Walorski Pushes for New Repeal of Medical Device Tax; Messer’s Reverse Transfer Concept Amended Into Reauthorization Bill

Congresswoman Jackie Walorski (IN-02) has brought forth legislation to suspend the medical device tax for five years. She joined Rep. Erik Paulsen (R-MN) in co-authoring the bill, H.R. 4617, which would delay the implementation of the 2.3% tax that was originally created through the Affordable Care Act. In 2017, Congress delayed the tax for two years, but without intervention it is set to take effect January 1, 2018.

“The job-killing medical device tax would have a devastating impact on Hoosier workers and patients across the country who depend on life-saving medical innovation,” Walorski said. “I am committed to permanently ending this burdensome tax. As we continue working toward repeal, we must protect workers and patients by preventing it from taking effect.”

Congressman Luke Messer (IN-06) and Congresswoman Jackie Walorski (IN-02)

Walorski’s bill was part of a group of legislation introduced by members of the House Ways and Means Committee aimed at stopping Obamacare taxes set to take effect in 2018. The other four measures are:

• H.R. 4618, introduced by Rep. Lynn Jenkins (R-KS), provides relief for two years from the tax on over-the-counter medications, expanding access and reducing health care costs by once again allowing for reimbursement under consumer-directed accounts;
• H.R. 4620, introduced by Rep. Kristi Noem (R-SD), provides relief in 2018 from the Health Insurance Tax (HIT) that drives up health care costs;
• H.R. 4619, introduced by Rep. Carlos Curbelo (R-FL), provides needed relief from HIT for two years for health care plans regulated by Puerto Rico; and
• H.R. 4616, introduced by Reps. Devin Nunes (R-CA) and Mike Kelly (R-PA), delivers three years of retroactive relief and one year of prospective relief from the harmful employer mandate paired with a one-year delay of the Cadillac tax.

Earlier this year, Congressman Luke Messer (IN-06) introduced legislation that encourages a more seamless transition for community college transfer students earning degrees. Messer’s proposal would make it easier for students to earn a degree through a “reverse transfer,” where students who transferred from a community college to a four-year-institution but haven’t completed a bachelor’s degree can apply those additional credits back toward an associate’s degree.

Originally titled the Reverse Transfer Efficiency Act of 2017, it was recently added as an amendment to the Higher Education Re-authorization by the House Committee on Education and Workforce. The provision would streamline credit sharing between community colleges and four-year institutions so transfer students can be notified when they become eligible to receive an associate’s degree through a reverse transfer.

“An associate’s degree can make a huge difference for working Hoosiers,” Messer said. “By making it easier for transfer students to combine credits and get a degree they’ve earned, Hoosiers will have more opportunities to get good-paying jobs and succeed in today’s workforce.” This legislation was supported not only by the Indiana Chamber, but also by Ivy Tech Community College and the Indiana Commission for Higher Education.

Senate Health Care Reform – Act III

A bipartisan agreement has been reached in the Senate to help stabilize health care markets – from Senate Health, Education, Labor and Pensions Committee Chairman Sen. Lamar Alexander (R-TN) and ranking member Sen. Patty Murray (D-WA).

Among other things, the Alexander-Murray agreement would:

  • fund cost-sharing reduction payments, which help lower consumers’ deductibles and co-pays, for two years;
  • broaden the pool eligible for a “copper plan” (catastrophic medical) coverage option, which would help reduce the mandate implications for essential benefits;
  • include funding to help Americans navigate signing up for health insurance, which had been cut by the Trump administration; and
  • set up high-risk pools that will allow for continued coverage for these individuals.

What this is not is a “repeal and replace”. That said, the two-year funding promise is good news for insurers and would help alleviate their unease, which would also be felt by consumers. But this bill does nothing to address the core problems in the individual marketplace that threaten its sustainability.

Indiana Sen. Joe Donnelly, who has been pushing for bipartisan fixes to the Affordable Care Act (ACA), has thrown his support behind the Alexander-Murray agreement and is a co-sponsor of the legislation. He stated, “This is the product of hard work from members on both sides of the aisle, and it’s an important step in providing much needed stability to the market. I’m proud to be part of the effort, and I will continue working with Republicans and Democrats to move this much-needed legislation forward.”

President Trump has alternately met the agreement with both optimism and skepticism. Overall, he’s indicated that he would favor a short-term subsidy fix; however, he doesn’t want to help insurers either.

It would appear the bipartisan legislation would garner most, if not all, Senate Democrat votes (as Minority Leader Chuck Schumer alluded to on Thursday), so that would leave a lot of wiggle room for passage if some, or even many, Republicans vote against it. The question is what Senate Majority Leader Mitch McConnell will do and what he says to his caucus.

Meanwhile, Sens. Bill Cassidy (R-LA) and Lindsey Graham (R-SC), the authors of the Senate’s second ACA reform attempt, have been working with Alexander and Murray on ways the bill can be made palatable to the very conservative arm of the congressional Republicans – most notably in the House.

In other words, this is far from a done deal.

Indiana Delegation Talks Affordable Care Act Repeal

The vote to repeal and replace the Affordable Care Act (ACA) couldn’t get off the ground in the U.S. Senate. But President Trump, Vice President Pence and many members of Congress instead have called for a simple repeal of the ACA – with a replacement coming at a later date.

Congressman Luke Messer (IN-06) is on board with that process. “Hoosiers are sick and tired of endless debate on the Obamacare repeal bill, and the failure of Congress to act. This is D.C. politics as usual, and exactly why Americans sent the President to Washington to shake things up and get something done.

“We’ve had more than enough time to deliver on this promise to Americans, who have sent us here for three election cycles to repeal this failed law. I agree with President Trump that we must repeal Obamacare NOW and then work together on a plan to ensure Hoosiers get the health care they want and deserve.”

Meanwhile, Sen. Joe Donnelly urged bipartisanship in finding common ground. “The proposed Senate health care bill would have been disastrous for Hoosiers. The latest plan to repeal without any replacement is downright reckless, playing politics with the health and economic well-being of millions of American families.

“It is time to do the hard work of forging a bipartisan bill to strengthen our current health care system, so that we can reduce costs for Hoosier families, continue to protect people with pre-existing conditions, and preserve the good work states like Indiana have done to expand affordable health care. The American people are counting on us to take a thoughtful approach together, and I urge the Senate to take this path in the coming days.”

Congressman Larry Bucshon (IN-08) had a different take. “Obamacare is collapsing and as a result patients across the country are at risk as premiums skyrocket and insurers flee the exchanges. In Indiana, premiums have increased an average of 74% and two of our state’s four insurers recently announced their departure from the Obamacare exchanges. Hoosiers are being priced out of the insurance market, if they can find insurance at all. This is not the health care Americans were promised by President Obama and congressional Democrats when they passed Obamacare, and certainly not what they deserve.

“To me, this is personal. I spent more than a decade as a surgeon before coming to Congress. This is about the well-being of my constituents who are struggling to access quality, affordable health care under Obamacare. That’s why I made a promise to repeal and replace this failed law to help drive down costs, expand access, and get the federal government out of decisions that should be left up to patients and their doctors. The House did its job to fulfill our promise. I’m extremely disappointed that, thus far, the Senate has failed to live up to its commitment to the American people. It’s time for the Senate to act.”

Health Care: Donnelly Co-Authors Bipartisan Bill to Speed Up FDA Approvals for Devices; Young Reaches Across the Aisle on ACA

Senators Joe Donnelly (D-IN) and Cory Gardner (R-CO) have re-introduced the bipartisan FDA Regulatory Efficiency Act, which would allow the Food and Drug Administration (FDA) to bring innovative medical devices to market more quickly.

Donnelly stated, “As scientists and innovators across Indiana and our country work to find new cures and therapies, we should be making it easier for them to bring these products safely to those who need them. I’m proud to work with Sen. Gardner on this bipartisan legislation to cut through the red tape at the FDA and safely speed up the approval process.”

The FDA Regulatory Efficiency Act would help the FDA concentrate on high-priority activities by authorizing third parties to approve quality systems of device companies. Authorized third parties could only approve changes that do not involve major technology changes or changes in the use of the product. The legislation would still hold companies accountable for their quality systems, while also helping to alleviate the overwhelmed FDA. Donnelly and Gardner first introduced the legislation in October 2015.

Health Care Reform Notes
Freshman Sen. Todd Young has reached across the aisle in an attempt to find common ground on health care. He recently sent a letter to all Democratic senators urging them to share their views on what’s working and what’s not with the Affordable Care Act. Young is a member of the Senate Health, Education, Labor and Pensions Committee, which will have a key role in shaping the Senate’s version of health care reform.

Congresswoman Jackie Walorski (IN-02) is touting the American Health Care Act (AHCA), as passed in the U.S. House of Representatives, and how it “brings us closer to a better health care system that puts patients first.” Her editorial appeared Sunday in the South Bend Tribune.

Congressman Larry Bucshon, M.D. (IN-08), who sits on the House Committee on Energy and Commerce where he is a member of the Subcommittees on Health, is using his web site to promote the Washington Post’s fact-checking of several recent claims about the AHCA. One is on coverage for those with pre-existing conditions and the other on classification of assault as a pre-existing condition; both claims were deemed untrue.

So What’s Going On With Obamacare?

NOTE: This video was recorded before Donald Trump’s election, which has likely changed the course of the Affordable Care Act going forward. But these comments are on the ACA as it now stands. 

Libertarian magazine Reason interviewed its features editor, Peter Suderman, about the status of the Affordable Care Act. He explains how the rising prices will impact consumers and taxpayers. Is this Obamacare’s “death spiral?”

Questions About Open Enrollment? The Indiana Chamber has Answers

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Open enrollment for health care insurance is now upon us, and many businesses are faced with difficult choices for 2017. Premiums are expected to increase sharply under the Affordable Care Act (ACA) according to many experts – the Department of Insurance says some in Indiana have seen premiums go up by almost 70%!

The Indiana Marketplace (Indiana’s federally mandated online health care insurance exchange) has not been the answer many were hoping for. And don’t forget about the penalty for businesses choosing not to offer insurance to their employees – a penalty that will be adjusted each year to account for inflation.

The Indiana Chamber of Commerce has been working since 2004 to provide members with reasonable health care insurance options supported by brands you trust. In 2016 and beyond, we’re excited to offer a new program called ChamberCare Solutions, with a larger portfolio of health plan options.

This partnership between the Indiana Chamber and Anthem Blue Cross and Blue Shield can help you find the coverage that is right for your business. We are committed to coverage that is simple to understand and affordable. All plans comply with the ACA.

ChamberCare Business Resources: A professional employer organization (PEO) administered by Human Capital Concepts (HCC). Why a PEO? PEOs allow employers to outsource their HR functions and employee benefits programs to ensure they’re in compliance with HR laws and the ACA. By outsourcing to a PEO, you can focus on what you do best — running your business. According to the National Association of Professional Employer Organizations, businesses that use a PEO grow 7% to 9% faster, enjoy 23% to 32% lower employee turnover and are over 50% less likely to go out of business.

ChamberCare Savings: An excellent choice for companies with 51-99 employees, with 5% savings on any Anthem plan.

ChamberCare Exchange: Access to flexible, affordable health plans for companies with 2-50 employees.

Which solution is right for you and your employees? Contact your insurance broker today or call/email Brett Hulse, Indiana Chamber, at (317) 264-6858 or BHulse@indianachamber.com.

ChamberCare Solutions Program Provides Health Care Answers

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More than six years after the Affordable Care Act was signed into law, it’s still not an easy process for companies to determine the best health care choices. Important assistance and options are now available through the ChamberCare Solutions program.

The Indiana Chamber has partnered with Anthem Blue Cross and Blue Shield since 2004 on ChamberCare – an insurance discount offering for businesses with between two and 99 employees. More than 25,000 employee lives (and 50,000 lives when spouses and dependents are included) were covered through ChamberCare.

Now, ChamberCare Solutions takes that partnership to an even higher level with a suite of solutions to help meet insurance needs.

“The Indiana Chamber-Anthem partnership has been an excellent one for our member companies, as well as their employees and families,” says Jennifer Elkin, Chamber senior vice president of marketing. “There have been more questions than answers since the Affordable Care Act was signed. We’ve been listening, discussing and searching for the right tools and products – and we’ve found them in this evolution to ChamberCare Solutions.”

The ChamberCare Solutions options include:

  • ChamberCare Savings: This is the previous ChamberCare discount program – now available for companies with between 51 and 99 employees. This was made possible by the late 2015 signing of the PACE Act (Protecting Affordable Coverage for Employees), which returned the definition of a small business back to one with fewer than 100 employees.
  • ChamberCare Exchange: For companies with fewer than 50 employees and a potentially unhealthy, higher-risk population, the exchange might be the best alternative. Important guidance and navigation is available through Anthem.
  • ChamberCare Business Resources or a PEO (Professional Employer Organization): This is an attractive option for companies that, in addition to a competitive health care product, are looking to outsource some of their human resources functions. The multiple employers in the PEO allow the advantage of using a company’s experience rating compared to the generally more volatile community rating.

