Via Teleconference

5:42 P.M. EDT

MR. MUNOZ:  Hi, everybody.  Happy Monday.  Thank you for joining us on this call about tomorrow’s announcement around the President, Vice President, and former President Obama’s event around the Affordable Care Act.  

We will be providing a factsheet very soon that will also be embargoed until 5:00 a.m. 

A reminder this call is attributable to “senior administration officials.” 

With that, I will kick it to [senior administration official] to discuss tomorrow’s announcement.

SENIOR ADMINISTRATION OFFICIAL:  Hi, everybody.  Thank you for joining us this afternoon. 

President Biden and Vice President Harris believe that healthcare is a right, not a privilege.  So, I want to discuss today three things: First, a regulation that will be released by the Department of the Treasury tomorrow to strengthen the Affordable Care Act; second, the tremendous progress we’ve made in helping people get affordable, high-quality healthcare; and third, an executive order that the President will sign tomorrow that will direct agencies to continue their efforts in making coverage more affordable and accessible for American families.

So, to start, tomorrow Treasury will release a proposed rule that will help hundreds of thousands more Americans get coverage under the Affordable Care Act.

Under the ACA, people who do not have access to affordable health insurance through their jobs may qualify for financial help to buy coverage under the ACA.

For single people, “affordable” means coverage that costs less than about 10 percent of their income.

But for spouses and kids that are offered coverage through a family member’s job, under current rules, they’re treated as having affordable coverage no matter what the actual cost of that coverage is for them.  So that could mean that families would have to pay 25 or 30 percent of income to get coverage through their employer, and they can’t get financial help under the ACA, under today’s rule. 

So, the rules that Treasury is releasing tomorrow will propose to change that.  Under Treasury’s new proposed rules, family members who have to pay more than 10 percent of income for coverage will be able to get financial help under the ACA.

As a result, 200,000 uninsured people are expected to gain coverage, and nearly a million more are expected to see lower premiums every day.

To borrow a phrase, this rule is a big deal.  We’re excited about it.  And we think it (inaudible) significant administrative action to improve implementation of the ACA that’s been taken since the law was first enacted.

Second, I want to highlight that tomorrow’s rule builds on the remarkable progress that we have already made as an administration in bringing affordable coverage to folks.

Enrollment in coverage through the ACA is at an all-time high, and the uninsured rate is near historic lows.

One of the very first things we did in this administration was open a special enrollment period to get people coverage.  President Biden had been in his seat for less than a month when HHS opened the doors to to ultimately help about 2 million people get (inaudible).

This winter, we ran the most successful open enrollment period under the ACA ever: 14.5 million people buying an ACA Marketplace plan; another 1 million signed up for coverage through a related program called the “Basic Health Plan” — a really tremendous open enrollment period that brought millions of people into coverage.

In addition, 19 million people are today covered through the Medicaid expansion, and Medicaid enrollment totals nearly 80 million people.

More people than ever before have the security and peace of mind that comes with affordable health insurance.

And the American Rescue Plan is a major contributor to this success.  We’ve made coverage much more affordable for everyone buying through the ACA.  And the President was proud to sign that legislation.

This also reflects the tireless work of agencies to expand their outreach and their enrollment assistance, including quadrupling the amount of in-person staff available to provide outreach assistan- — enrollment assistance in communities across the country. 

The ACA is facilitating the expansion of Medicaid in Missouri and Oklahoma, which brought another half a million people into eligibility for coverage.

In short, this administration has been working since our first hours in office to get more Americans healthcare, and we’re still at it.

We are incredibly proud of what we’re getting done, but there is more to do.  And so, tomorrow, the President will also sign an executive order that directs agencies to continue their efforts to strengthen access to affordable, high-quality healthcare. 

The executive order will highlight a number of areas:

  • Making it easier for people to enroll in and keep their coverage.
  • Helping people better understand their coverage options so they can pick the one that’s best for them.
  • Strengthening and improving the generosity of benefits and improving access to healthcare providers.
  • Improving the comprehensiveness of coverage and protecting Americans from low-quality health insurance.
  • Continuing to make health coverage more accessible and affordable by expanding eligibility and lowering costs for Americans with ACA, Medicare, or Medicaid coverage.
  • Connecting people to healthcare services by improving access to providers and improving linkages between the healthcare system and our communities to help Americans with health-related needs.
  • And finally, taking steps to help reduce the burden of medical debt that far too many Americans experience.

And so that’s a sort of a brief summary of the executive order that the President will sign tomorrow.  So I think, with that, I’m happy to take questions about this package of announcements.

MR. MUNOZ:  Thank you, [senior administration official].  And for those that joined a little bit late, we will be sending out an embargoed factsheet soon, and this is attributable to “senior administration officials.”

Please “raise your hand” if you have any question related to tomorrow’s announcement.

First, let’s go to Joyce Frieden at MedPage Today.

Q    Hi, thanks for taking my question.  Regarding the Treasury rule, I’m wondering how much fixing this family glitch is going to cost and how it will be paid for.

