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Looking Ahead at the Administration’s Healthcare Agenda

The Next 48 Hours

We’re just 48 hours from the inauguration of Donald Trump and the healthcare landscape is still shifting. From what we can see no one entity is driving the “Repeal & Replace” train, as competing statements in public and private change the course of the conversation on a daily basis.

For example, look no further than the President-elect’s comments to the Washington Post last weekend that he’d implement “insurance for everyone” which back-tracked to a discussion of Medicaid block grants with Axios in an interview Tuesday night that was released this morning.

Trump’s nominee for HHS Secretary, Rep. Tom Price, is in hearings today, but the potential scandal developing over his healthcare-related stock purchases could be a determining factor to his confirmation. Price’s own plan to replace the ACA introduced in the last Congress was hinted as the starting point for the GOP replace plan by some, until Sen. Orrin Hatch indicated that he didn’t see eye to eye with Price’s policies—shifting course again on replace priorities. That plan would have capped the tax exclusion for employer plans at $20,000 for families and $8,000 for individuals.

Sources in the Senate continue to note that Members are coalescing around a tax on benefits in some fashion to help fund the ACA repeal bill, namely the repeal of the Cadillac Tax, which CBO indicated in 2010 would generate $87 billion. The Council continues to adamantly oppose any taxes on employer benefits. Congress should repeal the Cadillac Tax and preserve the tax exclusion for employer provided plans.

The notion that $87 billion would have been raised by the Cadillac Tax was based on an assumption that companies would have increased salaries (taxable income) as they decreased benefits. There’s no indication from Fortune 500 companies that this would be the case. We continue to urge Congress to re-score the Cadillac Tax and avoid subjecting the only functional health insurance delivery market to its misguided and self-imposed budgetary constraints.

We’re talking to everyone we can, and what we’re hearing is simple: Hill Republicans want to be team players on replacing the ACA but there’s no defined “team” now, just several competing plans between Speaker Ryan, HHS-Nominee Price, Sen. Hatch and others. The only thing that’s really certain is that repeal looks a lot like last year’s bill, which President Obama vetoed.

Will repeal and replace actually happen at the same time? Which plan will it be? No one really knows yet, and anyone who says they do probably has a particular agenda to push.

Our next signal about what may be coming down the road could come in Friday’s inaugural address, but we’ll keep working to shape the conversation before and after Inauguration Day to protect the employer-provided markets in place.

Cheryl Matochik, SVP, Strategic Resources & Initiatives:

Michael Kanick, Digital Strategist:

Joel Kopperud, VP, Government Affairs: