Congressional Corner

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Aug. 17, 2017

Appropriations

The House Rules Committee released the final four of 12 appropriations bills for FY18 known as the minibus. Lawmakers hope to bring the bill to the floor in early September when Congress returns. Before leaving Washington, D.C., the House passed a partial minibus comprised of four bills. The final eight bills include: agriculture, commerce-justice-science, financial services, homeland security, interior-environment, labor-HHS-education, state-foreign operations, and transportation-HUD.

The Senate is expected to mark up appropriations bills during the first week of September, although this has not yet been officially announced.

In addition, it is important to note that only a handful of legislative work days remain in September before expiration of FY17 funding. Congress must also address the debt limit increase before the end of September. ASTHO will continue to monitor the progress of these bills.

Healthcare Reform

The House of Representatives continues to discuss ACA repeal without replacement. Doing this without involving House leadership would involve petitioning members to vote on a version of the bill that passed in 2015 but was vetoed by President Obama. A majority of the House must sign the petition to move forward. A similar version of the bill passed the Senate last month but failed, in part, due to the belief that it could not pass the House.

Included in the bill is repeal of Medicaid expansion, the individual and employer mandates, protections for preexisting conditions, banned funding for Planned Parenthood for one year, and elimination of the Prevention and Public Health Fund. The proposed bill would take effect at the end of 2018. ASTHO will continue to monitor this process.

Meanwhile, cost sharing reduction payments remain in limbo. The Congressional Budget Office (CBO) issued a report on the impact of ending these payments to insurance companies. The report states that gross premiums (before accounting for tax credits) for silver plans offered through the marketplace would rise by 20 percent in 2018 and inflate to 25 percent by 2020. The federal deficit would also increase and people would pay a similar or lower amount in net premiums (after accounting for tax credits) over the next decade, although there would be a slight increase in the next two years and a short-term increase in the uninsured rate. It would then drop after 2020.

The Centers for Medicare and Medicaid extended the deadline for insurers to file rates until Sept. 5. States that run their own exchange can also delay their filing deadline.

The Senate Health, Education, Labor and Pensions Committee will begin hearings on insurance market stabilization in early September, which may include payments of the cost-sharing reductions. In a statement, Sen. Alexander said that “Congress should pass balanced, bipartisan, limited legislation in September that will fund cost-sharing payments for 2018 as well as make section 1332 of the Affordable Care Act work better to give states more flexibility in approving insurance policies. These two actions will help make insurance policies available at affordable prices. Congress owes struggling Americans who buy their insurance in the individual market a breakthrough in the health care stalemate.”