SENIOR ADMINISTRATION OFFICIAL:  Yeah, so I can’t — I can’t speak to that directly.  Treasury is in charge of interpreting the provisions of 36B of the Affordable Care Act, which is the part of the law that provides financial assistance to people.  36B tax credits are an entitlement just like anything else in the tax code, and Treasury is interpreting their regulations to propose making this change.

MR. MUNOZ:  All right.  Let’s go to Tami at CNN.

Q    Thank you very much for holding this call.  Two questions.  One is: How quickly do you think that people in the family glitch will be able to get coverage?  How long will this take?

And then also, can you be a little bit more specific on what types of things the executive order might result in?  What types of changes?

SENIOR ADMINISTRATION OFFICIAL:  Sure.  On the first question, Treasury is proposing that the bona fide interpretation of affordability would take effect beginning January 1st, 2023, so people would be able to get financial assistance through the ACA starting at — during the next open enrollment period.

And as to the executive order, I think I’m not in a position tonight to preview more than what I have today.  We will be sending out a factsheet that, broadly, the President is directing agencies to do everything in their power to make coverage more affordable and accessible.

MR. MUNOZ:  Amy Lotven at Inside Health Policy.

Amy, you’re still muted.  All right, we’ll try you later, Amy.

Let’s go to Tom Howell with The Washington Times.

Q    Hey, thanks for doing the call.  I just want to know about the bigger subsidies in the ACA.  Does the President plan to address that?  I believe they expire at the end of the year, but his Build Back Better Agenda would extend them.  Does he plan to pressure lawmakers over that to get that part of the agenda passed?  Thanks.

SENIOR ADMINISTRATION OFFICIAL:  Yeah, I’m not going to comment on any potential negotiations with Congress.  But, as you know, the Build Back Better Act includes significant coverage policy, including extending the financial assistance under the ARP.  (Inaudible) policies have widespread support, and we look forward to getting it done.

MR. MUNOZ:  All right, let’s go back to you, Amy.

Q    Hi, yes.  Sorry about that.  I’m actually really wondering — it sounds like the affordability threshold will still apply to the families, but they’ll only — that they’ll be able to access the credit if they’re over the threshold.  I just — is that right?  So, you’re not fully — so, the rule doesn’t fully separate the families from the worker?

SENIOR ADMINISTRATION OFFICIAL:  So, under the rule, coverage for the family will be — the affordability of coverage for the family will be affected.  So, if coverage for the family as a whole costs more than about 10 percent of household income, then the non-employee family members will be eligible for financial assistance in the marketplace.

MR. MUNOZ:  Any more questions?  All right, a couple more.

Let’s go to Selena at NPR.

Q    Hi, thank you so much for doing the call.  I just have a question about the number of people who might be affected.  I was looking at an analysis from KFF on the so-called “family glitch” that estimated 5.1 million people nationally fall into the family glitch.  The numbers that you mentioned at the top of the call — you said 200,000 people are expected to gain coverage, and a million — or I forget — I might have missed that number — would pay a lower cost. 

I’m just wondering if you can explain, like, something behind your estimate of who might be impacted here.

SENIOR ADMINISTRATION OFFICIAL:  Yeah, sure.  So there won’t be any official estimates from the administration coming out tomorrow.  But to give you some context on sort of what’s out there: You’re right that there are estimates that there were — that there are about 10 million people who are affected in some way by the family glitch.  And so all of those people will have a new option under these proposed rules.

Some of them may choose to stay in the coverage that they’re in today because they find it more convenient to have their whole family in a single health plan.  And so, some of the 5 million people who were affected and get this new option will nonetheless choose to stay in the type of coverage that they have. 

But others, and the people for whom this is the greatest hardship, will change their current — you know, whatever they’re doing right now.  So, as a result, about 200,000 uninsured people are expected to gain coverage for the first time because they don’t — they have no coverage at all, say because it’s just too expensive for them. 

And another of that million people, you know, they switch from the coverage that they have today into more affordable Marketplace coverage.

MR. MUNOZ:  Great.  Let’s go to Brett Samuels with The Hill.

Q    Hey, thanks for doing this call.  I just had a quick question about former President Obama being part of the event tomorrow.  I was just hoping you could speak to kind of what role he’ll play in this event and sort of the significance of having him, you know, at the White House for the signings of these orders.  Thank you.

SENIOR ADMINISTRATION OFFICIAL:  I don’t have anything to preview there.  I think you’ll hear more from the President about that tomorrow afternoon.

MR. MUNOZ:  And, Brett, Jen spoke to this in the briefing today, so there’s a little bit more detail there. 

I don’t think we have any more questions.  So, with that, thank you, everybody, for joining.  As a reminder. we will provide a factsheet shortly tonight.  This and the factsheet are embargoed until 5:00 a.m.  

And if you have any other questions, please reach out to me.  Thank you.

5:58 P.M. EDT

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