By Katie Horneffer, Intern, Care4Carolina
On November 19, the U.S. House of Representatives passed the Build Back Better Act, a $1.75 trillion bill focused on social policy. Senate Leader Chuck Schumer is pushing the Senate to pass the Build Back Better Act by the end of the year. Importantly for North Carolinians, Build Back Better “includes numerous provisions that would dramatically strengthen and expand both public and private health insurance coverage.” Moreover, it builds on the health provisions and incentives included in the American Rescue Plan.
Recognizing the important of state efforts to increase health insurance access, the Build Back Better Act includes some new incentives to close the coverage gap. For example, the legislation will increase the federal match rate for closing the gap from 90% to 93% for three years. Additionally, in states that haven’t closed their coverage gap, hospitals will see a decrease in the federal funds that help cover the costs of care provided to uninsured patients.
Should North Carolina not close its coverage gap, Build Back Better creates a short-term solution allowing North Carolinians to purchase coverage through the Health Insurance Marketplace, with the federal government covering the full cost of monthly premiums. Through this plan, the federal government would limit the amount people have to pay out-of-pocket every time they receive care, making the plan comparable to Medicaid. This temporary program would be available from 2022 to 2025.
While this federal solution would improve North Carolinians’ access to health insurance, it would not provide the comprehensive healthcare solution that could be attained if North Carolina administered its own program. Additionally, through this program, North Carolina is missing out on the opportunity to draw down near $2 billion in federal dollars to close the gap on its own. Our state would not see the same level of economic benefits or job growth from a federal solution to close the gap.
The solution to close the coverage gap in the Build Back Better Act would be critical for improving the health of North Carolinians. At the same time, we need to continue to push for a permanent, state-level solution. The Build Back Better Act serves as an important first step to closing the coverage gap. We must continue to ask our leaders—at both the federal and state level—to fight for affordable health insurance for North Carolinians.