Health Care Under the Trump Administration & 115 th Congress

Transcription

1 Simply Unpredictable Health Care Under the Trump Administration & 115 th Congress WATES What Are the Experts Saying? Trust the Experts at Wolters Kluwer March 8, 2017

2 Our Moderators Jenna Ellis, Esq Legal Training Consultant Dan Totillo, Esq Legal Training Consultant

3 Our Featured Expert Health Law Associate Managing Editor Kelly J. Rooney, JD, MPH Kelly is the Associate Managing Editor of Explanations and Workflow Tools in the Health Law editorial team. Kelly s areas of content expertise include Medicare benefits and coverage, health care reimbursement, and Health Reform. Kelly has a law degree from DePaul University College of Law, a master in public health degree from Northern Illinois University, and an undergraduate degree in political science from Central Michigan University. She previously worked in private practice.

4 ACA Repeal / Replace?

5 Proposed Replacement American Health Care Act March, 2017 Two Bills One bill is from the House Ways & Means Committee: Budget Reconciliation Legislative Recommendations Relating to Remuneration from Certain Insurers The other is from the House Energy & Commerce Committee: Budget Reconciliation Legislative Recommendations Relating to Repeal and Replace of the Patient Protection and Affordable Care Act

6 January, 2017 Concurrent Resolutions in January passed in both the House and Senate. Reconciliation Act likely but a reconciliation act can only affect spending/revenue measures.

7 TOP STORY: Trump Administration previews health care plans with Executive Order, regulatory freeze (Jan. 23, 2017) By Kathryn S. Beard, J.D. One of President Donald Trump s first official acts was signing an Executive Order (EO) titled Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal. The EO, signed January 20, 2017, says it is the Trump Administration s policy to seek the prompt repeal of the ACA (P.L ). Link to Full Story WHITE HOUSE NEWS: Trump orders two regulations repealed for each one issued (Jan. 30, 2017) By Harold Bishop, J.D. President Trump has signed an executive order that is the first step in fulfilling his campaign promise to repeal two federal regulations for every one that is issued. The temporary regulatory freeze memorandum issued by the White House on January 20, 2017, remains in effect, and this new executive order sets up the process for reducing regulations and regulatory costs going forward. Link to Full Story General Reform Topics: Trump pushes governmentwide regulatory reform initiative (March 1, 2017) By Wolters Kluwer Editorial Staff The White House announced on February 24, 2017, that President Donald Trump signed an Executive Order (EO) requiring every agency to establish a Regulatory Reform Task Force to eliminate red tape..the White House s press release underscored its "commitment to reducing the regulatory burden on everyday Americans, their pocketbooks, and their businesses. Link to Full Story

8 Paul Ryan Tom Price William Bill Cassidy Rand Paul House Speaker US House of Representatives (R) Wisconsin A Better Way HHS Secretary Empowering Patient s First Act US Senator (R) Louisiana Patient Freedom Act US Senator (R) Kentucky Obamacare Replacement Act Link -

9 Topic Individual Mandate Proposal Notes Affordable Care Act (ACA) Current Law Individuals are required to maintain health insurance coverage and face a tax penalty if they don't. Paul Ryan A Better Way No. Tom Price Empowering Patient s First Act No. Bill Cassidy Patient Freedom Act Rand Paul Obamacare Replacement Act Up to the states. No. House Discussion Draft No tax penalty for not having coverage. Link -

10 Topic Tax Credits Proposal Affordable Care Act (ACA) Current Law Paul Ryan A Better Way Tom Price Empowering Patient s First Act Bill Cassidy Patient Freedom Act Rand Paul Obamacare Replacement Act House Discussion Draft Notes Tax credits are available to assist with the purchase of health care coverage in the form of refundable, advanceable premium tax credits to eligible individuals between % federal poverty level, computed on a sliding scale. Yes. Refundable, flat, age-adjusted tax credit. No amount provided, but described as enough to purchase a typical pre-aca plan. Yes. Refundable, flat tax credit: $900 per child $1,200 age $2,100 age $3,000 age 50+ If state mandates insurance, ACA tax credits maintained at 95% the amount. If state does not mandate insurance, instead provide deposits to new Roth Health Savings Accounts (HSA) Yes. Retain ACA premium tax credits (and make premiums tax deductible). Would change current credit amounts for In 2020, replace ACA credits with flat tax credit adjusted for age: $2,000 up to age 29 $2,500 age $3,000 age $3,500 age $4,000 age 60+ (max $14,000 per family) Link -

