WASHINGTON – President Joe Biden on Tuesday proposed a way to increase the number of dependents who can get subsidized insurance under the Affordable Care Act, a solution to what has been called the “family fault.”
The proposition: If a workplace plan for the whole family costs more than 10% of a family’s income, then the worker’s spouse and children could get help buying a private plan through the Obamacare marketplace.
“The Affordable Care Act is stronger than ever,” Biden said at a White House event attended by former President Barack Obama. “And today, we’re making it even stronger.”
The change, which would go into effect next year, could allow as many as 200,000 uninsured people to gain coverage, according to the White House.
About 1 million people could switch to a cheaper plan.
The change, which must complete a rulemaking process, is the biggest step the Biden administration can take without Congress to improve affordability under the ACA. according to Larry Levitt, executive vice president of health policy at the Kaiser Family Foundationa nonpartisan research group.
North Carolina Rep. Virginia Foxx, the top Republican on the House Education and Labor Committee, accused the administration of usurping congressional authority. She said the change will eliminate employer-sponsored coverage and increase Obamacare’s cost to taxpayers.
No Republicans voted for the Affordable Care Act, and Republican lawmakers tried unsuccessfully to repeal it during the Trump administration.
“We need to keep fighting,” Biden said of Republicans’ “relentless” attacks on the ACA.
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Saying he was quoting a “famous American,” Obama called the ACA a “big deal,” a clean version of Biden’s 2010 description of the law that he hadn’t realized was being captured on a microphone. .
“Barack, let me remind you, it’s a hot mic,” Biden said later as he turned to sign an executive order.
Before diving into the health care discussion, Obama joked that there have been a lot of changes in the White House since he’s been there. Secret Service agents have to wear aviator sunglasses. The Navy disaster has been replaced by a Baskin-Robbins. And there is a cat running.
“Bo and Sunny would have been very unhappy,” Obama said of the dogs running around the White House during his administration.
“Welcome back to the White House, man,” Biden said. “He feels like the good old days.”
The exeption? When the two had lunch before the event, they didn’t know who should sit where, Biden said, referring to presidential protocol.

The biggest expansion of health care since the passage of the ACA in 2010 occurred through the $1.9 trillion stimulus bill that Biden signed into law last year. That pandemic package increased Obamacare insurance subsidies for those who were already eligible for help through state and federal marketplaces. It also made help available to people earning more than four times the federal poverty level.
But the momentum expires in December.
Legislation to extend expanded subsidies was part of Biden’s “Build Back Better” plan that stalled in the Senate.
Fixing the “family problem” has been in the works since Biden signed an executive order during his first days in office directing agencies to review actions they could take to make health care more accessible and affordable.
The administration wants to change when insurance coverage offered by an employer is deemed unaffordable, making the worker’s family members eligible for a subsidized marketplace plan.
Currently, a workplace plan is considered affordable if the employee-only coverage costs less than 9.83% of the worker’s household income. That calculation doesn’t take into account the cost of including family members in the plan.
The Kaiser Family Foundation estimates that 5.1 million people are affected by the way the IRS initially drafted the regulation when interpreting the ACA. Most have insurance through an employer but pay high premiums.
For various reasons, not everyone affected would accept the market’s plans once the flaw is fixed. For example, because only family members, not the worker, would be eligible for a Marketplace plan, some may find it more convenient to keep the entire family on one plan.
Plus:Record 14.5 million Americans sign up for Obamacare during open enrollment for 2022 plans

A record 14.5 million people purchased an ACA Marketplace plan during open enrollment for 2022 coverage.
In addition to temporarily expanding subsidies, the administration quadrupled the number of people available to help with enrollment through HealthCare.gov.
Maureen Groppe has covered Washington for nearly three decades and is now the White House correspondent for USA TODAY. Follow her on Twitter @mgroppe.