Negotiations Continue on ACA Fix

President Trump has weighed in with specific requests for the Alexander-Murray health deal aimed at stabilizing the individual insurance market. The White House is asking that the penalties for failure to comply with the individual and employer mandates be lifted for the years 2015, 2016, and 2017. The Administration has also asked for additional state waiver flexibility, expanded use of health savings accounts (HSAs), and increased use of short-term, limited duration health insurance plans. While Republicans have welcomed the input, Democrats are opposed to reopening negotiations on a package that already has enough support to pass the Senate. Majority Leader Mitch McConnell (R-Ky.) has said that he will bring the health care bill to floor when the President indicates that he will sign it into law. House Freedom Caucus Chairman Mark Meadows (R-N.C.) has stated that the bill must be revised to be “substantially more conservative” in order to have a chance of passing the lower chamber. The changes that Meadows is working on with Sens. Lindsey Graham (R-S.C.), Ron Johnson (R-Wis.), and Rep. Tom MacArthur (R-N.J.) largely align with those requested by the White House.

The Congressional Budget Office (CBO) estimates that the Alexander-Murray plan would reduce the deficit by $3.8 billion between 2018 and 2027, according to the score released last week. CBO reports that the legislation would not substantially change the number of people with health insurance coverage compared to the existing baseline.

In related news, House Ways and Means Committee Chairman Kevin Brady (R-Texas) and Senate Finance Committee Chairman Orrin Hatch (R-Utah) released a bicameral proposal that would temporarily extend funding for cost-sharing reduction (CSR) payments for two years. The funding would be contingent upon structural reforms to the Affordable Care Act (ACA), including the expansion of HSAs to increase the maximum contribution limit, relief from the individual mandate penalty between 2017-2021, relief from the employer mandate between 2015-2017, and attaching pro-life protections to insurance carriers receiving CSRs. The full legislative language has yet to be released.

Judge Rejects Motion to Restore CSR Payments

A federal judge in California has rejected an emergency motion to temporarily restore the cost sharing reduction (CSR) payments to health insurers under the Affordable Care Act (ACA), which the President announced he would stop paying earlier this month. The judge said he was skeptical that cutting off the payments would cause immediate injury to residents because of preparatory steps taken by states in anticipation of the Administration’s decision. The motion for a temporary restraining order had been signed by 18 states and the District of Columbia.

House Passes Senate Budget Resolution by Narrow Margin

The House of Representatives passed the Senate-adopted budget resolution H. Con. Res. 71 by a vote of 216-212 last week. The resolution will allow lawmakers to begin work on a $1.5 trillion tax cut through the fast-track budget process known as reconciliation. The budget resolution also calls for $5 trillion in spending cuts over the next decade. House Budget Committee Chairwoman Diane Black (R-Tenn.) had supported $203 billion in deficit reductions from mandatory spending included in the House-passed budget adopted earlier this month. However, she decided to vote in favor of the Senate resolution in order to avoid a conference committee between the two chambers and speed the passage of tax reform legislation.

House Passes CBP Fentanyl Legislation

The House of Representatives passed legislation to increase the U.S. Customs and Border Protection’s (CBP) ability to prevent fentanyl and other synthetic opioids from being smuggled into the country. The bill would authorize $9 million to provide for chemical screening devices, scientists, and other personnel at the CBP to prevent the illegal importation of opioids. The bill was approved by a vote of 412-3. Companion legislation has been introduced by Sens. Ed Markey (D-Mass.), Sherrod Brown (D-Ohio), Marco Rubio (R-Fla.), and Shelley Moore Capito (R-W.Va.).

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