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.


Congress Continues work on ACA Repeal, Senate to Consider Cruz Amendment

As Congress returns from a week-long recess, Senate Republicans will continue to work to overcome deep divisions preventing a vote on legislation to reform the health care system.

The Congressional Budget Office (CBO) is currently working to analyze a version of the Senate proposal to repeal and replace the Affordable Care Act (ACA) that includes an amendment from Sen. Ted Cruz (R-Texas). Although legislative text has not yet been released, the proposal aims to provide for the availability of cheaper plans with lower premiums. The amendment would create two parallel health insurance markets across states. One market would include protections for individuals with preexisting conditions and coverage of essential health benefits. The other market would be allowed to sell plans that do not comply with these regulations, most likely without the support of federal subsidies, as long as insurers also sell plans that comply with the rules. While the Cruz amendment has been endorsed by the White House as well as both House and Senate conservatives, it is viewed as a nonstarter by moderate Republicans. There are concerns that the proposal would segment and destabilize the insurance market, sending healthy people into the deregulated, inexpensive plans, while sicker people with preexisting conditions would move into the regulated, but more expensive, insurance pool. It is also unclear whether Sen. Cruz’s proposal would pass the rules of budget reconciliation.

Republicans hope to vote on a measure before the end of July, but a vote is unlikely to be held in the coming week. Even Majority Leader Mitch McConnell (R-Ky.) has begun to express doubts about the chances of successfully passing repeal and replacement legislation. If Senate Republicans cannot coalesce around a bill, McConnell has said that Congress would instead need to immediately act to stabilize insurance markets. Congress is scheduled to be in Washington for only three more weeks before leaving for the month-long August recess.

Dems Examine Effects of Prevention Fund Repeal

Democratic leadership on the key House and Senate health committees released an analysis of how slashing Obamacare’s Prevention and Public Health Fund would impact each state. The report, released by Ranking Member of the Senate Health, Education, Labor and Pensions (HELP) Committee Patty Murray (D-Wash.) and Ranking Member of the House Energy and Commerce Committee Frank Pallone (D-N.J.), concludes that states would lose a cumulative $3 billion over the next five years. Both the House-passed American Health Care Act (AHCA) and current Senate repeal proposals call for elimination of the fund, which Democrats believe will debilitate public health efforts aimed at chronic disease, food-borne illness, pandemics, and other public health emergencies.

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