De­vice tax bat­tle es­ca­lates as King rul­ing looms

Modern Healthcare - - NEWS - By Steven Ross John­son

Con­gres­sional Repub­li­cans moved for­ward last week with their ef­forts to roll back the Af­ford­able Care Act even as the na­tion ner­vously awaits a U.S. Supreme Court rul­ing that could make healthcare cov­er­age un­af­ford­able for mil­lions of Amer­i­cans and throw the in­di­vid­ual in­sur­ance mar­ket into chaos.

The House, on a bi­par­ti­san 280-140 vote, ap­proved bi­par­ti­san leg­is­la­tion last week to re­peal the ACA’s 2.3% med­i­cal-de­vice tax. Pres­i­dent Barack Obama has said he will veto the bill be­cause it does not iden­tify an al­ter- na­tive rev­enue source to off­set the pro­jected $24 bil­lion loss of rev­enue over 10 years.

The vote tally, which fell one vote short of a veto-proof ma­jor­ity, comes as the Supreme Court is poised to is­sue its de­ci­sion on the le­gal­ity of the law’s pre­mium sub­si­dies in as many as 37 states. If the court strikes down the sub­si­dies, some observers think Obama and the Democrats could of­fer the de­vice-tax re­peal as a sweet­ener in a deal to pre­serve the pre­mium sub­si­dies.

ACA sup­port­ers are ner­vous about re­peal­ing the de­vice tax be­cause it likely would boost pres­sure to kill other ACA taxes that fund cov­er­age ex­pan­sion, in­clud­ing the health in­sur­ance pre­mium tax and the so­called Cadil­lac plan tax on high-value em­ployer health plans. Re­peal­ing the de­vice tax has bi­par­ti­san sup­port in the Se­nate be­cause many de­vice man­u­fac­tur­ers are lo­cated in Demo­cratic-lean­ing states such as Mas­sachusetts and Min­nesota. But it’s un­clear whether the leg­is­la­tion can win a veto-proof ma­jor­ity in that cham­ber.

A study re­leased by the Ad­vanced Med­i­cal Tech­nol­ogy As­so­ci­a­tion found that the de­vice tax had re­sulted in the loss of 33,000 jobs since tak­ing ef­fect in 2013.

But an anal­y­sis by the non­par­ti­san Con­gres­sional Re­search Ser­vice re­leased in Novem­ber found that the fi­nan­cial im­pact of the tax is likely to be neg­li­gi­ble.

Mean­while, the House last week post­poned fi­nal pas­sage of a bill that would re­peal the In­de­pen­dent Pay­ment Ad­vi­sory Board, a 15-mem­ber body of out­side ex­perts au­tho­rized by the Af­ford­able Care Act to pro­pose rec­om­men­da­tions to con­trol Medi­care spend­ing growth.

Crit­ics say the board, whose mem­bers have not yet been nom­i­nated, is an un­elected body with the uni­lat­eral power to im­pose Medi­care cuts that would re­duce se­niors’ ac­cess to care. Sup­port­ers say it would force Congress to act re­spon­si­bly if and when Medi­care spend­ing rose too fast.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.