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Extending the American Rescue Plan Act’s enhanced marketplace affordability provisions could benefit nearly 1 million uninsured children and parents
Extending the American Rescue Plan Act’s enhanced marketplace affordability provisions could benefit nearly 1 million uninsured children and parents
- Collection:
- Health Policy and Services Research
- Author(s):
- McMorrow, Stacey, author
Banthin, Jessica, author
Buettgens, Matthew, author
Simpson, Michael, author
Kenney, Genevieve M., author
Wang Pan, Clare, author - Contributor(s):
- Urban Institute, issuing body.
- Publication:
- Washington, DC : Urban Institute, October 2021
- Language(s):
- English
- Format:
- Text
- Subject(s):
- COVID-19 -- economics
Insurance, Health -- economics
Medically Uninsured -- statistics & numerical data
United States
United States. - Genre(s):
- Technical Report
- Abstract:
- Signed into law in March 2021, the American Rescue Plan Act (ARPA) contained numerous provisions aimed at supporting recovery from the COVID-19 pandemic and associated recession. 1 Among these provisions are changes to the subsidy schedule governing access to financial assistance to purchase health insurance coverage in the Affordable Care Act (ACA) Marketplaces. These changes give Americans access to greater financial assistance purchasing coverage through 2022 and have the potential to reduce uninsurance and make coverage more affordable for those already purchasing nongroup coverage. Making these provisions permanent is a topline priority in Senate Democrats’ fiscal year 2022 budget resolution. 2 Though children were not the primary target of the ACA coverage expansions or subsequent efforts to strengthen the ACA, recent increases in children’s uninsurance rates and the critical need to address unmet health needs and catch up on forgone care during the pandemic suggest that removing barriers to health care for children could be particularly important in the coming years (Alker and Corcoran 2020; McMorrow et al. 2020; Gonzalez, Karpman, and Haley 2021). These risks for children are also exacerbated by parents’ rising uninsurance rates and pandemic-related unmet health needs (Gonzalez et al. 2020; Haley, Kenney, Wang Pan, et al. 2021). Children may benefit from extending the ARPA’s enhanced subsidies if they gain coverage or their parents gain coverage or experience premium or OOP cost savings (Wright Burak 2019). In this brief, we consider the impacts of extending the enhanced subsidies on all children and their parents and children under age 6 and their parents. Using the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM), we find the following: (1) Nearly 1 million uninsured children and parents, including approximately 300,000 uninsured children, would gain insurance coverage if ARPA subsidy enhancements were made permanent. (2) About 67,000 uninsured children who would gain coverage through these provisions would be under age 6, and approximately 267,000 uninsured parents who would gain coverage would have a child under age 6. This suggests even more young children could benefit when their parents gain coverage. (3) Nearly two-thirds of the coverage gains for families would be concentrated among children and parents with incomes between 200 and 400 percent of the federal poverty level (FPL). (4) If ARPA subsidy enhancements were made permanent, we project that about 3.3 million children and 6.3 million parents would remain uninsured in 2022, unless additional policy changes are introduced. Most remaining uninsured children would be eligible for Medicaid or the Children’s Health Insurance Program, or CHIP (57.2 percent), or tax credits (13.6 percent). But about 41.2 percent of parents would be ineligible for subsidized coverage because of their immigration status or residence in a state that has not expanded Medicaid under the ACA; this represents approximately 2.6 million parents, including 636,000 uninsured parents who would become eligible for Medicaid if their state were to expand Medicaid under the ACA. (5) Approximately 4.5 million children and parents who had nongroup coverage before the ARPA would experience household premium reductions of 28 percent per person, on average; those with incomes below 200 percent of FPL would save even more, 41 percent per person. Total household spending on premiums and OOP costs would fall by averages of 18 percent per person overall and 25 percent per person in families with income below 200 percent of FPL.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-DC license. (More information)
- Extent:
- 1 online resource (1 PDF file (14 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918299889006676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918299889006676