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Here's what Biden's first budget will (and won't) say about health insurance

Sigrid Forberg
·4 min read
Here's what Biden's first budget will (and won't) say about health insurance
Here's what Biden's first budget will (and won't) say about health insurance

A key health care promise has fallen off President Joe Biden’s first federal budget.

Biden, while campaigning for president, pledged to introduce a government-run health insurance option to compete with private carriers..

But the White House has cut that proposal from its budget plan, which is set to be released on Friday, according to multiple media reports.

That means if you were counting on a publicly operated insurance plan, outside of existing Medicare and Medicaid, you’re out of luck — for now.

Here’s more on what Biden’s leaving on the cutting room floor and how you can still get affordable health insurance for you and your family.

What would a public option mean?

Man showing young couple something on a computer screen in an office.
G-Stock Studio / Shutterstock

By “public option,” Biden meant a government-sponsored insurance program that would compete alongside private insurance, either through the private or employer market.

Biden put forward the proposal as an alternative for “Medicare for All,” which would effectively replace most private insurance by making the government the “single payer” for the bulk of the country’s health care expenses.

But polling has shown that more Americans support a public option than support Medicare for All: Data released from the Kaiser Family Foundation last year found that 68% of adults in the U.S. supported a public option, including 85% of Democrats and 42% of Republicans.

Meanwhile, the same poll showed only 58% of Americans supported a Medicare for All approach.

That initial plan would have ensured 97% of Americans would have health insurance, according to Biden’s campaign. The ambitious proposal was put forward during the tight Democratic presidential primary amid polling that showed much of the party’s base ranked health care as a top issue.

This isn’t the only health insurance proposal Biden’s office has since dropped.

On the campaign trail, Biden had also pledged to lower the Medicare eligibility age from 65 to 60. But that proposal was left out of the White House’s $1.8 trillion American Families Plan, which was announced in April.

Here’s the good news

Man holding a tablet with insurance claim form open on it.
Kaspars Grinvalds / Shutterstock

There’s still some reason for optimism on the health insurance front.

Biden’s $1.9 trillion COVID relief bill, which passed in March, introduced generous new subsidies for health insurance plans bought on Healthcare.gov and other Affordable Care Act (ACA) exchanges.

Now, if you’re not covered through an employer or government plan like Medicare or Medicaid, your Obamacare premiums are capped at 8.5% of your income for the next two years.

And the plan makes those subsidies available to you if you earn more than four times the federal poverty rate — which works out to about $51,520 for single people and $106,000 for a family of four.

What does that look like?

Woman looking at insurance documents and using a calculator to add up numbers.
JOKE_PHATRAPONG / Shutterstock

The changes, which went into effect April 1, qualify about 15 million uninsured Americans for financial assistance and offer 9 million people with subsidized plans even more help.

On average, you’ll see your premiums decrease about $50 a month. And anyone making more than $51,000 will be able to get coverage for about $1,000 less per month than before the bill was passed.

To get the premium discount, you’ll have to go back to the website where you bought your health insurance plan and confirm that you want the new, expanded tax credit for your existing plan. That could either be HealthCare.gov or your state’s version of the site.

In response to the COVID pandemic, Biden established a special ACA enrollment period, meaning you now have until Aug. 15 to take advantage of these new subsidies right away instead of waiting for the discount to be applied on your taxes next year.

By mid-May, a million people had already signed up for a new, more affordable health insurance plan.

And while these new premiums are meant to be temporary — meaning pricing could return to normal in 2023 — Biden’s families plan proposes to make them permanent.

Finding room in your budget right now

Older senior married couple in distress, looking at laptop on the kitchen counter.
El Nariz / Shutterstock

You don’t have to wait for Congress to make moves to provide you with a more affordable health insurance plan. You can start looking around now to find a policy that meets your budget and coverage needs right now.

And if you want to add a little more to your monthly budget too, you have a few options.

  •  Cut the cost of your debt. If you’re currently being crushing by their health insurance and medical costs (or other debts), you may want to consider folding your loans into a single, lower interest loan to give yourself some breathing room and help get out from under your debt sooner.

