Senate Health Care Reform Effort: Round Two

Senate Health Care Reform Effort: Round Two

  • On July 14, 2017

 

Congress is still working on repealing and replacing the Patient Protection and Affordable Care Act (ACA).  Last month, the Senate Republican leadership had to postpone action on the Better Care Reconciliation Act due to a lack of consensus.  Now that the Senators are back from celebrating the 4th of July, Majority Leader Mitch McConnell (R-KY) plans try again with a revised plan to repeal at least parts of the Patient Protection and Affordable Care Act (ACA).

The revamped version of the GOP Senate health reform bill includes a proposal championed by Senator Ted Cruz (R-TX) that would let insurers sell slimmed down, lower cost individual policies alongside fully ACA-compliant coverage. The idea is to create lower premium plans for healthy individuals, but insurers are worried about how the availability of these plans could further damage the individual market risk pool and drive up costs more.  The revision also adds $45 billion in funding for states to address the opioid addiction crisis and gives the states an additional $70 billion dollars over 10 years to stabilize insurance markets (bringing the total available to $182 billion).  Furthermore, people would be able to pay for their health insurance premiums with money from health savings accounts and the legislation ensures that cost-sharing subsidies for low-income individual market purchasers will remain in place through 2019.

The new bill remains controversial though, and the main sticking point is Medicaid since it keeps most of the original legislation’s adjustments to that program’s federal funding stream in place.  The Congressional Budget Office’s cost estimate, including their analysis of how the new bill would impact the number of uninsured Americans, will have a significant impact on how Senators decide to vote.

Meanwhile, Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) have unveiled another alternative that they think could have bipartisan appeal.  Their bill would keep all current health reform taxes except for the medical device tax and block grant all federal health reform funds annually to the states (this amount was about $110 billion in 2016).  Medicaid funds would remain unchanged, as would most ACA market reforms but the individual and employer mandate penalties would be zeroed-out.  Their measure could be considered as a stand-alone plan, or it could be offered as an amendment to the GOP leadership bill.

If the second (or third) time is the charm in Senate, whatever passes must be merged with the American Health Care Act  that was approved by the House of Representatives in May.  After that, both chambers will need to agree on the legislation before President Trump can sign it into law.  Majority Leader McConnell will keep the Senate working during the first two weeks of its previously scheduled August recess in hopes of getting health care reform and other priority items done.  The House of Representatives still plans to be back at home for most of August, but its leadership has made it clear that if the Senate passes a health reform repeal and replace bill while they are gone, the House will reconvene within 72 hours.

If the second (or third) time is the charm in Senate, then whatever final measure passes will still need to be merged with the American Health Care Act that passed the House of Representatives in May.  After that, both chambers will need to agree on the legislation before President Trump can sign it into law.  Majority Leader McConnell plans to keep the Senate working during the first two weeks of its previously scheduled August recess in hopes of getting health care reform and other priority items done.  The House of Representatives still plans to be back at home for most of August, but its leadership has made it clear that if the Senate passes a health care reform repeal and replace bill while they are gone, the House will reconvene within 72 hours.

Kistler Tiffany Benefits continues to actively monitor Congress’s progress on health care reform with an eye towards any changes that would impact employer-sponsored health benefit plans.  So far, nothing has changed, and existing health care reform compliance efforts need to continue.  Plan design options for 2018 also remain unaffected for now.  If and when changes occur that will affect our clients, Kistler Tiffany Benefits will ensure you and your employees understand what the impact will be.

By Jessica Waltman, Special Contributor

Jessica Waltman is a health reform strategist, with more than 20 years of experience in health insurance markets and health policy. She is the former Senior Vice President, Government Affairs, for the National Association of Health Underwriters.

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