The Indiana Chamber and Anthem are teaming with Indianapolis-based Human Capital Concepts (HCC) on the PEO. Harlan Schafir, CEO of HCC, started the state’s first PEO in the early 1990s; he and his team have more than 125 years of experience in the industry.

“We are in the midst of an unprecedented talent war,” Schafir explains. “A PEO allows companies to attract and retain talent by improving employee benefit offerings and helps these organizations mold an attractive culture. Working with a PEO allows companies to focus on their core mission. The PEO takes care of compliance with ever-complex laws and regulations; company leaders focus on running their business.”

  • ChamberCare Shared Savings: This is a future offering under development by Anthem. It is expected to allow for self-funding for employers with as few as 25 employees. To date, such plans have only been available for organizations with at least 100 employees.

“The Indiana Chamber has advocated and educated on health care issues for many years. We’re pleased to add this in-depth navigation benefit,” Elkin adds. “Being able to offer these choices – with more to come – will save members money and allow to further invest in their people and businesses.”

Learn more or contact Nick Luchtefeld at (800) 824-6885.

Letter: Federal Health Insurance Tax Harmful to Employers

The federal Health Insurance Tax is an aspect of the Affordable Care Act that poses a threat to businesses across the country. The following letter of concern from Caryl Auslander, the Indiana Chamber’s vice president of federal affairs, was sent to Sen. Joe Donnelly and explains the Chamber’s position on the issue.

Senator Donnelly,

As Hoosiers, we are proud that our state has shown strong and sustained economic growth ever since the nationwide recession in 2009. It is our concern that the Federal government is hurting, rather than helping, by enacting policies that harm the employer community, specifically small businesses. In particular, we are deeply concerned by the Health Insurance Tax (or “HIT”) that is embedded in the Affordable Care Act.

This provision ensures that those individuals and businesses that have to turn to private insurance companies for coverage are stuck with a disproportionate share of the costs of the ACA. While the original intent of the HIT was supposed to be paid by the insurance companies, in reality the companies really act only as tax-collecting proxies for the Federal government.

When a consumer cannot avoid purchasing a good or service, they have little or no power to resist price increases imposed by suppliers. And when all of the suppliers are charged the same tax, they all have the same incentive to pass it along to their consumers. Thus the HIT forms a hidden tax on health insurance consumers: The families and small businesses who can’t afford to self-insure.

By some estimates, the HIT will cost more than $500 per family every year. A tax burden like that can place real hardship on a middle-class family, push poor families straight into insolvency, and keep small businesses from being able to hire new workers, reinvest in their company or provide other services to consumers. In a small firm with 80 employees, the hidden HIT alone could cost more than $40,000 a year — well over the state’s per-capita income.

The HIT is a hidden and regressive tax, and bipartisan agreement has been enough thus far to delay its full implementation. But middle-class Hoosiers and small business owners here cannot afford the continued uncertainty. On behalf of 24,000 Chamber members and customers across the state of Indiana, it is our request that you place the permanent elimination of the Health Insurance Tax at the top of your agenda. Its unconditional repeal would be a victory for transparency, good government, and economic opportunity for all.

Thank you for your leadership on this issue and for defending the people of Indiana.

Sincerely,

Caryl Auslander
Vice President, Federal Affairs

Poll: Almost One in Four Americans Open to Separating from U.S.

CAlthough Scotland’s movement to secede from the United Kingdom fell a bit short at the ballot box, it appears it’s not just 45% of Scots who have separation on their minds.

And frankly, it’s no secret most Americans aren’t enthusiastic about the federal government these days. Between gridlock, behemoth budgets and trying to solve the health care puzzle, many have grown frustrated. Poll results explained in this Reuters article, however, are still a bit alarming.

Whoever takes the White House in 2016 may have his/her hands full in trying to unify the country. 

Congress Can Do It, But You Can’t

An interesting blurb in a recent Kiplinger newsletter on one of the privileges of congressional service:

Congress can do what employers can’t when it comes to health coverage: use tax-advanced funds to reimburse workers who buy individual health care policies on exchanges. Employers face a tax penalty of $100 a day per worker for violations.

Yet the government gives lawmakers and Capitol Hill staffers tax free contributions to help offset insurance premiums, covering about 72% of exchange-bought insurance. The government allowed the payments because of concerns about higher premiums and the loss of the government subsidy for insurance for both lawmakers and staff.

The IRS restated its view that such subsidies aren’t permitted in the private sector after some vendors told employers that the pretax payments would allow them to meet the mandate to provide insurance. The double standards isn’t likely to change.