Week of January 16, 2017

ACA Repeal

Last week was another blockbuster week in Congressional efforts to repeal the Affordable Care Act. Both the Senate and the House of Representatives passed S. Con. Res. 3, a resolution setting forth budget amounts for the remainder of FY 2017, and providing a path to repeal portions of the Affordable Care Act by majority vote (through the process known as reconciliation). Included in this resolution were instructions to the House Ways & Means Committee and Energy & Commerce Committee and the Senate Finance Committee and HELP Committee to report out “changes in laws affecting” their respective jurisdictions by January 27 which would reduce the deficit by $1B apiece. The resolution also contained “reserve funds” that allow for payment for a health care replacement bill. The votes in both House and Senate were largely along party lines. In the Senate, all Democrats and Rand Paul (R-KY) voted against and in the House, no Democrats and a few Republican voted against the resolution (largely because of cost concerns).

While the budget resolution sets the stage for a quick repeal of those portions of the ACA that are budget-related (for example, the tax penalties for failing to comply with the individual and employer mandate, and the Medicaid expansion), the politics around repeal are challenging. LeadingAge and other advocates have been focused on the negative impact of reducing Medicaid coverage, whether by repealing the Medicaid expansion or radically changing the structure of the program through block grants or per-capita payments. In addition, there has been much concern expressed about the impact of repeal on the insurance market and the ability of persons currently innsured through the exchanges to be able to get health insurance.

Advocates opposed to repeal have now been joined by supporters in saying that there has to be a replacement to the ACA identified at the same time as repeal. The challenge is that members in the majority party have not settled on a specific replacement. In addition, President-elect Trump stated this weekend that he and his team were working on a replacement with the goal of “insurance for everyone”, that we believe would be introduced as part of the repeal legislation, after the President’s nominee for Secretary of HHS is confirmed. Read more at The Washington Post.

HHS Secretary Nominee

Last but not least, the nominee for Secretary of HHS, Tom Price, is scheduled for the first of two hearings on his nomination – the HELP Committee hearing is set for Wednesday, January 18 at 10 a.m. The HELP Committee does not actually vote on the nomination. The Senate Finance Committee has announced that it will hold its confirmation hearing for Rep. Price on Tuesday, January 24. Hearings on other nominees, like Seema Verma, the nominee for Administrator of CMS, have not been announced.