This information is updated frequently and will continue to evolve. We will keep you posted of significant developments as they occur. If you have any questions on these materials, please contact Joel Kopperud at joel.kopperud@ciab.com.

Repeal

In early January 2016, Republicans attempted to use the budget reconciliation process to dismantle the Affordable Care Act. On January 8, 2016, President Obama vetoed the bill. The Republicans’ bill, HR 3762: Restoring Americans Health Care Freedom Reconciliation Act of 2015, repeals many key components of the ACA including: government-run exchanges, employer and individual mandate, medical device tax and the Cadillac tax. It also phases out Medicaid expansion over a two-year period. President-elect Trump has repeatedly stated that his top priority will be a quick and full repeal of the ACA. The repeal bill will likely build on the repeal legislation from January 2016. You can read a summary of that bill here and see it in it’s entirety here.

Replace

It is not clear yet what exactly the replacement for the ACA will look like. There have been multiple repeal efforts by both House and Senate Republicans followed by both legislation and road maps for an ACA replacement bill.

As part of his broader tax reform plan, A Better Way, Speaker Ryan has released a blueprint for a healthcare reform bill. This blueprint would cap the tax exemption on employer-provided benefits at “a level that would ensure job-based coverage continues unchanged for the vast majority of health insurance plans,” thus taxing the most robust plans. The tax would be adjusted for factors including cost of living. HSA contributions made on a pre-tax basis will NOT be counted toward the cost of coverage for purposes of the cap.

President-elect Trump has nominated Rep. Tom Price (R-GA) as Secretary of Health and Human Services. Rep. Price has been active in creating replacement legislation. In 2015, Rep. Price, along with Sens. John McCain (R-AZ) and David Perdue (R-GA), introduced HR 2300: Empowering Patients Act. This plan would cap the tax exclusion for employer-provided benefits, allowing for an exclusions of health coverage of $20,000 for a family and $8,000 for an individual, with any additional funds used to be taxable dollars. The plan also expands HSAs and provides a universal tax credit for individuals purchasing coverage on the individual market.

In 2015, Rep. Fred Upton (R-MI) and Sens. Orrin Hatch (R-UT) and Richard Burr (R-NC) released an alternative replacement plan entitled, The Patient Choice, Affordability, Responsibility and Empowerment Act. This plan would cap the tax exclusion for employer-provided benefits at $30,000 for a family and $12,000 for an individual, with any additional health benefits to be considered taxable income subject to the regular income tax for that employee. The plan also expands HSAs and reforms Medicaid.

  • Speaker Ryan’s A Better Way Plan: Full Bill
  • HHS Secretary Nominee Rep. Tom Price’s bill: Full Bill
  • The Hatch/Burr/Upton Bill: Full Bill

We anticipate that you’ll see many more plans put forward in the near future and we’ll try to summarize them here.

To see the National Journal‘s webinar slides on the future of the ACA, please click here.

Preserve the Tax Treatment of Employer-Sponsored Health Insurance

Employer-Sponsored Insurance (ESI) is the most common type of health coverage in the United States, with more than 177 million Americans depending on it. But some in Congress want to tax employees on the cost of their health care benefits.

Imposing a tax on employer-sponsored health plans is a dangerous policy experiment that could significantly erode employer-sponsored health coverage. Any cap on the tax exclusion is a direct tax on employees and the middle class.

According to the American Health Policy Institute, capping the tax exclusion will increase the burden of the tax, which will ultimately fall on a significant number of hardworking employees and their families. Click here to see our full page on ESHI.

Resources

May 15, 2017 House Republicans Release NFIP Discussion Draft

The House Financial Services Committee released last week its long-awaited legislative draft to reauthorize the National Flood Insurance Program.

May 2, 2017 Financial CHOICE Act of 2017 discussion draft

An overview of the discussion draft of his Financial CHOICE Act of 2017.

May 1, 2017 Comparison of the ACA and AHCA Bills

Get an easily digestible and downloadable PDF comparison of the ACA and the American Health Care Act (AHCA) provided by our legal team at Steptoe & Johnson.

Apr. 6, 2017 Engage China Letter Ahead of President Xi Visit

A letter to President Trump encouraging him to use his April 6, 2017, meeting with Chinese President Xi to begin re-defining the U.S./China relationship to reduce barriers to U.S. financial services exports to China in order to bolster America’s economic growth.

Mar. 16, 2017 Joint letter to Treasury on prudential insurance and reinsurance

CIAB sent a joint letter to Treasury Secretary Steven Mnuchin strongly supporting the “Covered Agreement” that was recently negotiated by the United States and the European Union