House Democrats Set Legislative Priorities For Health Care | Locke Lord LLP
On September 9, 2021, the U.S. House of Representatives Energy and Commerce Committee released its health care proposals for the Reconstruct Better Act. On September 10, 2021, the Ways and Means Committee published a summary of certain provisions in their bill. Together, the proposals aim to close the Medicaid coverage gap, add benefits to Medicare and lower prescription drug prices, and make the enhanced premium tax credits permanent under the American Rescue Plan Act (ARPA).
While the policies proposed by Democrats in the House of Representatives are not currently passed as proposed, the changes being considered would have significant impacts on the healthcare industry.
The proposals provide the clearest information on Democratic legislative priorities ahead of the 2022 midterm elections. It is anticipated that Senate budget reconciliation legislation will need to be narrower and less costly in order to gain support. required for its adoption.
Notably, the proposals do not include lowering the age of Medicare eligibility as advocated by some stakeholders. Energy and trade proposals include:
Medicaid / CHIP
- Closing the Medicaid Coverage Gap: A Medicaid program for people in non-expanding states from 2025 that gives the HHS secretary the authority to contract with third parties to operate the program.
- Funding to expand access to home and community services for people enrolled in Medicaid.
- Twelve months of continuous Medicaid / CHIP eligibility for postpartum women.
- Ongoing funding for the Children’s Health Insurance Program (funding is currently available until 2027).
- Provide 30 days of justice-related coverage prior to a person’s release from incarceration.
- The addition of vision care benefits as of October 1, 2022.
- The addition of hearing care benefits as of October 1, 2023.
- The addition of benefits for dental and oral care as of January 1, 2028.
Affordable Care Act
- Provide premium tax credits and improved cost-sharing assistance to people in states that have not extended Medicaid to purchase Exchange coverage from 2022 to 2024 (until the new Medicaid program to cover this population is established in 2025).
- Create a health insurance affordability fund that would make available $ 10 billion per year that states could use to establish a reinsurance fund or reduce out-of-pocket expenses. CMS would be required to implement a reinsurance program for states that do not use these funds in plan years 2023 and 2024.
- Permanent ARPA Premium Tax Credit expansions that offered enhanced tax credits to people with household income up to 150% of the Federal Poverty Line (“FPL”) and capped the premium contribution amount at 8.5% of household income, even for individuals with household income above 400% FPL.
- Modify the affordability threshold for employer-sponsored coverage to permanently maintain a cap of 8.5% of household income. To exchange.
- Extend ARPA tax credits until 2025 so that people receiving unemployment benefits are eligible for premium tax credits as if their household income was no more than 150% FPL.
Funding for the creation of the Agency for Advanced Research Projects for Health to “make critical investments in cutting-edge technologies and widely applicable platforms, capabilities, resources and solutions that have the potential to transform fields. important aspects of medicine and health which cannot be easily accomplished by traditional methods. biomedical research or commercial activity.
A memorandum of the committee can be found here. An information sheet can be found here. Please look to Locke Lord for further updates on material developments as Congress considers these important healthcare proposals.