En español | The third leg of President Joe Biden's domestic proposals, the American Families Plan, would make permanent increased subsidies for the Affordable Care Act and also create a national paid family and medical leave program.
The proposal was released on April 28 ahead of the president's first address to a joint session of Congress. The plan invests heavily in education — from preschool to college — as well as child care and nutrition. According to a senior White House official who briefed reporters, even though the latest proposal does not include several major health initiatives that would particularly benefit older Americans, including changes to the Medicare program, “The President has been very, very clear that he remains fully committed to negotiations to reduce prescription drug prices.”
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ACA subsidies would be permanent
The proposal seeks $200 billion to make the increased Affordable Care Act (ACA) subsidies that were included in the American Rescue Plan permanent. As of now, those increases would remain in effect only for 2021 and 2022. The subsidies would:
- Remove the cap — at 400 percent of the federal poverty level ($51,520 for an individual) — on ACA subsidies, so more people would qualify for monthly premium assistance.
- Limit the cost of health insurance premiums for those who buy insurance through the marketplaces to no more than 8.5 percent of their annual income. That could make marketplace insurance more affordable, especially for older Americans. In 2019, for example, a single 64-year-old earning $49,000 who bought health insurance in the marketplace faced an average premium that was 30 percent of his or her income.
- Save families who buy health insurance through the marketplaces an average of $50 a month. The White House says 9 million people would save on their premiums.
National family and medical leave program
The plan points to AARP research that found that 1 in 5 retirees left or were forced to leave the workforce earlier than planned to care for a sick family member. The proposal also says that 95 percent of the lowest wage workers — mostly women and people of color — do not have access to paid family leave. The plan would:
- Invest $225 million over 10 years.
- Guarantee 12 weeks of paid parental, family and personal illness leave by the 10th year of the program.
- Provide workers on leave up to $4,000 a month, which would replace two-thirds of average weekly wages.
Dena Bunis covers Medicare, health care, health policy and Congress. She also writes the Medicare Made Easy column for the AARP Bulletin. An award-winning journalist, Bunis spent decades working for metropolitan daily newspapers, including as Washington bureau chief for the Orange County Register and as a health policy and workplace writer for Newsday.