This Week in Washington - December 15, 2017

House and Senate Republicans Reach Deal on Tax Reform

On December 13, House and Senate Republicans announced they’ve reached an agreement on how to reconcile the differences between their respective tax reform bills. Although text of the legislation has not been released, reports indicate the final version will repeal the ACA’s individual mandate and keep the current tax exemption for private activity bonds. The measure temporarily reduces the medical expense deduction to 7.5 percent for two years but otherwise keeps it at 10 percent. The reports also indicate that taxing graduate school tuition waivers and eliminating the deduction for student loan interest will be not be included.

Although House Republicans expect to pass the bill with relative ease as early as Wednesday, Senate Republicans have a more difficult task ahead given their narrow 52-48 majority. Sen. Susan Collins (R-ME) has conditionally agreed to vote for the legislation on the premise that continuing the ACA’s cost-sharing reduction subsidies and creation of a federal reinsurance program will be included in other bills. Sen. Jeff Flake (R-AZ) is still undecided. Meanwhile, Sens. John McCain (R-AZ) and Thad Cochran (R-MS) are receiving treatment for health problems and their ability to cast votes next week is unknown.

House Introduces Funding Proposal that Includes CHCs and CHIP

On December 13, House appropriators introduced a temporary funding measure to keep the government running through January 19, 2018. It would also fund Community Health Centers (“CHCs”) for two years and the Children’s Health Insurance Program (“CHIP”) for five years. While CHIP funding is welcome news for states, Republicans have included provisions to cover the cost of extending CHIP that have been roundly rejected by Democrats. These include cutting the ACA Prevention and Public Health Fund by $10.5 billion, shortening the grace period in which ACA enrollees can miss premium payments without losing coverage and banning lottery winners from getting Medicaid benefits. As a result, the measure could be filibustered by Senate Democrats, which, if not resolved or overcome, would result in a partial government shutdown.

The funding measure does not include an expected funding boost for telemedicine provided in Medicare Advantage plans. Last month, members of the House Ways and Means Committee introduced a bipartisan bill (H.R. 3727) to allow Medicare Advantage plans to account for telemedicine in their annual bids from Medicare. The measure is expected to save Medicare $80 million over a decade.

Ways and Means Republicans Introduce Bills Minimizing ACA Taxes

On December 12, House Ways and Means Committee Republicans introduced several bills to repeal or delay several ACA-related taxes. Reps. Erik Paulsen (R-MN) and Jackie Walorski (R-IN) introduced legislation (H.R. 4617) to delay the medical device tax for five years. Legislation (H.R. 4616) retroactively lifting the employer mandate for the last three years, as well as over the next year, paired with a one-year delay of the tax on “Cadillac” health plans (currently set to go into effect in 2020) was introduced by Reps. Devin Nunes (R-CA) and Mike Kelly (R-PA). Rep. Lynn Jenkins (R-KS) introduced a measure (H.R. 4618) to lift a ban on using health savings accounts to pay for over-the-counter medicine.

Rural Broadband Program Expanded by FCC

This week, the Federal Communications Commission (“FCC”) voted to put additional funds into its rural health broadband subsidy program this year. The funds will be redistributed to ensure all eligible applicants in 2017 receive money. The Rural Health Care Program distributes $400 million annually for rural doctors, hospitals and nursing homes to adopt and pay for broadband internet access. The additional funds were necessary since the program reached its funding cap the last two years due to the increase in telemedicine use, as well as nursing homes being eligible for subsidies.

Health-Related Bills Introduced This Week

Rep. Christopher Smith (R-NJ) introduced the Global Brain Health Act (H.R.4621) to galvanize government programs in support of brain health for global victims of autism, hydrocephalus and Alzheimer’s and other forms of dementia and for other purposes.

Sen. Michael Enzi (R-WY) introduced a bill (S.2214) to amend Title XVIII of the Social Security Act to provide for the recognition of attending physician assistants as attending physicians to serve hospice patients.

Rep. Peter King (R-NY) introduced a bill (H.R. 4638) to establish a National Commission on Fibrotic Diseases.

Sen. Angus King introduced a bill (S. 2241) to amend the Patient Protection and Affordable Care Act by clarifying that State Exchanges are prohibited from imposing fees or assessments on issuers of excepted benefits and standalone dental plans not sold through an Exchange.

Next Week in Washington

When Congress returns next week, Republicans plan to pass the tax reform legislation so it can be on President Trump’s desk for signature before Christmas. After the early week focus on tax reform, Congress will spend the remainder of the week working to pass new government funding legislation before the current funding measure expires on Friday.

This Week in Washington in History

50 years ago this week, 1967: President Lyndon B. Johnson signs the Wholesale Meat Act of 1967 into law. The signing ceremony in the East Room of the White House was attended by Upton Sinclair, the author of the 1906 book The Jungle, which controversially described conditions in Chicago’s meatpacking plants.

14 years ago this week, 2003: President George W. Bush signs the CAN-SPAM Act of 2003, establishing the United States’ first national standards regarding email and gives the Federal Trade Commission authority to enforce the act.

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