congressional roll call

HOUSE BAN ON ‘JUNK INSURANCE’ HEALTH PLANS:

Voting 224 for and 184 against, the House on July 24 blocked a Democratic attempt to call up a bill (HR 6479) designed to gird the Affordable Care Act (ACA) against a new order by President Trump that would circumvent many of the law’s core provisions. The bill would effectively prohibit a revival of health insurance plans that do not meet ACA requirements such as coverage of pre-existing conditions and “essential health benefits,” including maternity and pediatric care. The Trump administration would allow the sale of non-ACA-compliant “association” and “short-term” policies to small businesses and self-employed individuals apart from the 2010 health law. Calling Trump’s order a return to pre-Obamacare “junk insurance,” critics say it would siphon young, healthy individuals out of the diversified insurance pool needed to hold down premium costs and stabilize ACA marketplaces.

Michael Burgess, R-Texas, said, “President Obama told me I had a junk insurance plan and that I was going to get something better. I didn’t get something better” than the previous plan “which had covered every medical contingency that had occurred in my family’s life for a number of years” for a lower premium.

Sponsor Raul Ruiz, D-Calif., said his bill is needed because “instead of protecting the 130 million Americans with pre-existing conditions, this Congress is sitting idly by as this administration once again allows insurance companies to sell junk plans that don’t even cover basic healthcare services.”

A yes vote was in opposition to bringing the bill to the floor.

ARKANSAS

Voting yes: Bruce Westerman, R-4

TEXAS

Voting yes: Louie Gohmert, R-1, John Ratcliffe

EXPANSION OF HEALTH SAVINGS ACCOUNTS:

Voting 277 for and 142 against, the House on July 25 passed a bill (HR 6199) that would add payments for fitnessfees and over-thecounter drugs to the list of medical expenses reimbursable from tax-advantaged Health Savings Accounts (HSAs). In 2018, participants can make tax-free contributions of up to $3,450 as individuals and $6,900 as couples to an HSA and use the account to pay qualified medical expenses with pre-tax dollars. Unspent balances are carried forward each year. By law, HSAs must be linked to high-deductible health plans. But under this bill, they could be opened in tandem with plans having deductibles as low as $250 for individuals and $500 for families. Because the bill is not paid for, it is projected to add several billion dollars to the national debt each year.

In addition, the bill would loosen the rules for tax-advantaged Flexible Spending Accounts (FSAs), which individuals who have a health plan at work can use to pay certain out-of-pocket medical expenses, co-pays and deductibles.

Michael Burgess, R-Texas, said the bill “will allow those Americans with health savings accounts to use those accounts to pay for over-thecounter medications, the practice which existed up until the Democrats took away that ability in the Affordable Care Act.”

Norma Torres, D-Calif., said the bill “only benefits (the) 6 percent of Americans” who have a Health Savings Account, “not the 14 percent who lack healthcare insurance at all. We must help those who are falling further and further behind while this Congress buries us in debt.”

A yes vote was to send the bill to the Senate.

ARKANSAS

Voting yes: Westerman

TEXAS

Voting yes: Gohmert, Ratcliffe

REPEAL OF MEDICAL-DEVICE TAX:

Voting 283 for and 132 against, the House on July 24 passed a bill (HR 184) that would repeal a 2.3 percent excise tax levied by the Affordable Care Act on manufacturers and importers of medical devices used by hospitals and doctors, from CT scanners to surgical tools. Because the repeal is not paid for, the bill is projected to add more than $20 billion to federal debt through fiscal 2028. The purpose of the levy is to help pay the cost of premium subsidies in ACA marketplaces. Backers say it is fair to tax an industry that has reaped new profits from the law’s expansion of healthcare to millions of Americans. But critics say the tax dampens innovation and costs jobs in the medicalindustry.

Richard Neal, D-Mass., said the bill amounts to “billions of dollars in unpaid tax cuts on top of the $2.3 trillion this Congress has already passed into law, all with borrowed money. Republicans are using the deficit, which they keep making larger, to justify the deep cuts they plan to make to Medicare, Social Security and Medicaid.”

Erik Paulsen, R-Minn., said, “Usually the government puts an excise tax on things we want to discourage, like tobacco, alcohol or gas-guzzling automobiles. Why would we want to discourage medical innovation? Only in Washington would you impose a tax on lifesaving medical devices and then think you are going to help reduce healthcare costs.”