Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


House Passes Bill to Prohibit PPACA Premium Subsidies for Individuals

By a vote of 235-191, on Thursday the House passed H.R. 2775, the “No Subsidies Without Verification Act,” legislation that would prohibit any federal premium subsidies to be made to individuals enrolled under Patient Protection and Affordable Care Act (PPACA) health insurance exchanges until there is a system in place that verifies an individual’s income eligibility as certified by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). The Statement of Administration Policy (SAP) said the President would veto the bill if it were to reach the President’s desk, but it will not proceed beyond the House given opposition to the bill in the Senate by Majority Leader Harry Reid (D-NV). Fending off the need for this legislation, the White House Chief Technology Officer released a statement saying that the Centers for Medicare and Medicaid Services (CMS) technology office has certified the security of the federal data hub that will provide personal and income data to health insurance exchanges to help them verify the eligibility of individuals for premium subsidies. Nonetheless, at a hearing held by a House Homeland Security Subcommittee, Republicans said they still have “grave concerns” about the federal data hub and the security of personal information that will be shared.

House Passes Bill to Allow Insurance Agents to Operate Multi-state

The House also passed overwhelmingly the bill H.R.1155, the “National Association of Registered Agents and Brokers Reform Act of 2013,” legislation which would reestablish the National Association of Registered Agents and Brokers (NARAB) as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements. The legislation would allow such licensed agents to operate in multiple states and facilitate, among other things, their offering of health insurance under PPACA health insurance exchanges.

House Republican Leaders Face Continued Threat to Passage of CR

House Republican leaders were forced to withdraw their efforts last week to advance a continuing resolution (CR), House Joint Resolution 59, which would provide funding for federal agencies through December 15. House Appropriations Committee Chairman Harold Rogers (R-KY) said the short-term CR does not contain controversial riders (such as defunding the PPACA), but provides some flexibility for the funding of certain Interior Department and Veterans Administration (VA) activities. The resolution would otherwise continue federal funding for fiscal year (FY) 2014 at about the same level as for FY 2013 after taking into account the reductions in spending required under sequestration. The legislative maneuver that Republican leaders proposed in an effort to gain enough Republican votes in the House to pass the CR involved the concurrent adoption of another resolution which would result in the defunding of PPACA activities as demanded by a substantial number of conservative Republicans. The move would have required the Senate to vote on both resolutions with the most likely result being a defeat for PPACA defunding and the passage of a clean CR that the President would sign into law. If House Republican leaders cannot resolve the conundrum involving PPACA defunding, Senate Democrats have opined that a government shutdown is inevitable. The extent of the CR hurdle in the House was further demonstrated when 43 House Republicans introduced an alternative (H.R. 2682) providing funding over the 12-month fiscal year beginning October 1st at a level lower ($967 billion) than in FY 2013. The strategic move, authored by Rep. Tom Graves (R-GA), would also zero out funding for all of the PPACA. Senator Tom Coburn (R-OK) has also endorsed the $967 billion spending level as mandated by the Budget Control Act (BCA) for FY 2014 in a letter to Senate Majority Leader Reid (D-NV) and Speaker Boehner (R-OH). Given the impasse over the CR, the House is likely to remain in session during the week of September 23rd to give congressional leaders and the White House time to discuss another legislative route that would not only provide for agency funding into FY 2014 but also provide for an increase in the federal debt limit. House Budget Committee Chairman Paul Ryan (R-WI) has proposed a vote on legislation to delay the PPACA until 2015 as a means to persuade enough Republicans to pass a less contentious CR. The CR is not the only legislation Republican opponents of PPACA are using to change the law. Senator David Vitter (R-LA) has slowed action in the Senate on a pending energy bill until he is given assurance by leaders that he will get a vote on his proposal that would require all congressional staffers, not just members’ staff, to obtain their health insurance through state health insurance exchanges.

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