While the legislation might notgo anywhere significant till 2020, it serves as a strongcounterpoint to the Trump administration's most recent and moreextreme filing against the ACA. (Image: Shutterstock)

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Meeting fire with fire, House Democrats have unveiled their plan to strengthen theAffordable Care Act with subsidies and additional provisions–but noMedicare for All.

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The new plan of attack: cut premiums and deductibles, createmore lower-cost options for uninsured Americans, reinstate pre-existing condition protections, fix the“family glitch” and restore enrollment outreach resources. Keyprovisions include:

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Expansion of premium tax credits: The billcalls for changing the maximum paid for premiums for those making150 percent of federal poverty level from 4 percent to 2 percentand from 10 percent to 7 percent for those making 300 percent ofFPL and remove the overall income limit for receiving taxsubsidies. Premium payments would be capped at 8.5 percent of totalincome.

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The “family glitch” prohibiting low-income individuals fromreceiving subsidies if they are eligible for insurance through afamily member's employer-sponsored plan would also be fixed.

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Walking back Trump administration changes: Thebill would restore outreach funding for the federal exchange'sopen enrollment period and restore protections for people withpre-existing medical conditions, which has been significantlyreduced with the expansion of short-term and other alternativehealth plans.

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“The Republicans did say during the campaign that they weren'tthere to undermine the pre-existing condition benefit, and herethey are, right now, saying they're going to strip the wholeAffordable Care Act as the law of the land,” Speaker NancyPelosi told reporters.

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Reforms at the state-level: The bill would reinin the state-based waiver program that has allowed statesto lessen or eliminate or to allow lesser or no “essential”benefits, such as mental health and addiction treatmentcoverage.

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Additionally, the bill would promote state reinsurance programs,providing a mix of federal and state funds, and provide federalmoney to states that want to set up their own marketplaces but havenot yet done so.

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“With skyrocketing premiums in the federal marketplace,state-based exchanges have proven to be more effective atincreasing the rate of coverage and lowering costs,” said Representative Brian Fitzpatrick ofPennsylvania.

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Among the significant omissions: no funding for the cost-sharingreduction subsidies halted in 2017, and of course, no mention ofMedicare for All.

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Democrats plan to pass piecemeal, anticipating some support fromacross the aisle in both the House and the Senate for variousprovisions contained within it. While the legislation might not goanywhere significant till 2020, it serves as a strong counterpointto the Trump administration's most recent and more extreme filingagainst the ACA, advocating that the entire law be thrown out asunconstitutional instead of simply pursuing the elimination of asingle part of the law.

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“This is about very immediately answering the promises ourmembers made in the campaign to lower health care costs,” a seniorDemocratic aide told Vox. “This isn't the end of stuff we're goingto do on health care, in any regard.”

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Emily Payne

Emily Payne is director, content analytics for ALM's Business & Finance Markets and former managing editor for BenefitsPRO. A Wisconsin native, she has spent the past decade writing and editing for various athletic and fitness publications. She holds an English degree and Business certificate from the University of Wisconsin.

Marlene Satter

Marlene Y. Satter has worked in and written about the financial industry for decades.