  •  Keep the insurance savings rolling. By shopping around for the cheapest policies, you could potentially cut car insurance costs by more than $1,000 and knock down your homeowners insurance bill by hundreds as well

  •  Turn your pennies into a portfolio. Forget everything you thought you knew about the stock market: You don’t need to be rich or know all the lingo or pay massive brokerage fees to see serious gains. Using a popular app, you can invest "spare change" from everyday purchases and grow those pennies into serious profits.

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    MEHTAR LAM, Afghanistan — Ammunition was depleted inside the bedraggled outposts in Laghman province. Food was scarce. Some police officers hadn’t been paid in five months. Then, just as U.S. troops began leaving the country in early May, Taliban fighters besieged seven rural Afghan military outposts across the wheat fields and onion patches of the province, in eastern Afghanistan. The insurgents enlisted village elders to visit the outposts bearing a message: Surrender or die. Sign up for The Morning newsletter from the New York Times By mid-month, security forces had surrendered all seven outposts after extended negotiations, according to village elders. At least 120 soldiers and police were given safe passage to the government-held provincial center in return for handing over weapons and equipment. “We told them, ‘Look, your situation is bad — reinforcements aren’t coming,’ ” said Nabi Sarwar Khadim, 53, one of several elders who negotiated the surrenders. Since May 1, at least 26 outposts and bases in just four provinces — Laghman, Baghlan, Wardak and Ghazni — have surrendered after such negotiations, according to village elders and government officials. With morale diving as U.S. troops leave, and the Taliban seizing on each surrender as a propaganda victory, each collapse feeds the next in the Afghan countryside. Among the negotiated surrenders were four district centers, which house local governors, police and intelligence chiefs — effectively handing the government facilities to Taliban control and scattering the officials there, at least temporarily. The Taliban have negotiated Afghan troop surrenders in the past, but never at the scale and pace of the base collapses this month in the four provinces extending east, north and west of Kabul. The tactic has removed hundreds of government forces from the battlefield, secured strategic territory and reaped weapons, ammunition and vehicles for the Taliban — often without firing a shot. The base collapses are one measure of the rapidly deteriorating government war effort as one outpost after another falls, sometimes after battles, but often after wholesale surrenders. The surrenders are part of a broader Taliban playbook of seizing and holding territory as security force morale plummets with the exit of international troops. Buyoffs of local police and militia. Local cease-fires that allow the Taliban to consolidate gains. A sustained military offensive despite pleas for peace talks and a nationwide cease-fire. “The government is not able to save the security forces,” said Mohammed Jalal, a village elder in Baghlan province. “If they fight, they will be killed, so they have to surrender.” The surrenders are the work of Taliban Invitation and Guidance Committees, which intervene after insurgents cut off roads and supplies to surrounded outposts. Committee leaders or Taliban military leaders phone base commanders — and sometimes their families — and offer to spare troops’ lives if they surrender their outposts, weapons and ammunition. In several cases, the committees have given surrendering troops money — typically around $130 — and civilian clothes and sent them home unharmed. But first they videotape the men as they promise not to rejoin the security forces. They log their phone numbers and the names of family members — and vow to kill the men if they rejoin the military. “The Taliban commander and the Invitation and Guidance Committee called me more than 10 times and asked me to surrender,” said Maj. Imam Shah Zafari, 34, a district police chief in Wardak province who surrendered his command center and weapons on May 11 after negotiations mediated by local elders. After the Taliban provided a car ride home to Kabul, he said, a committee member phoned to assure him that the government would not imprison him for surrendering. “He said, ‘We have so much power in the government and we can release you,’ ” Zafari said. The Taliban committees take advantage of a defining characteristic of Afghan wars: Fighters and commanders regularly switch sides, cut deals, negotiate surrenders and cultivate village elders for influence with local residents. The current conflict is really dozens of local wars. These are intimate struggles, where brothers and cousins battle one another and commanders on each side cajole, threaten and negotiate by cellphone. “A Taliban commander calls me all the time, trying to destroy my morale, so that I’ll surrender,” said Wahidullah Zindani, 36, a bearded, sunburned police commander who has rejected Taliban demands to surrender his nine-man, bullet-pocked outpost in Laghman province. The negotiated surrenders are part of a broader offensive in which the