Congress re­turns to ACA bat­tles and a nar­row re­form tweak

Modern Healthcare - - THE WEEK AHEAD - —Paul Demko

Mem­bers of Congress were back in their districts on hol­i­day break when Pres­i­dent Barack Obama an­nounced that en­roll­ments in the in­sur­ance ex­changes had reached 8 mil­lion and the Con­gres­sional Budget Of­fice pro­jected that ex­change plan pre­mi­ums would be 15% lower in 2016 than an­tic­i­pated.

But don’t ex­pect Repub­li­cans to sing Oba­macare’s praises when Congress reconvenes this week. In­deed,

the con­ser­va­tive group, Amer­i­cans for Pros­per­ity, an­nounced it is launch­ing big an­tiOba­macare ad buys in Colorado, Louisiana, Michi­gan and New Hamp­shire mostly blast­ing Demo­cratic sen­a­tors run­ning for re-elec­tion.

Any sub­stan­tial changes to the law are highly un­likely be­fore Novem­ber’s elec­tions—and per­haps be­yond. “It’s go­ing to be some­thing that’s go­ing to be con­tested for at least the next two elec­tion cy­cles,” said James Capretta, a con­ser­va­tive health­care an­a­lyst at the Ethics and Pub­lic Pol­icy Cen­ter.

Still, Congress has shown some bi­par­ti­san will­ing­ness to tweak the law. The “doc fix” bill passed last month de­layed the Pa­tient Pro­tec­tion and Af­ford­able Care Act’s Medi­care cuts to hos­pi­tals serv­ing a dis­pro­por­tion­ate share of low-in­come pa­tients. And this week could see House de­bate on the Expatri­ate Health Cov­er­age Clar­i­fi­ca­tion Act of 2014, spon­sored by Rep. John Car­ney Jr. (D-Del.), ex­empt­ing plans pur­chased by Amer­i­cans liv­ing abroad from ACA re­quire­ments.

Car­ney ar­gued for ex­empt­ing such plans by say­ing “expatri­ate” plans “of­fer high-end, ro­bust cov­er­age to ex­ec­u­tives and oth­ers work­ing out­side their home coun­try, giv­ing them ac­cess to a global net­work of health­care providers.” The bill has noth­ing to do with low-in­come or unin­sured people, and it has bi­par­ti­san sup­port.

Pres­i­dent Obama

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