Skip to main content

Sign up for our newsletter.

Quality journalism. Progressive values. Direct to your inbox.

Joe Manchin

Sen. Joe Manchin (D-W.Va.) participates in a Senate Energy and Natural Resources Committee markup on May 3, 2022 in Washington, D.C. (Photo: Kevin Dietsch/Getty Images)

Manchin Pushes Even More Healthcare Means Testing as West Virginians Suffer

As the West Virginia Democrat blocks Medicare expansion and demands more restrictions on Affordable Care Act subsidies, residents of his home state are "extracting their own teeth with a hammer."

Jake Johnson

Having tanked his party's effort to expand Medicare and close the Medicaid coverage gap, Sen. Joe Manchin is now dangling his support for an extension of Affordable Care Act subsidies as massive premium hikes loom for millions of people who buy insurance on the exchanges.

Insider reported Wednesday that Manchin has "signaled he's open to extending enhanced subsidies under the Affordable Care Act, a move that would help Democrats avert a huge political threat in the November midterms."

The American Rescue Plan—a Covid-19 relief package that President Joe Biden signed into law last year—included provisions that boosted ACA subsidies for low-income people and ended the income cap on subsidies. The changes were aimed at ensuring no one is forced to pay more than 8.5% of their total income to purchase health coverage in the ACA marketplace, which can be prohibitively expensive without federal subsidies.

But the provisions are set to expire at the end of the year in the absence of congressional action, sticking the roughly 14 million people who buy insurance on the ACA exchanges with dramatically higher premiums. Notifications of premium increases would begin going out in October, just ahead of the crucial midterm elections.

Even though eligibility for ACA subsidies—which progressives often characterize as gifts to the insurance industry—is already restricted on the basis of income, Manchin told Insider that he wants even more means testing, which he called "the main thing."

"We should be helping the people who really need it the most and are really having the hardest time," said Manchin, who supported the ACA subsidy boost in the American Rescue Plan. "With healthcare, people need help. They really do."

That's certainly true of people in his home state of West Virginia. After visiting a free medical clinic located just miles from Manchin's riverfront home in Charleston, The Lever's Andrew Perez reported earlier this week that one resident, Charles Combs, "has resorted to extracting his own teeth because dental care is too expensive."

Traditional Medicare currently doesn't cover dental services. Late last year, Manchin blocked an effort—spearheaded by Sen. Bernie Sanders (I-Vt.)—to expand the program to cover dental, vision, and hearing.

"The Charleston clinic made clear just how badly people need such care—and not just seniors, and not just West Virginians. Combs, for instance, is still in his 50s, while the clinic saw patients of all ages driving hours from Ohio, Kentucky, and Virginia," Perez noted. "The [Remote Area Medical] clinic hinted at the kind of universal healthcare system America could have, if not for senators like Manchin and their healthcare industry donors."

"The organization doesn't ask patients about what its team calls the 'three I's': identification, income, or insurance," Perez continued. "Patients are treated with kindness, compassion, and professionalism—and fairly quickly. All services are free."

In an interview with Punchbowl News this week, Manchin voiced concerns about the price tag of extending the ACA subsidies—scrutiny he has not applied to the trillions of dollars in Pentagon spending he's voted for over the past decade.

"The bottom line is there's only so many dollars to go around," Manchin said.

According to a recent analysis by Families USA, the roughly 23,000 West Virginians who buy health insurance coverage on the ACA exchanges will see their annual premiums rise by an average of $1,536—63%—if Congress lets the subsidy provisions expire.

"With little debate or media focus, Democrats are on the verge of dooming millions of Americans to huge new healthcare bills, which will in turn serve to ruin any hope Democrats have of winning the midterms," journalist Jon Walker warned in The American Prospect earlier this year. "Beyond broadly hurting 14 million people, the end of these subsidies will create thousands of uniquely horrific stories of financial devastation."


Our work is licensed under Creative Commons (CC BY-NC-ND 3.0). Feel free to republish and share widely.

We've had enough. The 1% own and operate the corporate media. They are doing everything they can to defend the status quo, squash dissent and protect the wealthy and the powerful. The Common Dreams media model is different. We cover the news that matters to the 99%. Our mission? To inform. To inspire. To ignite change for the common good. How? Nonprofit. Independent. Reader-supported. Free to read. Free to republish. Free to share. With no advertising. No paywalls. No selling of your data. Thousands of small donations fund our newsroom and allow us to continue publishing. Can you chip in? We can't do it without you. Thank you.

Conservative British Prime Minister Boris Johnson Agrees to Resign

"It is good news for the country that Boris Johnson has resigned as prime minister. But it should have happened long ago," said Labour Leader Keir Starmer. "He was always unfit for office."

Jake Johnson ·


Fulton County Subpoenas of Trump Allies Offer Hope 'That Justice Will Ultimately Be Served'

"The coordinated attempts by former President Donald Trump and his associates to discount and ignore the will of Georgian voters during the 2020 election cannot be swept under the rug," said one activist.

Jessica Corbett ·


Russian Official Makes Nuclear Threat Over US Support for Ukraine War Crimes Probe

Another official responded to Western sanctions by suggesting that Russia could reclaim Alaska.

Brett Wilkins ·


Biden Denounced for Imposing New Sanctions as Iran Nuclear Talks Falter

One Middle East expert accused the U.S. administration of "continuing and embracing Trump's max pressure policy, while expecting a different result."

Brett Wilkins ·


Under 'Draconian Abortion Ban,' Woman in El Salvador Sentenced to 50 Years for Pregnancy Loss

Laws like El Salvador's are "now being replicated in states across the U.S.," noted one observer.

Julia Conley ·

Common Dreams Logo