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Jill Swenson and her husband were raising buffalo in upstate New York in 2009, when he had a recurrence of skin cancer. The couple had no health insurance, a factor that Ms. Swenson says contributed to her husband’s suicide. The Affordable Care Act made coverage accessible to her again in 2014, and she has had it every year since, but it was still a stretch.

She now lives in Appleton, Wis., where she is a self-employed editor and literary agent. She earned around $45,000 last year, and paid more than $300 a month for her insurance. During the pandemic, Congress has temporarily increased the premium subsidies provided under the health law — a $200-a-month discount that Ms. Swenson, 63, said has allowed her to buy birthday gifts for her niece and nephew, keep up with rising grocery costs, and pay utility bills and her mortgage.

“There’s nothing to cut,” she said. “It’s not like I’m living high on the hog.”

The temporary boost in subsidies extends up and down the income spectrum, lowering the cost of insurance for almost everyone who buys it through the Obamacare marketplaces. The social policy bill would keep it in place until the end of 2025.

Biden’s ​​Social Policy Bill at a Glance


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The centerpiece of Biden’s domestic agenda. The sprawling $2.2 trillion spending bill aims to battle climate change, expand health care and bolster the social safety net. Here’s a look at some key provisions and how they might affect you:

Child care. The proposal would provide universal pre-K for all children ages 3 and 4 and subsidized child care for many families. The bill also extends an expanded tax credit for parents through 2022.

Paid leave. The proposal would provide workers with four weeks of paid family and medical leave, which would allow the U.S. to exit the group of only six countries in the world without any national paid leave. However, this provision is likely to be dropped in the Senate.

Health care. The bill’s health provisions, which represent the biggest step toward universal coverage since the Affordable Care Act, would expand access for children, make insurance more affordable for working-age adults and improve Medicare benefits for disabled and older Americans.

Drug prices. The plan includes a provision that would, for the first time, allow the government to negotiate prices for some prescription drugs covered by Medicare. ​​

Climate change. The single largest piece of the bill is $555 billion for climate programs. The centerpiece of the climate spending is about $320 billion in tax incentives for producers and purchasers of wind, solar and nuclear power.

Taxes. The plan calls for nearly $2 trillion in tax increases on corporations and the rich. The bill also raises the cap on how much residents — particularly in high-tax blue states — can deduct in state and local taxes, undoing the so-called SALT cap.

The change was a response to a widespread concern that the Affordable Care Act had not, in fact, made insurance affordable enough for many Americans. More than half of people who were uninsured last year qualified for premium subsidies or Medicaid, according to an analysis from the Kaiser Family Foundation. Since the new subsidies were introduced, along with a big advertising push, an additional 2.8 million people have enrolled in coverage.

Source : https://www.nytimes.com/2021/12/01/us/build-back-better-act-health-coverage.html

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