May 10, 2017
The Senate is starting from scratch on the American Health Care Act. Since the narrow passage of the House repeal bill last week, Senate Majority Leader Mitch McConnell has created a healthcare working group comprised of 13 all-male members (including himself):
- John Cornyn (Texas), majority whip
- John Thune (South Dakota), chairman of the Senate Republican Conference
- John Barrasso (Wyoming), chairman of the Senate Republican Policy Committee
- Orrin Hatch (Utah), chairman of the Senate Finance Committee
- Lamar Alexander (Tennessee), chairman of the Senate Health Committee
- Michael Enzi (Wyoming), chairman of the Senate Budget Committee
- Tom Cotton (Arkansas)
- Cory Gardner (Colorado)
- Rob Portman (Ohio)
- Patrick Toomey (Pennsylvania)
- Ted Cruz (Texas)
- Mike Lee (Utah)
While there’s no timeline on their process, don’t expect significant movement anytime soon. In fact, it could be months in the making. Just this afternoon, the Congressional Budget Office indicated it would release its analysis of the AHCA the week of May 22, leaving the working group in waiting.
Because Republicans hold 52 seats in the Senate, Leader McConnell can only afford to lose two members of his caucus to pass the bill by 50 votes (using reconciliation as a vehicle to avoid the Senate’s usual 60 vote threshold). They assuredly will not receive any Democratic support but they will be able to count on Vice President Mike Pence to break a tie, if necessary.
What to Watch For
There are a lot of contentious issues that could swing any senator but the highest profile among them are funding of planned parenthood, eliminating or delaying the ACA’s Medicaid expansion provisions, the size and scope of subsidies or tax credits, age bands, the ability for states to opt out of essential health benefits regulations and the creation of high risk pools for individuals w pre-existing conditions.
The tax exclusion was ultimately preserved for employer-sponsored health insurance in the House bill, but is very much on the table again in the Senate. We’re working hard to retain that exclusion, and advocating for a full repeal of the Cadillac Tax in the Senate bill.
Repeal Tracker: AHCA vs. ACA
In case you missed it, click here for a memo detailing notable provisions in the AHCA, produced by our legal team at Steptoe & Johnson.
And click here for Steptoe’s side by side comparison of the ACHA and the ACA.
This repeal tracker published yesterday by Axios is also a good, quick read outlining what’s at risk, what’s in play and what’s safe between the two bills.
When Good People Do Nothing
By Mike Turpin, EVP, USI, as seen in Leader’s Edge
Speaker of the House Paul Ryan and the newly minted Trump administration vowed to replace what some called the “Obamination” with a national health strategy that would return insurance plan choice to individuals. Many in the brokerage community seemed excited at the prospect. But they failed to read the Republican bills closely.
Key elements of the GOP legislation were fixated on taxing employer-sponsored benefits as a means to finance new reform. The hastily assembled legislation proposed tax credits indexed to the Consumer Price Index and eliminating both the individual mandate and most taxes currently funding the ACA. The proposed law would return America to a time when healthcare was still a privilege, not a right—and certainly not a social obligation.
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