ACA Repeal Watch: House Republicans Release “Repeal and Replace” Blueprint

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    Whitfield L. Knapple, MD, FACG
    Chair, ACG National Affairs

    This week, U.S. House Republicans released a “policy brief” in advance of the Presidents’ Day congressional recess, outlining a replacement plan for the Patient Protection and Affordable Care Act (known as the ACA). This 18-page blueprint states that House Republicans will soon advance repeal and replace legislation that is designed to:

    • Provide relief during the transition period, including waiving the individual mandate as well as the employer mandate to provide coverage.
    • Provide a “Universal Health Care Tax Credit.”  The credit is “advanceable and refundable,” universal for all citizens or qualified aliens not offered other qualifying insurance, age-rated, and available for dependent children up to age 26.
    • Eliminate ACA tax provisions, including the tax on health insurance premiums, taxes related to prescription drugs, the tax on medical devices, the increased expense threshold for deducting medical expenses.
    • Reform Medicaid with a “per capita allotment” (block grant) and repeals the ACA’s Medicaid expansion, with a transition period of continued enhanced federal payments.
    • Utilize “state innovation grants” to improve insurance markets.  The blueprint notes that states may also use these resources to increase access to preventive services or reduce cost-sharing.
    • Promote health savings accounts, including increasing maximum HSA contribution limit; allow both spouses to make catch-up contributions to the same HSA.

    This is the first blueprint released by House Republicans and will likely change.  ACG is working with leaders in Congress to improve any repeal and replace package.  This includes protecting preventive benefits and those patients with pre-existing conditions.  ACG is also advocating for physician-related provisions that promote independent GI practices and reduce administrative burdens borne by practices.

    Senate Finance Committee Hearing, Nomination of Seema Verma

    On Thursday, February 16th, the Senate Finance Committee, led by Chairman Orrin Hatch (R-UT), held a hearing for the nomination of Seema Verma to serve as the Administrator of the Centers for Medicare & Medicaid Services (CMS).  In his opening remarks, Ranking Member Ron Wyden (D-OR) stressed his concern about Ms. Verma’s potential conflict of interest in reference to her involvement in the management of the state insurance program, the Healthy Indiana Plan (HIP), while being paid by a consulting firm.  Ms. Verma confirmed that she had previously consulted with the Office of Ethics regarding this conflict. Other topics of questions from the Committee included lowering prescription drug costs for seniors, the future of Medicaid and Meaningful Use, and the possible increase in the Medicare enrollment age from 65 to 67.

    ACG is actively involved in all health care reform and will keep you updated on any proposed legislation and news affecting ACG members and your patients.

    Whitfield L. Knapple, MD, FACG

    Chair, ACG National Affairs Committee

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