Dive Brief:
- US Reps. Anna G. Eshoo and Mike Thompson, both from California, have reintroduced the Fair Access to Health Care Act, which would tie health insurance subsidies to the local cost of living rather than to the national federal poverty level.
- The legislators say that treating families the same based on their income, and disregarding their location, continues to leave health insurance out of reach for those in high-cost areas like Silicon Valley and New York City.
- "A middle class income means different things in different parts of the country," Thompson says. "This bill will help make health insurance affordable, no matter where someone lives."
Dive Insight:
The real question is how the ACA doesn't already account for cost of living differences. As insurancenewsnet.com notes, the ACA does recognize this issue for Alaska and Hawaii, and allows those residents to use a higher income threshold to determine their eligibility for subsidies. Perhaps the next wave of healthcare expansion will come via extending this cost of living adjustment to the rest of the US.
The legislation reportedly would not impact those in low-cost geographical areas; everyone eligible for subsidies based on the FPL would continue to qualify, and there would be no reduction in subsidies to those in low-cost regions.