Senate Republicans Add Repeal Of ACA’s Individual Mandate To Tax Reform Bill.
The New York Times (11/14, A1, Kaplan, Tankersley, Subscription Publication) reports on its front page that GOP senators have decided to add a provision to repeal the ACA’s individual mandate to their tax reform bill, thus “merging the fight over health care with the high-stakes effort to cut taxes.” The article says this is also “a calculated gamble to help speed their bill to passage on a party-line vote.” These moves “are attempts by Republicans to solve two problems: math and politics.” Repealing the mandate would enable the federal government to save hundreds of billions of dollars over the next decade, which would allow expanded tax cuts for the middle class. The piece says several healthcare groups, such as the American Medical Association and America’s Health Insurance Plans, are opposed to repealing the ACA’s mandate.
In a front-page article, the Washington Post (11/14, A1, Paletta, Debonis) reports that this was “a major change of strategy” as Senate Republicans attempt “to accomplish two of their top domestic priorities in a single piece of legislation.” The Post says repealing the ACA’s individual mandate “would free up more than $300 billion in government funding over the next decade that Republicans could use to finance their proposed tax cuts.” However, the Congressional Budget Office has warned this “would result in 13 million fewer people having health insurance.” The CBO also predicted that repealing the mandate would raise premiums for many consumers by about 10 percent.
The Wall Street Journal (11/15, A1, Armour, Rubin, Subscription Publication) reports on its front page that the decision to include a repeal of the ACA’s individual mandate in Senate Republicans’ tax bill makes the debate even more complicated. Although McConnell expressed optimism that the revised bill would pass, House Speaker Paul Ryan (R-WI) said the House will not take similar action until the Senate proves it can pass such a measure.
Legislation and Policy
Federal Government Owes Insurers $12.3 Billion In ACA Risk-Corridor Payments, Analysis Indicates.
Modern Healthcare (11/14, Livingston, Subscription Publication) reports that to date, the federal government “owes health insurers $12.3 billion in risk-corridor payments to cover losses those health plans incurred on the insurance exchanges between 2014 and 2016,” according to an analysis of the latest figures from CMS. That amount “includes roughly $3.95 billion in payments to cover insurers’ losses in 2016 alone.” CMS “also owes insurers $5.8 billion in risk-corridor payments for 2015,” in addition to “the $2.5 billion shortfall for 2014 losses.” The article says the government has made little headway in reimbursing insurers.
House Republicans Oppose Bipartisan ACA Stabilization Bill.
The Washington Examiner (11/14, King) reports several House Republicans spoke out against bipartisan legislation to stabilize the ACA exchanges crafted by Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA). Rep. Mark Walker (R-NC), chairman of the Republican Study Committee, said, “I don’t see that as something we are gonna take up right now,” and Rep. Joe Barton (R-TX) tweeted, “Alexander-Murray is toxic. Congress should not subsidize health insurance companies.” Some Republicans, such as Rep. Phil Roe (R-TN), suggested that adding repeal of the individual mandate to the legislation would “make me think more positively in that direction,” he said.
Public Health and Private Healthcare Systems
CBO Says GOP Tax Plan Could Lead To Medicare Cuts Of $25 Billion.
Roll Call (11/14, Mejdrich) reports that congressional Republicans’ tax proposal could lead to mandatory multi-billion dollar cuts under a sequester, according to a Congressional Budget Office report Tuesday. The CBO “calculated if the tax package were to add up to $1.5 trillion to the deficit over 10 years as currently expected, automatic cuts required under the 2010 pay-as-you-go law would amount to $136 billion in fiscal 2018.” Medicare is the largest nonexempt mandatory program and would be cut $25 billion, with the remainder coming out of other programs such as agricultural subsidies, state workforce development grants for individuals with disabilities, and even some mandatory funding streams for the immigration enforcement and border protection agencies.
Vox (11/14, Golshan) reports Sen. Pat Toomey (R-PA) answered questions about the CBO’s letter, saying of cuts to Medicare and other programs, “No such thing is going to be triggered automatically.” Vox adds that there “are ways Congress can get around this – namely by passing a law that wipes the scorecard clean for the year,” but describes the political challenge for Republicans of “voting to undermine a deficit-management law.” The piece adds that such a law could not be done under budget reconciliation and would require 60 votes.
Iowa Lawmakers Promise To Reconsider “Mistake” Of Changing Retroactive Medicaid Benefits Policy.
The Des Moines (IA) Register (11/14, Pfannensteil) reports that Iowa legislators from both parties on the Administrative Rules Review Committee “expressed concern Tuesday” over a change in the law of Medicaid retroactive eligibility that was “tucked into a massive budget bill that was introduced and approved in the chaotic final weeks of the last legislative session.” State Rep. Guy Vander Linden (R) said, “We may all regret what’s in code, but it’s not within the power of this … committee to overturn the will of the Legislature,” and promised to “take another look at this once we reconvene” in January. State Sen. Pam Jochum (D) added, “We made a mistake, and we have to be statesmanlike enough to admit that a mistake was made and to correct it.” Some 40,000 Iowans may be affected by the change.