Ways and Means Marks Up Health Care Reform Legislation

The House Ways and Means Committee has advanced three bills aimed at reforming the nation’s health care system. e markup was considered part of the third phase of the Republican approach to repealing and replacing the A ordable Care Act (ACA). e rst phase is the American Health Care Act (AHCA) – repeal legislation that can be advanced through reconciliation. e second phase consists of administrative changes that can be made unilaterally by Secretary of the U.S. Department of Health and Human Services (HHS) Tom Price to roll back the law. The third phase encompasses legislation that reforms the health care system but cannot be passed under the rules of reconciliation. The Committee advanced H.R. 1671, introduced by Rep. Lou Barletta (R-Pa.), to require veri cation of eligibility by the Social Security Administration and Homeland Security in order to qualify for premium subsidies, with no Democratic support. H.R. 2372, o ered by Rep. Sam Johnson (R-Texas), would codify the current practice of allowing veterans to access premium subsidies if they are not enrolled in coverage at the Veterans Administration, in the event that the American Health Care Act becomes law. H.R. 2372 was also passed with no Democratic committee member support. H.R. 2579, from Rep. Pat Tiberi (R-Ohio), would allow the ACA’s premium subsidies to be applied to COBRA coverage. e bill was advanced with the support of one committee Democrat, Rep. Ron Kind (D-Wis.). Republicans hope to pass these bills through the House with bipartisan support.

CBO Scores the American Health Care Act

The Congressional Budget Office (CBO) has released its score of the American Health Care Act (AHCA), which would repeal and replace Obamacare. According to the non-partisan budget agency, AHCA would lead to 23 million more uninsured over the next decade. This estimate is in keeping with previous versions of the bill. The House-passed legislation, however, would produce fewer savings than previous versions of the bill. CBO estimates that the AHCA would reduce the deficit by $119 billion over the next ten years, down from earlier projections of $151 billion and $337 billion. Premiums would increase for two years before decreasing by 20 percent in 2018 and five percent in 2019. CBO predicts that the changes to the Medicaid program would reduce coverage by 10 million people and cut program funding by $834 billion over the next decade. The agency also warns that the bill could undermine the stability of insurance markets in one-sixth of the country – those states which choose to waive ACA insurance regulations. As a result, older and sicker Americans would see a drastic increase in the cost of their insurance coverage. While the score was well-received by Speaker of the House Paul Ryan (R-Wis.) for confirming that the bill would lower the deficit, Secretary of the U.S. Department of Health and Human Services (HHS) Tom Price questioned the score’s accuracy. In the Senate, some Republican members warned that the CBO’s analysis underscored the need for the upper chamber to pass legislation that does more to protect those with pre-existing conditions. Majority Leader Mitch McConnell (R-Ky.), however, reiterated that the ACA status quo was unacceptable and unsustainable, regardless of the CBO report.

Senate Repeal Legislation to be Drafted is Week

Senate sta plans to spend the week of Memorial Day recess drafting a health care bill and building consensus around a plan to repeal and replace the Affordable Care Act (ACA). Staff will also confer with the Senate parliamentarian to discuss which aspects of Obamacare repeal and replacement can be accomplished through reconciliation. Majority Leader Mitch McConnell (R-Ky.) has confirmed that he does not yet have the votes to bring repeal legislation to the Senate floor. The biggest sticking point appears to be Medicaid – lawmakers in the Senate can’t seem to agree on how much to scale back Obamacare’s expansion, or how to rein in program spending. Additionally, there is still disagreement about whether to allow states to waive the health care law’s insurance regulations, which require coverage of essential health benefits and community rating. The Senate GOP is currently in the early stages of weighing a proposal to stabilize the insurance market in 2018 and 2019, while postponing ACA repeal until 2020. Lawmakers are also looking into the idea of reinsurance as an alternative to the use of high-risk pools to provide coverage to high cost patients.

Continuous Coverage Legislation Introduced

Lawmakers in the House and Senate introduced the bipartisan Stabilize Medicaid and CHIP Coverage Act of 2017 last week.  The legislation would offer continuous eligibility for Medicaid and Children’s Health Insurance Program (CHIP) enrollees for the full year, in order to reduce the number of beneficiaries going on and off  the programs because of slight changes to their income. The bill was introduced by Reps. Gene Green (D-Texas) and Joe Barton (R-Texas) in the House (H.R. 2628), and by Sen. Sherrod Brown (D-Ohio) in the Senate (S. 1227).

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