ACA Repeal or Reform Tops Trump Administration Agenda

President-Elect Donald Trump named health care as one of his top three priorities last week, while his transition team outlined additional information related to the incoming administration’s health care policy plans. Trump has picked Paula Stannard as his point person on health reform. Stannard is a lawyer at Alston & Bird and has worked as deputy general counsel and acting general counsel at the U.S. Department of Health and Human Services (HHS). Trump plans to replace the Affordable Care Act (ACA) with a plan that includes high-risk pools for people with expensive medical conditions, Health Savings Accounts (HSAs), and return of the regulation of health insurance to the states. The administration will also allow the sale of health insurance across state lines. Come January, a top priority for both President Trump and congressional Republicans will be confronting the ACA. While Trump campaigned on a promise to repeal and replace the ACA, in an interview with the Wall Street Journal last week he expressed willingness to review whether to keep parts of the 2010 health care reform law intact. Specifically, he suggested that he was open to keeping provisions that prevent insurers from refusing to cover preexisting conditions, and which allow children to stay on their parents’ insurance plans until age 26. Congressional Republicans are split on whether the law should be quickly repealed, with or without a replacement plan, or whether it should be gradually phased out over time. While a formal plan is yet to be determined, it is likely that lawmakers will use the fast-track budget tool known as reconciliation, which would allow a health reform bill to pass the Senate with a simple majority rather than the 60-vote threshold normally required to overcome a filibuster. HealthCare.gov experienced its strongest day of signups in this year’s open enrollment period last week, with more than 100,000 people choosing plans the day after Donald Trump’s presidential election win.

White House Drops Push for TPP

The Obama Administration will stop pursuing passage of the Trans-Pacific Partnership (TPP) trade deal, following the election of Donald Trump and announcements by congressional leadership that the deal will not be considered during the lame-duck session. While both presidential candidates campaigned in opposition to the agreement, some administrators and Republican elected officials had remained optimistic that a deal could be reached before President Obama left office. Senate Majority Leader Mitch McConnell (R-Ky.), however, announced that he plans on working with the president-elect on a trade agreement in the future. The TPP deal would have included patent protections for biologics.

115th Congress Committee Changes and Priorities

Congressional committees are already beginning to prepare for the next session of congress amidst changes to chairs and ranking members that will occur due to retirements and party term limits on chairmanships. In the Senate, the Health, Education, Labor and Pensions (HELP) Committee may see a change in its ranking member if Patty Murray (D-Wash.) decides to run for a leadership position. This decision would require giving up her position as ranking member. The HELP Committee will focus on the reauthorization of the user fee agreements between the Food and Drug Administration (FDA) and the pharmaceutical and device manufacturer industries. Current authority expires September 30, 2017. Chairman Lamar Alexander (R-Tenn.) has also pointed to the development of medical countermeasures for public health emergencies, the regulation of laboratory developed tests (LDTs), and improving the use of health information technology as priorities for the coming year. Mental health and substance abuse are expected to remain a focus of the committee as well. In the House, the Energy and Commerce Committee will see a new chairman during the 115th Congress. Rep. Fred Upton (R-Mich.) is party term limited, and committee members John Shimkus (R-Ill.), Greg Walden (R-Ore.), and Joe Barton (R-Texas) are interested in assuming the chairmanship. House Ways and Means Committee Chairman Kevin Brady (R-Texas) has already said that he intends to move legislation that will overhaul the U.S. tax code during President Trump’s first 100 days in office. The plan will cut tax rates for both individuals and companies. This priority has also been echoed by Senate Majority Leader Mitch McConnell (R-Ky.). In addition to tax reform, Ways and Means will be involved in any efforts to repeal or revise the Affordable Care Act (ACA). The Committee will also continue its work on reforming Medicare hospital payment policies. The Senate Finance Committee also plans on prioritizing a revamp of the tax code for the beginning of the 115th Congress. The House Oversight and Government Reform Committee is expected to use the 115th Congress to explore the high cost of prescription drugs. Members are also interested in focusing on reducing improper payments and addressing premium increases and the failure of the CO-OPs under the ACA.

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