How Build Back Better would impact healthcare and insurance

My Democratic colleagues in the United States House of Representatives just passed President Biden’s Build Back Better Act. Perhaps the most significant of the plan’s many provisions is an expansion of the Affordable Care Act to make health coverage more accessible for millions of vulnerable Americans.

The Build Back Better plan’s changes to health insurance policy would include:

  • An extension of the expanded Premium Tax Credit to reduce premiums for working families across the board.
  • Securing permanent funding for the Children’s Health Insurance Program (CHIP), which ensures affordable healthcare for millions of children.
  • Health care coverage for up to 4 million uninsured people in states that have rejected expansions to Medicaid (these states are Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, North Dakota, South Carolina, South Dakota, Tennessee, Texas and Wisconsin).
  • Coverage for hearing aids and audiology services starting in 2023
  • Subsidies for patients in need of long-term care services to receive those services in-home, rather than in nursing home facilities.
  • A cap on payments for prescription drugs at $2,000 per year for Medicare patients, along with provisions aimed at reducing the cost of prescription drugs.

That’s just a quick overview. Go deeper, though, and the impacts of President Biden’s Build Back Better Act are even more impressive (and critically necessary). When it comes to drug prices, maternal health, children’s health and mental health services, the Build Back Better Act does some heavy lifting.

Prescription Drug Prices 

The Build Back Better Act will empower Medicare to negotiate directly with prescription drug makers, uniting consumers around calls to make prescription drugs more affordable. It’s worth noting that the Congressional Budget Office estimates the Build Back Better Act provisions on prescription drug prices would reduce the federal deficit by $297 billion over 10 years. Key among these provisions include:

  • Allowing the federal government to negotiate prices for some high-cost drugs covered under Medicare.
  • Limiting annual increases to drug prices in both Medicare and private insurance to the rate of inflation.
  • Capping out-of-pocket spending on prescription drugs for most patients at $2,000 per year.
  • Limiting patient cost-sharing for insulin to no more than $35 per month.

Maternal Health

Our nation faces a maternal health crisis. The United States has the worst maternal mortality rate among industrialized countries. Black and brown mothers face disproportionate risk, with Black women dying from causes related to pregnancy at three times the rate of white women. As part of a growing effort to address this, the Build Back Better Act would:

  • Provide a full year of funding for postpartum coverage to an estimated 1,170,000 new mothers over 10 years. Currently, many women with Medicaid lose coverage just 60 days after giving birth.
  • Establish a permanent Medicaid state plan option for maternal health homes, which offer care to pregnant and postpartum people.
  • Offer loans, scholarships and other support to perinatal nursing students, doulas and maternal mental health and substance abuse professionals to help train and diversify the prenatal care workforce.

Children’s Health

This should be something we all agree on — that no matter what situation or circumstances the parents find themselves in, no child should be denied access to health care. The Build Back Better Act implements some key provisions to bolster Medicaid coverage for children, such as:

  • A requirement for 12 months of continuous eligibility for children under Medicaid and the Children’s Health Insurance Program (CHIP). Currently, only 24 states offer 12 months of continuous coverage under both Medicaid and CHIP, while 17 do not have continuous coverage for any children.
  • A permanent extension of CHIP, which was previously set to run out of funding after fiscal year 2027. 

Mental Health

While the Build Back Better Act could go further in bolstering coverage and support for mental health care, there are some provisions aimed at increasing behavioral health clinics and mobile crisis intervention services. These include:

  • An expansion of the Certified Community Behavioral Health Clinic demonstration program, through which states can award planning grants with matching federal funds for services provided to Medicaid recipients at certified behavioral health clinics.
  • A permanent extension of the state option to provide community-based mobile crisis intervention services, which render aid to individuals experiencing mental health or substance use disorder crises. 


While it is exciting to see progress made on these important issues, we aren’t done. For one thing, the Build Back Better Act passed in the House, but still faces a crucial Senate vote that could include removal or re-writing of some provisions. I look forward to President Biden signing these badly-needed policies into law.

That said, I will continue to advocate for the aims of the Build Back Better in Maryland, and will seek to hold our state’s leadership accountable for properly implementing these plans and programs. I have seen too many instances of Marylanders being denied coverage, or struggling to navigate the complicated regulations and rules of our health insurance system. With the innovations from the Build Back Better Act in mind, I will continue to fight for changes in Maryland law to improve access to and affordability of healthcare for families across our state.

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