Cross-posted from our joint Raising Women’s Voices campaign
This week, the House is set to pass a COVID relief package that closely tracks with the Biden-Harris administration’s original proposal. While several big questions remain, and there are procedural hurdles to be overcome, we have a good sense now of the rough outline of the final package.
We’ll describe the process for passing this bill below in detail. But first, here’s what we know about the package thus far. Among other provisions, the House bill includes:
- $1,400 stimulus checks for individuals earning $75,000 or less per year and married couples making $150,000 or less per year with an additional $1,400 per dependent, regardless of age. The payments would phase out above those levels until reaching $0 for individuals making over $100,000 and couples making over $200,000. House Republicans offered an amendment that would have reduced those cut-offs to $40,000 for an individual and $80,000 for a couple; although not guaranteed, the higher amounts included in the House bill are currently expected to pass the Senate.
- A temporary increase in federal unemployment benefits from $300 to $400 per week through August.
- A temporary increase in tax credits for children, up to $3,000 for children 6 to 17 and up to $3,600 for children under 6, with a gradual phase-out for individuals making more than $75,000 per year and married couples making more than $150,000. “Families eligible for the full credit would get payments of $300 per child, per month, from July 2021 through the end of the year,” according to NPR.
- Expanded tax credits through the Earned Income Tax Credit (EITC) for low-income workers without dependent children.
- Federal subsidies to help unemployed workers stay on their employer’s health plan through COBRA. The bill would reduce workers’ premiums to 15% of what they would otherwise pay through September. Unlike GOP-led proposals which included COBRA coverage, the Democrats’ bill does not impose new, Hyde-like restrictions on abortion coverage. This provision could be on the parliamentarian’s chopping block (see discussion below) though it’s seen as having a higher chance for success than several other provisions.
- Public health funding to spur production of medical supplies and protective equipment under the Defense Production Act; distribute, promote and track COVID vaccines; upgrade schools to protect students and teachers from COVID exposure; and more.
- Emergency rental assistance, with funds set aside for people experiencing homelessness, survivors of domestic violence, and victims of human trafficking; support for low-income families through the Low Income Home Energy Assistance Program (LIHEAP); increased food assistance through the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps); and more.
Key provisions would bolster the ACA
In addition, the House bill takes important steps toward bolstering and building upon the Affordable Care Act (ACA). We have long called on Congress to make the ACA’s subsidies for individuals purchasing insurance through the individual market more generous and to make them available to more people. The House package does both, albeit temporarily. Through the end of 2022, the bill significantly reduces monthly premiums for households already eligible for coverage — those making between 100% and 400% of the federal poverty level (FPL). For those making more than 400% FPL, the bill makes them eligible for subsidies for the first time, ensuring that they never have to pay more than 8.5% of their income for coverage.
People at the higher end of the current eligibility range (those making 300% or more of the FPL) and those who have never been eligible were already most likely to forgo coverage out of affordability concerns. By offering them assistance, the bill could help lower premiums across the board by bringing millions of healthy people back into marketplaces. Vox reports that, “Based on prior estimates of such a proposal, somewhere between 4 million and 5 million people would be expected to gain coverage as a result of expanding the subsidies.”
This could be key to driving the uninsured rate back down to the historically low levels achieved during the Obama era. Under the Trump Administration, the number of Americans without health insurance increased to 9.2%. The pandemic has exacerbated those trends, as millions of people have lost their jobs.
The bill also includes the first increase in outreach and enrollment funding for the ACA in years after the Trump administration slashed resources leaving private sector advocates (including Raising Women’s Voices) scrambling to fill the gap. As we reported earlier this month, the Biden-Harris administration has re-opened healthcare.gov for a special, pandemic-related enrollment period that lasts through May 15. To encourage enrollment, the package allocates $50 million to advertisements and counselors to help people with the enrollment process.