Taliban have surrounded at least five provincial capitals this spring, according to a Pentagon inspector general report released May 18. The offensive has intensified since the U.S. withdrawal began May 1. The Taliban have used their control of several major highways to cut off bases and garrisons, leaving them vulnerable. The surrenders have a profound psychological effect. “They call and say the Taliban are powerful enough to defeat the U.S. and they can easily take Laghman province, so you should remember this before we kill you,” Rahmatullah Yarmal, Laghman’s 29-year-old governor, said of the Taliban committees during an interview inside his barricaded compound in Mehtar Lam, the provincial capital. It’s an effective propaganda tactic, the governor conceded — so effective that some outpost commanders now refuse to speak to elders or Taliban negotiators. He said many elders were not neutral peacemakers, but hand-picked Taliban supporters. Yarmal said 60 police officers who surrendered and took refuge in his government center are now primed to fight to retake the seven lost outposts. “I think we’ll have them back in a month,” he said. But just hours after the governor spoke on May 19, a nearby district center, Dawlat Shah, surrendered without any resistance after negotiations. By the next morning, five more outposts had surrendered the same way in the district of Alishing, also in Laghman, district officials said. Those Taliban victories were facilitated, in part, by a 30-day cease-fire negotiated by elders on May 17 in the heavily contested district of Alingar, allowing the Taliban to shift resources to the Alishing, where they forced the negotiated surrender of the five outposts just two days later. (On May 21, the Taliban violated the cease-fire with renewed attacks in Alingar, Khadim said.) The series of base collapses represented the second wholesale surrender in a Laghman district in two weeks. On May 7, three outposts and a military base collapsed the same way without a fight, said Nasir Ahmad Himat, the Alingar district governor. “The soldiers simply dropped their weapons, got in their vehicles and went to the district center or provincial capital,” said Faqirullah, a village elder who goes by one name. As Taliban fighters advanced on the provincial capital Sunday, Yarmal announced that 110 security force members who had surrendered, and several commanders who were supposed to supervise them, had been detained for negligence. Also Sunday, the Afghan military announced that troop reinforcements and the military chief of staff had rushed to Laghman to try to repel the Taliban assault. In Ghazni province, Hasan Reza Yousofi, a provincial councilman, said he begged officials to send reinforcements to an outpost and a military base that ultimately fell to the Taliban this month. He played a recorded phone call from a police officer, Abdul Ahmad, who said his ammunition was gone and his men were drinking rainwater because the base water tower had been destroyed by a rocket. “We have been sold out — we make calls for reinforcements, but officials don’t help,” the recorded voice said. “The Taliban sent us tribal elders who said, ‘Surrender, you are sold out, no one will help you.’ ” Yousofi said he did not know whether Ahmad survived after his outpost fell. Negotiations have proved remarkably fruitful for the Taliban in Baghlan province, where at least 100 soldiers surrendered, and in Wardak province, where about 130 security force members surrendered following negotiations, officials said. In Laghman province, negotiations leading to the surrender of the seven outposts stretched over 10 days. Khadim, the village elder, said different elders negotiated with commanders of each outpost. “We guaranteed they would not be killed,” he said. “There was nothing written, just our word.” A few miles away, Zindani refused to surrender his forlorn outpost near the front line. He said officers who had negotiated surrenders at three nearby outposts had betrayed their country. One of his men, Muhammad Agha Bambard, said he would fight to avenge the deaths of two brothers he said were killed by the Taliban. He would never surrender, he said. Zindani’s nine men were down to a machine gun, a rocket-propelled grenade launcher and one AK-47 rifle each inside a ramshackle outpost with bloodstained walls. But he said he intended to fight on — as he told the Taliban commander who regularly phoned to demand his surrender. “I told him, ‘I’m a soldier of my country,’ ” the commander said. “I am not here to surrender.” Four days later, on Sunday, the outpost was overrun during a firefight with the Taliban, a member of the provincial council said. One police officer was shot dead and Zindani and his outgunned men were taken prisoner. A few hours later, the Taliban released a video showing Bambard being questioned by a Taliban commander as he lay on a mattress, his face and neck bandaged. In a mocking tone, the commander asked why Bambard had posted on his Facebook page that he would not let the enemy capture his outpost while he was alive. The wounded officer responded, “This is Afghanistan.” This article originally appeared in The New York Times. © 2021 The New York Times Company

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