As part of a $3.5 trillion package proposal, Congressional Democrats are crafting a new federal program to provide health insurance coverage to more than 2 million people living in the 12 U.S. states that declined to expand Medicaid under the Affordable Care Act (ACA).
First, the plan would subsidize private insurance on the ACA marketplace for this population until 2025 or 2026, when a new federal coverage program would kick in. As the program could represent a step toward a larger, government-run public health insurance option, it may draw criticism from the health care industry.
"We have significant concerns with any proposal that would establish a new Federal Medicaid lookalike program to fill the coverage gap," the Federation of American Hospitals wrote to Congress in August. "The formation and implementation of a new federal program or a Medicaid public option would be complex and costly, burdened by bureaucracy and rulemaking that would unnecessarily delay access to care for millions." The group suggested permanently subsidizing private ACA marketplace insurance instead.