Back To Articles

President Biden Unveils Build Back Better Framework

October 29, 2021

On Thursday, October 28th, President Biden released a framework of his Build Back Better plan. The framework includes historic investments that will be critical to increasing access to affordable healthcare, ending childhood poverty, and protecting seniors, older adults, and individuals with disabilities.

Here’s what you need to know:

What’s In The Proposal: 

  1. Continued lower health insurance premiums. The plan continues to cut premiums in half for over 340,000+ Pennsylvanians who purchase their own health coverage through Pennie, our state-based marketplace. Currently, 53% of premiums are now under $1, and 71% of plan premiums are now under $50. This would continue through 2025.
  2. Extends the child-tax credit. Families who make under $150,000 annually will continue to receive a monthly payment for their dependent children until 2024. For more than 200,000 Pennsylvania children, reducing poverty keeps kids healthy.
  3. Expands Home and Community Based Services (HCBS). HCBS are crucial Medicaid programs that help seniors and people with disabilities live at home while receiving the care they need. The Build Back Better framework improves conditions for the 146,000 homecare workers in Pennsylvania, and reduces the waitlist of 16,000 Pennsylvanians waiting for services.
  4. Investments in Affordable Housing. Having reliable housing is an important part of staying healthy. The proposed investment in this area will go towards building affordable homes, public housing, and providing for rental and down payment assistance.
  5. Extends coverage to individuals who give birth on Medicaid. The American Rescue Plan made it optional for states to extend coverage from 60-days to 1 year postpartum. Under this proposal, this extension is now mandatory and permanent. This ensures that about 10,000 Pennsylvanians a year will have the care they need when they most need it.
  6. Ensures kids stay connected to coverage. If enacted, the Children’s Health Insurance Program, that provides coverage to over 150,000 Pennsylvania kids, would be permanent, no longer requiring federal re-authorization, and kids enrolled in that program would no longer lose coverage in the middle of the year due to unexpected changes in income.
  7. Covers hearing needs for Medicare enrollees. This proposal would expand Medicare coverage to cover hearing for enrollees. Hearing needs are often expensive, and many enrollees currently skip regular appointments due to cost. Providing enrollees with this coverage would be life improving for many.
  8. Expands Medicaid to non-expansion states. If enacted, this proposal would offer Medicaid Expansion coverage to the 4 million people across the country who are financially eligible but live in non-expansion states. In an average year, nearly 500,000 Pennsylvanians benefit from Medicaid expansion.

What’s Missing: 
It is disappointing that not all of the provisions that were in early drafts made it into the proposed bill. Here’s what’s missing:

  1. Allowing Medicare to negotiate for lower drug prices. Prescription drug prices are out of control and are only rising. Without meaningful prescription drug reform, such as allowing Medicare to negotiate for lower costs, Pennsylvanians will continue to be forced to choose between managing their health and meeting their basic needs.
  2. Expanding Medicare to cover dental and vision. Older adults rely on Medicaid to provide coverage for expensive vision and dental needs. Leaving this out harms older adults by requiring them to spend their already limited income on medically necessary exams and procedures or forcing them to go without.
  3. National paid family leave program. Paid leave is critical for individuals to be able to care for themselves and their family members when they get sick, or when a new family member is welcomed into the household. Without this, individuals will have to rely on their employer’s policies, which may not be sufficient.

What Happens Next? 
It’s important to know that this is just a proposal and not the final bill. Lawmakers in Washington will be working over the next few months to produce a final package, pass it through both Chambers of Congress and send it to President Biden for his signature.

In the meantime, lawmakers in Harrisburg can still take action to lower drug prices in Pennsylvania. We call on the PA General Assembly to take swift action and pass SB 579, HB 321 or HB 1722 into law and quickly provide relief for Pennsylvanians struggling with high prices.