Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


Lawmakers Recess with Little Progress on Health Care Reform

Following withdrawal of the American Health Care Act last month, Republican leadership has been working to secure enough votes for passage of Obamacare repeal and replacement through uniting members of their own party. The focus of the debate has been on lowering premiums and protecting access to health care. Instead of Speaker of the House Paul Ryan (R-Wis.), Vice President Mike Pence has been taking the lead on negotiations between the moderate and conservative factions of the Republican Party. Disagreement continues around a proposal to give states the ability to opt out of the essential health benefit requirement, community rating (preventing insurers from charging sick people more for insurance), and guaranteed issue (coverage for people with pre-existing conditions). The conservative House Freedom Caucus supports the elimination of these insurance regulations as a means to drive down premiums. House lawmakers must also continue to ensure that any bill passed by the House would be in line with the Senate’s Byrd Rule, which prevents “extraneous matter” from reconciliation legislation. Some had hoped that a vote would be held before Congress left for a two-week recess, but members of the House went home without having reached a compromise. Speaker Ryan has stressed that there is no deadline for a vote on Affordable Care Act (ACA) repeal and replacement but anticipates that his conference will be able to wrap up work on health care this spring. The House Rules Committee met on Thursday to add a provision to the health care legislation that would create a $15 billion highrisk pool program to help insurers cover the cost of the sickest, most expensive patients, beginning in 2018 and lasting through 2026. The federal subsidy would allow seriously ill individuals to remain in the general insurance pool, and for risk to be shared among taxpayers and insurers. The amendment, known as the Federal Invisible Risk Sharing Program, was sponsored by Reps. Gary Palmer (R-Ala.) and David Schweikert (R-Ariz.). It would give the U.S. Department of Health and Human Services (HHS) the authority to determine how the money is distributed. In 2020, the program would be handed over to the states. The measure was approved by the Rules Committee by a party-line vote of 9-2. Speaker Ryan has said that the measure is supported by a broad part of the GOP conference, while Freedom Caucus Chairman Mark Meadows (R-N.C.) called the risk-sharing amendment a positive step toward bringing down insurance rates, “but certainly not the final step.” House Majority Leader Kevin McCarthy (R-Calif.) has stated that the April recess could be cut short if a deal is reached on health care reform. The House is scheduled to be out of session until Tuesday, April 25. Congressional staff and the relevant committees will continue to work on the bill during the two-week recess.

December 31, 1969: | Page 1 Page 2 Page 3 Page 4 Page 5



 -  2019

 +  2018