Study: Reform Law Adjustment Could Expand Access in California
An additional 144,000 Californians could become eligible for health care coverage subsidiesÂ if a provision in the federal health reform law is amended, according to a study from UC-Berkeley and UCLA, The Hill's "Healthwatch" reports (Pecquet, "Healthwatch," The Hill, 12/13).
Background on the Provision
The provision stipulates that if workers contribute more than 9.5% of their income toward employer-sponsored health benefits, they qualify for federal subsidies to purchase health plans through state insurance exchanges.
Many family health advocates believed the provision also applied to family coverage. However, the Joint Committee on Taxation in 2010 interpreted the measure to mean that workers and their families are not eligible for subsidies as long as the employer's individual plan is affordable, regardless of the cost of family coverage.
Advocates say the cost of buying insurance for the entire family could be too high for some workers without subsidies (California Healthline, 7/22).
Key Study Details
According to the study, if the provision were modified to determine affordability based on the cost of a family plan, an extra 144,000 California residents would be eligible for coverage (UC-Berkeley release, 12/13).
Ken Jacobs of the UC-Berkeley Center for Labor Research and Education said that if the data on California are extrapolated to represent the U.S. as a whole, more than one million residents could gain access to coverage (Bunis, CQ HealthBeat, 12/13).
The study's authors recommended that federal regulators change the provision to exclude individuals with affordable workplace insurance from receiving subsidies but still let their families receive them ("Healthwatch," The Hill, 12/13).
Potential for Increasing Costs?
Supporters of the current provision say adding dependents to the calculation would dramatically increase the cost of the subsidies for the federal government.
However, Gerald Kominski -- incoming director of the UCLA Center for Health Policy Research -- said that it would not be a problem because fewer "than 1% of people with employer-based coverage would move to subsidized coverage in the exchange as a result of having unaffordable coverage" (CQ HealthBeat, 12/13).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.