Finally, the bill includes sweeteners to encourage the 12 remaining Medicaid non-expansion states to finally close their Medicaid coverage gap. The incentive comes in the form of a 5-point bump in the federal share of funding (FMAP) for states’ original Medicaid populations. (The federal government already picks up 90% of the tab for covering the Medicaid expansion population, but its share for the original Medicaid population is much lower and varies state to state.)
Despite the promise of new funds, none of the remaining states — all of which are governed by Republican legislatures and most of which are former Confederate states — is likely to be persuaded by economic factors alone. As we have previously argued, state Medicaid policymaking is often driven more by systemic racism than economics. But while the bill may not be enough to persuade reluctant lawmakers on its own, it could provide a valuable tool for advocates engaged in grassroots advocacy.
What are the procedural hurdles to passing this bill?
Senate leaders from both parties made their cases to Senate Parliamentarian Elizabeth MacDonough this week about whether key provisions should or should not qualify under the narrow rules of budget reconciliation, the procedural tool that allows Democrats to bypass a GOP filibuster on the relief package. Under the rules of reconciliation, policy changes must have a direct impact on the budget.
Senate Budget Chairman Bernie Sanders (I-VT) told reporters that he believes the proposal to raise the minimum wage to $15 an hour over five years complies with the rule, noting that the Congressional Budget Office “has found that the $15 minimum wage has a much greater impact on the federal budget than opening up the Arctic National Wildlife Refuge to oil drilling and repealing the individual mandate penalties — two provisions that the parliamentarian advised did not violate the Byrd Rule when Republicans controlled the Senate.”
If, however, the parliamentarian determines that the budgetary impact of the minimum wage increase — or any other provision — is “merely incidental,” she will advise the presiding officer of the Senate (in this case, Vice President Kamala Harris) that it should be struck from the bill. Harris has the option under the rules of ignoring the parliamentarian’s guidance and keeping the provision in the bill. Opponents of the provision would then need 60 votes to overturn Harris. While unusual, this move would not be unprecedented. The majority party even has the power to fire the parliamentarian over a ruling they don’t like, as then-Majority Leader Trent Lott (R-MS) did in 2001. But conservative Democratic Senators Joe Manchin (WV) and Kyrsten Sinema (AZ) have said they won’t vote to overrule the parliamentarian, and the White House has said they won’t pressure Democrats to do so, which would risk splintering the party's support for the underlying package.
As of this writing, the parliamentarian has not yet publicly announced her decisions about any part of the package. Once she does, House Democrats are expected to attach a manager’s amendment to the bill reported out of committee that to ensure that the House package conforms to the parliamentarian’s guidance in order to ease passage in the Senate. The House vote is expected late Friday or early Saturday, on a near party-line vote. The Senate has signaled their intent to pass the House bill without undertaking its own committee process with the goal of getting relief out as quickly as possible.
This process matters for two reasons. First, Senate Democrats have indicated that they plan to use reconciliation again, perhaps immediately, in order to pass other key priorities unrelated to the COVID emergency, meaning we could be deep in this same process again by the late spring.
Second, it will be harder for Democrats to blame any legislative failures on their Republican counterparts if they have the option of removing arcane procedural roadblocks and choose not to. As we argued last month, we are in the midst of multiple national emergencies, including a wave of state-based attacks on voting. This is not the time for Democrats to choose ‘decorum over democracy.’
This week’s newsletter was written by Sarah Christopherson, Policy Advocacy Director for the National Women’s Health Network with contributions from Kristen Batstone, NWHN Policy Intern, and edited by Lois Uttley, Women’s Health Program Director for Community Catalyst.
Sarah Christopherson, MA, is the Legislative Director for the social justice campaign, Americans for Tax Fairness, and the NWHN’s former Policy Advocacy Director. Her 10 years working for Congress and her deep knowledge of health policy and consumer protection make her the NWHN’s issue area expert on federal health reform implementation and defense, drug and device safety and efficacy, and sexual and reproductive health.