11 Topic Annual & Lifetime Dollar Limits Proposal Annual Limits Lifetime Limits Affordable Care Act (ACA) Current Law Prohibited. Prohibited. Paul Ryan A Better Way Prohibited. Not addressed. Tom Price Empowering Patient s First Act Not prohibited. Not prohibited. Bill Cassidy Patient Freedom Act Prohibited. Prohibited. Rand Paul Obamacare Replacement Act Not prohibited. Not prohibited. House Discussion Draft Prohibited. Prohibited. Link -

12 Topic PreExisting Condition Exclusions Proposal Notes Affordable Care Act (ACA) Current Law Excluding individuals from coverage due to a pre-existing condition is prohibited. Dependents are covered up to the age of 26 under the ACA. Paul Ryan A Better Way Prohibited. Tom Price Empowering Patient s First Act Repealed. Going forward, if more than 18 months of continuous coverage, cannot exclude. If less than 18 months, can exclude for a specific period of time. Bill Cassidy Patient Freedom Act Rand Paul Obamacare Replacement Act House Discussion Draft If state mandates coverage, ACA prohibition continues. If state does not mandate coverage, prohibited for residents with continuous coverage Repeal ACA prohibition on preexisting conditions. Prohibited (except for some transition plans). Link -

13 Topic Dependent Coverage Thru Age 26 Proposal Affordable Care Act (ACA) Current Law Paul Ryan A Better Way Tom Price Empowering Patient s First Act Bill Cassidy Patient Freedom Act Rand Paul Obamacare Replacement Act House Discussion Draft Notes Yes. Yes. No. Yes. Yes. Yes. Link -

14 Topic Medicaid Expansion Proposal Affordable Care Act (ACA) Current Law Paul Ryan A Better Way Tom Price Empowering Patient s First Act Bill Cassidy Patient Freedom Act Rand Paul Obamacare Replacement Act Notes The ACA expanded Medicaid to provide coverage to non-elderly adults up to 138% FPL and provided federal funding to states choosing to expand their programs. Would change Medicaid to either a per capita allotment or a block grant program. Repeal. Not affected. Not affected. House Discussion Draft Would convert Medicaid program to a per capita model beginning Link -

15 Proposed Replacement American Health Care Act March, 2017 Two Bills One bill is from the House Ways & Means Committee: Budget Reconciliation Legislative Recommendations Relating to Remuneration from Certain Insurers The other is from the House Energy & Commerce Committee: Budget Reconciliation Legislative Recommendations Relating to Repeal and Replace of the Patient Protection and Affordable Care Act

16 Trump Campaign Promises

17 Trump Cabinet Positions

18 Tom Price, M.D. HHS Secretary Physician/Surgeon Member of U.S. House of Representatives from Nominated by Donald J. Trump on Nov. 29, 2016 for Secretary of the U.S. Department of Health and Human Services Confirmed on Feb. 10, 2017 Tom Price, M.D.

19 Seema Verma, M.P.H. Nominee CMS Administrator President Trump nominated Seema Verma as CMS Administrator on November 29, 2016 Advised several states on Medicaid programs and ACA implementation Cleared Senate Finance Committee and now awaiting full Senate vote for confirmation Seema Verma, M.P.H.

20 FDA Commissioner

21 Judge Neil Gorsuch Nominee US Supreme Court Seated on 10th Circuit Court of Appeals since 2006 (nominated by George W. Bush) Wrote concurring opinion in Hobby Lobby v Sebelius concerning ACA's contraception coverage mandate

22 LOOKING AHEAD What we will be following

23 LOOKING AHEAD What we will be following Medicare Spending / Drug Prices FDA Drug Approval Process Food Safety Regulations

24 Questions?

25 Contact Us & Training A brief survey link will follow. Any additional questions, please contact: Jenna Ellis jennifer.ellis@wolterskluwer.com To request training for your organization, please contact: legaltraining@wolterskluwer.com

26