Democratic Proposal to Improve Health Coverage in Response to COVID-19
With the nation’s health care system reeling under the unprecedented strain of the COVID-19
pandemic, and hard-hit American families struggling with the health and financial consequences,
Senate Democrats are pushing a bold and multi-pronged public health care response to the crisis.
Our Agenda stands up to the Trump Administration’s efforts to make health care harder to
access, and says “no” to cutting Medicaid funding and promoting junk insurance plans. Instead,
Senate Democrats are responding with a health care coverage plan that prioritizes quality,
affordable health care and makes it available to every American family when they need it. We
propose:
Improve Health Coverage and Care Affordability for Middle-Class Americans
Expand Access to Premium Assistance: Premium Tax credits are currently capped at 400%
of the federal poverty level ($51,040 for an individual in 2020). By removing the current cap
on income, more middle class individuals and families will be able to afford high quality
health coverage. Senator Shaheen’s “Improving Health Insurance Affordability Act” would
lift these caps to allow more families to qualify for support.
Increase Tax Credits to Protect Families from the Effects of Trump Sabotage: The
Trump Administration’s policies to sabotage the ACA have spiked marketplace premiums and
increased the number of uninsured. Increasing the percentage of the premium that tax credits
help cover will allow more Americans to afford quality insurance coverage. Shaheen’s
legislation would also increase the value of tax credits.
Provide Peace of Mind on Potential Tax Credit Penalties: People who lose their jobs or
have their hours changed will have trouble predicting their annual income, particularly during
this time of severe disruption. As a result, many may forgo enrolling in private health
coverage out of concern that they may be forced to repay thousands of dollars in premium
assistance on Tax Day. There is a cap on repayment obligations for some, but none for those
with incomes over 400 percent of the poverty line. Implementing a premium tax credit “true
up” holiday will give Americans more peace of mind when signing up for insurance coverage.
Senators Cardin and Van Hollen introduced legislation to provide this true up holiday.
Cover all costs for COVID-19 treatment: Our health as a nation has never been more reliant
on the health and safety of individuals. Securing coverage for COVID-19 treatment at no cost
to all patients will eliminate any cost barriers, help stop the spread of this disease and save
lives.
Allow More Americans to Access Comprehensive, Affordable Health Coverage
Provide a federal special enrollment period: Despite calls from patient groups, health
insurers, Governors, and Democrats in Congress, the Administration has refused to offer a
special enrollment period for federally operated marketplaces. Although the Affordable Care
Act establishes an automatic special enrollment period for workers who lose their insurance
because they lose their job, numerous state-based exchanges have opened special enrollment
periods to allow the uninsured and others to purchase coverage. Mandating a special
enrollment period would allow millions of Americans to access health care coverage during

 this public health crisis. Senator Casey released a proposal that would establish this special
enrollment period during the COVID-19 pandemic.
Restore funding for marketplace outreach and enrollment support: Executive actions that
cut marketing and enrollment support has made it more difficult for individuals to shop for
health insurance. Reinstating these resources would help countless customers search for and
find the best insurance plan for themselves and their families and make sure they are taking
advantage of opportunities to sign up for coverage like automatic special enrollment periods.
Senator Shaheen’s “MORE Health Education Act” would restore this marketing and
enrollment support funding.
Deliver COBRA subsidies for the newly unemployed: Millions of newly unemployed
workers now find themselves without health coverage. In addition to the automatic special
enrollment period established by the Affordable Care Act, COBRA continuation coverage is
an option for staying covered. Since COBRA premiums are often very high, a subsidy to help
pay premiums would help patients and families retain the coverage they are on now. A similar
policy was enacted by the 2009 stimulus bill to help families retain health insurance coverage.
Senator Durbin has pressed for COBRA premium assistance in future COVID-19 legislation.
Pass the SAME Act to incentivize Medicaid expansion in holdout states and support
Medicaid, an essential social safety net: Currently, fourteen states have not expanded
Medicaid, leaving over two million adults in the coverage gap without access to
comprehensive, affordable health coverage. Senator Warner’s “SAME Act” will enhance
payments to states in order to incentivize Medicaid expansion and improve the fiscal health of
state governments. It is vital to support essential social safety net programs like Medicaid that
helps ensure Americans have access to comprehensive, affordable coverage.
Protect Americans with Pre-Existing Conditions
Prohibit the sale of junk plans: Instead of protecting customers from risky plan options, the
Administration has expanded and promoted short-term limited-duration insurance or “junk
plans” that discriminate against people with pre-existing conditions and do not cover the
essential health benefits -- like prescription drugs, cancer treatment, mental health, or
maternity care. Patients with junk plans have already been stuck with huge bills for
coronavirus testing, and patients with COVID-19 who sign up for a junk plan risk having their
treatment denied on the basis of their pre-existing condition. Senator Baldwin’s “No Junk
Plans Act” would overturn these rules and ensure that insurers cannot sell coverage that
leaves patients paying huge bills for testing and treatment during the COVID-19 pandemic.
Prevent federal spending on junk plans and weakened consumer protections: The Trump
Administration issued guidance that allows states to waive critical ACA consumer
protections. These waivers allow insurers to sell plans that don’t meet consumer protections
for comprehensiveness and affordability in states where they are granted. They would also let
states funnel taxpayer money to junk plans. Rescinding the guidance that would permit these
waivers will stop wasteful spending on junk plans and protect patients with pre-existing
conditions. Senator Warner’s “Protecting Americans with Pre-existing Conditions Act” would
rescind this guidance.