The night of 400 votes in the Senate

Ladies and gentlemen, please keep your seats because I have an important announcement: The United States Senate has passed a budget. I know, I know -  it hasn't happened in four years, so we all thought we'd be more likely to see February 29th again on the calendar before we saw another passed budget, but it actually happened.  Here's the skinny:

In the wee hours of a Saturday morning vote, over 400 proposed budget amendments were passed, eight of which were healthcare related. They serve as a solid indicator as to where some members stand on popular issues and what types of legislation are likely to be introduced in this Congress.

In terms of healthcare, Senator Susan Collins (R-ME) proposed an amendment (#144) that was then passed by a voice vote that would "restore a sensible definition of full-time employee for purposes of the Patient Protection and Affordable Care Act."

Senator Orrin Hatch (R-UT) proposed an amendment that would repeal the medical device tax (#297) component of PPACA. This idea has historically received bipartisan public support, passed the Senate in a 79-20 vote.

Senator Mike Johanns (R-NE) proposed a budget amendment that eventually passed by a voice vote that would repeal the $2,500 federal cap on flexible spending account contributions and the requirement that individuals must have a prescription form from their physician before purchasing an over-the-counter drug with their account funds.

Senator Ben Cardin (D-MD) introduced an amendment that would expand oral and dental healthcare, which also passed by a voice vote.

Amendments that sought to repeal the healthcare reform law, allow employers to opt out of contraception coverage, place restrictions on illegal immigrants who gain legal status from accessing the health law, a prohibition on funds to advertise the health law, and a ban on the health law's taxes on low and middle-income Americans all failed during the night of more than 400 votes.

The Energy and Commerce Committee has been busy, busy, busy

The March 13 hearing attempted to analyze the impact of health reform on job availability and employer-sponsored health coverage. Witnesses included Diana Furchtgott-Roth, senior fellow at the Manhattan Institute, Tom Boucher, owner of Great New Hampshire Restaurants Inc., who testified on behalf of the National Restaurant Association, and Linda Blumberg, a senior fellow at the Urban Institute. 

During the hearing, GOP representatives argued that uncertainty about health reform implementation is leading to hesitation by employers to hire. They discussed the potential for 49ers and 29ers—employers that try to stay under the 50 full-time equivalent threshold to avoid the shared responsibility requirements or try to hold employees to a 29-hour-a-week or less average to avoid offering them coverage. Meanwhile, Democratic ranking member Henry Waxman defended the law, citing millions of new jobs created and claiming dire assertions are unfounded. You can watch the highlights of the proceedings here.

The March 14 letter to HHS Secretary Kathleen Sebelius expressed concern about the proposed applications for health insurance exchange coverage that were released in January. (NAHU expressed similar concerns in a letter dated February 28.) The Energy and Commerce Committee letter was signed by Committee Chairman Fred Upton (R-MI), Vice Chair Marsha Blackburn (R-TN), Chairman Emeritus Joe Barton (R-TX), Heath Subcommittee Chairman Joe Pitts (R-PA), Oversight & Investigations Subcommittee Chairman Tim Murphy (R-PA) and Vice Chairman of the Health and Oversight and Investigations Subcommittees Michael C. Burgess (R-TX).

Among other things, the letter states that the draft health insurance exchange applications “are troubling for several reasons. First the applications request information not easily available to most Americans, including information on their employers’ health plans that most employees would have difficulty obtaining. For example, it is unlikely most Americans would be able to determine which of their employer health plans meet the ‘minimal value standard’ as defined by PPACA.” The members requested HHS provide a briefing and additional information on HHS’ process for reviewing applications by March 29, so stay tuned.

As for today’s hearing on coverage affordability, the witnesses will be Douglas Holtz-Eakin, the former director of the Congressional Budget Office, Christopher Carlson, actuarial principal at Oliver Wyman, and Wendell Potter, the senior analyst at the Center for Public Integrity. We expect that the impact of age rating for small employers and the new looming national health insurance premium tax on all fully insured group and individual policies will be a focus. Now would be a great time to send your lawmakers an email asking them to sign on to Representative Gingrey’s LIBERTY Act bill to address the impact of the age-rating provision.

Source: NAHU Washington Update

Should your health insurance bill look like your phone bill?

You know all those taxes and fees that are listed out at the end of your phone bill? A member of the House of Representatives believes that when it comes to taxes and fees resulting from health reform, a health insurance premium bill should look like that too. This week, Representative Greg Walden (R-OR) introduced legislation titled A Patient's Right to Know that would require insurers to inform the public about the extra costs health reform will add to their bills in the years ahead.  

The bill proposed by Walden will require insurance companies to itemize the cost of PPACA on their customer’s annual coverage summary and premium statements, including the new annual premium tax on health insurers, fees to fund the Patient-Centered Outcome Research Institute (PCORI), reinsurance contributions and proposed fees on insurance exchange users, risk corridor payments and risk-adjustment charges. The bill also calls for a review by the Government Accountability Office (GAO) to examine the impact of the law’s guaranteed issue and community rating, age rating, women’s preventive services and essential health benefits. 

While it is highly unlikely that the Walden bill will ever be signed by President Obama, we believe that similar laws could become a trend among states. In Georgia, lawmakers are currently working toward informing more Americans how much this law is really going to cost them. Georgia Senate Bill 236 would require health insurance companies doing business in the state to show how much PPACA is costing all consumers on every premium statement. The bill also requires that those who get their benefits from the state’s health benefit program receive the same information. The bill passed the Georgia Senate last week 36-17 and is currently working its way through the Georgia House Committee process. Senator Burt Jones (R-Jackson), who sponsored the bill, is obviously pleased with the outcome and has said, “It is good for us to be transparent with the consumers of Georgia and show exactly what this legislation coming down is going to do to our insurance premiums.” 

Source: NAHU Washington Update

House and Senate Budgets are as different as black and white, north and south, east and... well, you get the idea

Well folks, it’s that time again! Just this week, Representative Paul Ryan (R-WI), chairman of the House Budget Committee, published his budget plan for the coming year. In the Senate, Senator Patty Murray (D-WA) released the Senate Budget Committee version and, guess what, they look absolutely nothing alike, account for vastly different levels of federal spending over the next 10 years, and we’re not sure the kinks can be worked out. Meanwhile, both the House and Senate spent the past two weeks working on continuing resolutions just to keep the federal government from shutting down at the end of this month. 

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