On December 2, the U.S. Senate passed a tax bill by a 51-49 vote. The legislation would not repeal the Affordable Care Act (ACA) individual health insurance mandate but instead would eliminate tax penalties for con-compliance with the mandate. Senator Susan Collins (R-ME) announced her support for the bill in a press release in which she indicated that Senate Majority Leader Mitch McConnell (R-KY) has committed to support passage of: (i) the Alexander/Murray Bipartisan Health Care Stabilization Act that would provide funding in 2019 and 2020 for the cost-sharing reductions received by low-come enrollees; and (ii) legislation Senator Collins introduced that would protect individuals with pre-existing conditions while lowering premiums through the use of high-risk pools; the bill would provide $5 billion annually for two years for states to establish high-risk pools or reinsurance programs. Senator Collins also declared that Senate Majority Leader McConnell and House Speaker Paul Ryan (R-WI) have pledged that Medicare funds will not be cut in 2018 as result of the Pay-As-You-Go Act of 2010. Senator Collins’ press release is available here. The Congressional Budget Office (CBO) analyzed the combined effects of repealing the individual health insurance mandate and enacting the Bipartisan Health Care Stabilization Act. The CBO concluded that passage of the Bipartisan Health Care Stabilization Act would not change its previous calculations that repeal of the mandate would result in 4 million people losing health coverage in 2019 and premiums in the individual market would increase by 10 percent. The CBO’s most recent analysis is available here. Unless the House adopts the Senate bill, the Senate and House tax bills will have to be reconciled by a conference committee and then voted on again by the full House and Senate before the final legislation can be presented to President Trump for signature.
On December 1, the Centers for Medicare & Medicaid Services (CMS) published a final rule cancelling the mandatory hip fracture and cardiac bundled payment models that were to be operated by the CMS Innovation Center and implemented changes to the Comprehensive Care for Joint Replacement (CJR) model. The final rule is available here.
On November 29, the Senate Committee on Health, Education, Labor and Pensions held a confirmation hearing for Alex M. Azar II, President Trumps nominee for Secretary of Health and Human Services. A video of the hearing and written testimony is available here.