Federal News for AHIP’s Individual Members
(1) House Approves Health Care Reform Legislation
Late yesterday evening, the House approved both the health reconciliation bill and the Senate health reform bill, after defeating a Republican motion to recommit the reconciliation bill back to the House Budget Committee.
The Senate health reform bill is now ready to be signed into law by President Obama. The health reconciliation bill will be considered in the Senate this week.
A key factor in the outcome of yesterday’s debate was an agreement between pro-life Democrats, led by Rep. Bart Stupak (D-MI), and Democratic leaders and the White House. Under this agreement, Stupak and his allies agreed to support the health reform legislation with the understanding that the President will sign an executive order establishing safeguards to prevent federal funds from being used to pay for abortions.
The House cast the following health reform votes:
By a vote of 220 to 211, the House approved H.R. 4872, the “Health Care and Education Affordability Reconciliation Act.”
By a vote of 219 to 212, the House approved H.R. 3590, the “Patient Protection and Affordable Care Act.” This is the same bill that was approved by the Senate on December 24, 2009.
By a vote of 232 to 199, the House defeated a motion to recommit the reconciliation bill back to the House Budget Committee with instructions to add stronger language to prohibit federal funding for abortions.
By a vote of 224 to 206, the House approved the rule that was adopted last night by the House Rules Committee.
(2) CBO and JCT Release Cost and Revenue Estimates for Health Reform Legislation
The Congressional Budget Office (CBO) released a preliminary cost estimate Thursday for H.R. 4872, the “Health Care and Education Affordability Reconciliation Act of 2010.” Another new document, prepared by the Joint Committee on Taxation (JCT), outlines revenue estimates for the bill’s tax provisions.
CBO estimates that enactment of both the reconciliation bill (H.R. 4872) and the Senate-passed health reform bill (H.R. 3590) would reduce the number of uninsured Americans from 50 million in 2010 to 23 million in 2019. According to the CBO score, the coverage expansions of the combined bills are estimated to cost $940 billion over ten years. This includes $466 billion for premium subsidies and related spending, $434 billion for increased spending by Medicaid and CHIP, and $40 billion for small employer tax credits. When the budget offsets of the combined bills are factored in, the legislation is estimated to reduce the federal budget deficit by $138 billion over ten years.
Tax Provisions
The JCT document outlines ten-year estimates for the following tax provisions:
- the high-value health plan tax is estimated to raise $32 billion;
- the premium tax on health insurance plans is estimated to raise $60 billion;
- the annual fee on manufacturers and importers of prescription drugs is estimated to raise $27 billion;
- the excise tax on manufacturers and importers of medical devices is estimated to raise $20 billion; and
- the broadening of the Medicare payroll tax for high-income taxpayers is estimated to raise $210 billion.
(3) AHIP Addresses Letter to Secretary Sebelius
On March 15, AHIP addressed a letter to Secretary of Health and Human Services (HHS) Kathleen Sebelius, responding to the issues she raised at our National Policy Forum earlier this month.
In her comments at the Policy Forum, the Secretary outlined two requests to AHIP’s membership: (1) that we increase transparency for consumers by releasing information on premium increases; and (2) that we provide additional recommendations on how to make the system more affordable and address the current cost crisis.
In response to the request for greater transparency, AHIP’s letter emphasizes that we are working with the National Association of Insurance Commissioners (NAIC) to develop a template our members can use in providing information on the factors that are driving premium increases. Our letter encourages the Secretary to consider pursuing transparency for hospitals, physicians, pharmaceutical and device companies, and other suppliers. It also outlines recommendations for improving the current health reform legislation, including steps to achieve enforceable, system-wide cost containment and ensure that the legislation does not increase costs and undermine the goals of reform.
(4) House Approves 30-Day Extenders Bill With Physician Payment and COBRA Provisions
On March 17, by voice vote, the House approved legislation, H.R. 4851, that provides for another one-month extension – through April 30, 2010 – of the Medicare physician payment fix and the eligibility period for premium assistance for unemployed workers with COBRA and state continuation coverage. Under current law, both provisions are scheduled to expire at the end of this month.
Senate leaders will try to pass this bill shortly, so it can be signed into law by the President. Recently, the Senate approved a separate bill, H.R. 4213, that includes a longer term extension for both the physician payment fix (through September) and the COBRA provision (through December). This bill also includes a one-year extension of both Medicare Advantage Special Needs Plans and Medicare Cost Plans, and a six-month extension of the enhanced Medicaid FMAP that was enacted last year as part of the economic recovery legislation.
H.R. 4213 requires further action – either conference committee deliberations or House approval – before it can be signed into law. However, there has been little progress on this bill over the past week because its primary sponsors have been deeply involved in the health reform debate. Congressional leaders are hoping that enactment of the current one-month extension bill will give them enough time to complete action on H.R. 4213 during the month of April after health reform legislation has been signed into law.
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