ALBANY, Ga. — After giving up on their goal of creating a new Medicaid program to cover two million poor adults, Democrats are aiming to provide them with free private coverage as part of the party’s social policy bill. But there is a catch: The benefits would last only four years.
Even with that expiration date, the legislation cannot come fast enough for people like Evelyn Davis, who suffered two heart attacks and has high blood pressure and diabetes. A former home health care aide, she lost coverage when she got divorced two years ago. She has chest pains and heart palpitations but said she cannot afford to see a cardiologist.
“If I can’t get any medicine, I just get Tylenol PM when I sleep,” Ms. Davis, 63, said, “and just pray to God when I wake up that I won’t be in pain.”
She is among an estimated 2.2 million American adults who lack insurance because they live in one of the 12 states where Republicans have refused to expand Medicaid, which is jointly financed by the federal government and states, under the Affordable Care Act. Too poor to qualify for subsidized private insurance through the Obamacare exchanges yet not poor enough for Medicaid, they navigate a byzantine system of charity care — and often skip care altogether.
Now these patients may get what many have hoped for since the Affordable Care Act’s passage more than a decade ago — albeit with no guarantee that the new benefits are here to stay. The framework announced last week by President Biden for the $1.85 trillion social policy bill includes the biggest expansion of health care since the Obama-era health law, patching holes in the landmark law that had long seemed impossible to fix.
Still, the framework is tenuous. On Monday, Senator Joe Manchin III, Democrat of West Virginia, dashed hopes for a quick Senate vote by refusing to endorse the measure, whose health care provisions had already been pared back under pressure from Mr. Manchin and other centrists to keep the price down.
The “public option,” promoted by Mr. Biden during his presidential campaign as a way for people to buy into a Medicare-like plan, was never even considered. Language authorizing the government to negotiate prices with drug companies was scrapped. A plan to give dental, vision and hearing coverage to Medicare recipients has been whittled down to just hearing.
And in the end, negotiators dropped the idea of a new Medicaid plan financed entirely by the federal government for people in the 12 …….