As you know, the Senate has been going through the Budget Reconciliation process with the objective of adopting legislation that would effectively repeal and replace the Affordable Care Act (ACA). After rejecting a proposal to effectively repeal the ACA with no replacement and another proposal to repeal the ACA with alternatives for maintaining coverage, last week the Senate turned its attention to considering a so-called “skinny option.”
Recently, the Senate GOP leadership released a “discussion draft” of legislation to repeal and replace the Patient Protection and Affordable Care Act (ACA). The bill follows many of the same general pathways toward “repeal and replace” of the ACA as were included in the House bill (American Health Care Act), however, there are some significant differences.
The Senate leadership proposal, called the Better Care Reconciliation Act of 2017 (BCRA):
Like the American Health Care Act (AHCA), the Senate proposal would provide “refundable” and “advanceable” tax credits for individuals to help lower the cost of purchasing insurance; however, unlike the AHCA, the Better Care Reconciliation Act (BCRA) would tie the tax credits to BOTH age and income. The AHCA health insurance tax credits would only be available to individuals based on their age.
It has often been said that when it comes to health insurance, what’s good for the insurance company may not be good for the physician or patients. That sentiment certainly seems to ring true with the newly announced “market stabilization” regulations recently finalized by the Centers for Medicare and Medicaid Services (CMS).
While members of Congress have been busy pondering how to repeal and/or replace the Affordable Care Act (ACA), CMS has been moving forward with regulations the agency maintains will “stabilize” the existing health care exchange marketplace. They will accomplish this objective primarily by easing requirements on health insurers.
In the early hours of Feb. 10, the United States Senate confirmed Congressman Tom Price (R-GA) as the next Secretary of Health and Human Services (HHS). Congressman Price is an orthopedic surgeon by training and will become the second physician to run this massive agency.
HHS is the largest federal agency and the policies, programs and services operated or overseen by HHS (Medicare, Medicaid, Social Security, FDA, NIH, Graduate Medical Education, and the National Health Services Corps to name a few) touch almost every American in one way or another.
On Wednesday, January 25th, the Senate Finance Committee majority hosted a roundtable discussion with representatives of health care provider organizations to discuss options for replacing the Affordable Care Act (ACA). This was the third in a series of ACA-related roundtable discussions the Committee’s staff have hosted over the past few weeks. Previous roundtables have included representatives of health insurance companies and employers.
The legislative consultant for the ACAAI Advocacy Council was among the select group of individuals invited to participate. Among the panelists were representatives of the American Medical Association, the American Hospital Association, and the Association of American Medical Colleges, as well as select safety-net provider organizations.
Your Advocacy Council constantly monitors developments in Washington which may impact the practicing allergist. In anticipation of rapid changes during the first several months of the new administration, we will be periodically giving you updates of actions by either Congress or the President that may eventually effect the practice of medicine. We intend these to be objective, without editorial opinions, which we will leave to you, our readers.
- James L. Sublett, MD, FACAAI, executive director of advocacy and governmental affairs