of Congress

Chris Pappas
Member of Congress

Katie Porter
Member of Congress

David E. Price
Member of Congress

Mike Quigley
Member of Congress

Jamie Raskin
Member of Congress

Deborah K. Ross
Member of Congress

Raul Ruiz, M.D.
Member of Congress

Linda T. Sánchez
Member of Congress

John P. Sarbanes
Member of Congress

Brad Schneider
Member of Congress

Kim Schrier, M.D.
Member of Congress

David Scott
Member of Congress

Terri A. Sewell
Member of Congress

Haley Stevens
Member of Congress

Mike Thompson
Member of Congress

Bennie Thompson
Member of Congress

Rashida Tlaib
Member of Congress

Ritchie Torres
Member of Congress

Lori Trahan
Member of Congress

David Trone
Member of Congress

Marc Veasey
Member of Congress

Peter Welch
Member of Congress

FOOTNOTES

1U.S. Department of Health and Human Services: HHS Secretary Becerra Announces Reduced Costs and Expanded Access Available for Marketplace Health Coverage Under the American Rescue Plan. April 1, 2021.

2Centers for Medicare & Medicaid Services: Biden-Harris Administration Announces 14.5 Million Americans Signed Up for Affordable Health Care During Historic Open Enrollment Period. January 27, 2022.

3President Joseph R. Biden, Jr: Statement by President Biden on 4.6 Million Americans Gaining Health Insurance This Year. December 22, 2021.

4Centers for Disease Control and Prevention National Center for Health Statistics: Health Insurance and Access to Care. March 2018.

5U.S. Department of Health and Human Services Office of Minority Health: Minority Population Profiles. Accessed April 22, 2021.

6Centers for Disease Control and Prevention: Racial/Ethnic Disparities in Pregnancy-Related Deaths — United States, 2007– 2016. September 6, 2019.

7United States Census Bureau: Rates of Uninsured Fall in Rural Counties, Remain Higher Than Urban Counties. April 9, 2019.

8Gopal K. Singh & Mohammad Siahpush: Widening rural-urban disparities in life expectancy, U.S., 1969-2009. February 2014.

9Centers for Disease Control and Prevention: About Rural Health. Accessed December 27, 2021.

10Assistant Secretary for Planning and Evaluation Office of Health Policy: Access to Marketplace Plans with Low Premiums on the Federal Platform. April 1, 2021.

11Ibid.

END FOOTNOTES

DOCUMENT ATTRIBUTES
  • Authors
    Underwood, Rep. Lauren
    Williams, Rep. Nikema
    Adams, Rep. Alma
    Allred, Rep. Colin
    Axne, Rep. Cynthia "Cindy"
    Barragán, Rep. Nanette
    Bishop, Rep. Sanford D., Jr.
    Rochester, Rep. Lisa Blunt
    Bonamici, Rep. Suzanne
    Bourdeaux, Rep. Carolyn
    Brown, Anthony G.
    Cárdenas, Rep. Tony
    Castor, Rep. Kathy
    Castro, Rep. Joaquin
    Cherfilus-McCormick, Rep. Shelia
    Chu, Rep. Judy
    Cicilline, Rep. David N.
    Clarke, Rep. Yvette D.
    Connolly, Rep. Gerald E.
    Cooper, Rep. Jim
    Craig, Rep. Angie Dawn
    Crow, Rep. Jason
    Dean, Rep. Madeleine
    DeFazio, Rep. Peter A.
    DeGette, Rep. Diana
    DeSaulnier, Rep. Mark
    Dingell, Rep. Debbie
    Doggett, Rep. Lloyd
    Espaillat, Rep. Adriano
    Gallego, Rep. Ruben
    Grijalva, Rep. Raúl M.
    Hayes, Rep. Jahana
    Horsford, Rep. Steven
    Johnson, Rep. Eddie Bernice
    Johnson, Rep. Henry C., Jr.
    Brownley, Rep. Julia
    Kildee, Rep. Daniel T.
    Kilmer, Rep. Derek
    Larson, Rep. John B.
    Lawrence, Rep. Brenda L.
    Lawson, Rep. Al, Jr.
    Levin, Rep. Andy
    Malinowski, Rep. Tom
    Maloney, Rep. Carolyn B.
    Manning, Rep. Kathy E.
    Matsui, Rep. Doris O.
    McBath, Rep. Lucy
    McNerney, Rep. Jerry
    Moore, Rep. Gwen
    Norton, Del. Eleanor Holmes
    Pappas, Rep. Chris
    Porter, Rep. Katie
    Price, Rep. David E.
    Quigley, Rep. Mike
    Raskin, Rep. Jamie
    Ross, Rep. Deborah K.
    Ruiz, Rep. Raul
    Sánchez, Rep. Linda T.
    Sarbanes, Rep. John P.
    Schneider, Rep. Bradley Scott
    Schrier, Rep. Kim
    Scott, Rep. David
    Sewell, Rep. Terri A.
    Stevens, Rep. Haley M.
    Thompson, Rep. Mike
    Thompson, Rep. Bennie G.
    Tlaib, Rep. Rashida
    Torres, Rep. Ritchie
    Trahan, Rep. Lori
    Trone, Rep. David J.
    Veasey, Rep. Marc A.
    Welch, Sen. Peter
    Nadler, Rep. Jerrold
    Newman, Rep. Marie
  • Institutional Authors
    U.S. House of Representatives
  • Subject Area/Tax Topics
  • Industry Groups
    Health care
    Insurance
  • Jurisdictions
  • Tax Analysts Document Number
    2022-12921
  • Tax Analysts Electronic Citation
    2022 TNTF 76-9
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