Over the summer, Congress will likely take a more incremental approach to addressing any amendments to the Patient Protection and Affordable Care Act (PPACA).[1] After the House sent a shock wave of “repeal” earlier in the year, things appear to be cooling down a little with the new mantra of “repair.”
Some changes to PPACA original requirements already have been made both at the legislative and regulatory levels. For example, the Republicans succeeded in repealing the infamous 1099 filing requirement earlier this spring -- albeit through a bipartisan vote and which was signed into law by President Obama.[2]
Further, some Republicans are now sending mixed messages as to what their next steps will be. Here is one example:
"Our focus right now is on repealing all of ‘Obamacare’ and pieces of it where we can,” said Rep. John Kline (R-MN), chairman of the Education and Workforce Committee, one of several U.S. House committees with jurisdiction over the health policy.[3] “The replacement pieces for health care are still on the table, but we're not pushing them right now because we've got a full plate with other stuff."[4]
BenefitMall has written several Congressional updates in recent months exploring a myriad of issues associated with PPACA, including:
This blog provides a quick update on several new bills that have been introduced in Congress that are more incremental in nature.
Efforts to Expand Health Savings Accounts[5]
Sen. Orin Hatch (R-UT) and Rep. Erik Paulson (R-MN) have offered companion bills entitled, “The Family and Retirement Health Investment Act of 2011” (H.R. 2010, S. 1098), which would protect and even expand opportunities to purchase Health Savings Accounts (HSAs).[6] PPACA currently restricts the use of health care savings plans that offer low premiums but carry high deductibles. Small business employers will not be able to offer health care savings plans with deductibles of more than $2,000 to individual employees. For families, the upper limit is $4,000. These bills would repeal those restrictions, allowing small business employers to keep offering high-deductible plans. The PPACA prohibition against paying for over the counter non-prescription drugs would also be repealed. Several powerful groups including the American Medical Association (AMA) have gone on record supporting this legislation.[7] The House version has 34 co-sponsors and has been referred to the House Subcommittee on Health, and the Senate version has 3 co-sponsors and has been referred to the Senate Committee on Finance.
Medical Liability Reform
Earlier this year the House Republicans introduced the “Help Efficient, Accessible, Low Cost, Timely Health care (HEALTH) Act of 2011” (H.R .5). The goal is to get medical malpractice costs under control. The official summary of the bill states that it would establish “conditions for lawsuits arising from health care liability claims regarding health care goods or services or any medical product affecting interstate commerce.”[8] Some of the specifics include:
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Sets a statute of limitations of three years after the date of manifestation of injury or one year after the claimant discovers the injury, with certain exceptions.
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Limits noneconomic damages to $250,000. Makes each party liable only for the amount of damages directly proportional to such party's percentage of responsibility.
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Allows the court to restrict the payment of attorney contingency fees. Limits the fees to a decreasing percentage based on the increasing value of the amount awarded.
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Allows the introduction of collateral source benefits and the amount paid to secure such benefits as evidence. Prohibits a provider of such benefits from recovering any amount from an award in a health care lawsuit involving injury or wrongful death.
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Authorizes the award of punitive damages only where: (1) it is proven by clear and convincing evidence that a person acted with malicious intent to injure the claimant or deliberately failed to avoid unnecessary injury the claimant was substantially certain to suffer; and (2) compensatory damages are awarded. Limits punitive damages to the greater of two times the amount of economic damages or $250,000.
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Denies punitive damages in the case of products approved, cleared, or licensed by the Food and Drug Administration (FDA), or otherwise considered in compliance with FDA standards.
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Provides for periodic payments of future damages.[9]
Several weeks ago, the House Committee on Energy and Commerce reviewed and marked up the bill. Currently H.R. 5 has 134 co-sponsors – most of whom are Republicans.
Addressing the National Debt Issue
The major focus in Congress for rest of this month certainly will be the debate of whether or not to raise the U.S. debt ceiling and the need to implement tax reform. This debate also will impact several health care programs. For example, Republicans are still hoping to reform Medicare and Medicaid while Democrats are opposed to drastic changes. During a televised news briefing last week, House Minority Leader Nancy Pelosi asserted she opposes cuts to entitlement programs as part of a debt deal. Although she sent a signal that there may be some room for compromise on changes to key programs, Pelosi also stressed the need to continue investing in these public sector programs.[10] Additional bi-partisan meetings are scheduled at the White House and Congress in the near future to see if a deal can by hammered out before the August 2, 2011 deadline (i.e., where the U.S. would have to suspend investments in federal retirement funds).
Stay tuned for more details as BenefitMall continues to track health care reform initiatives and other federal public policy activities that might directly or indirectly impact brokers and their clients. Please monitor www.BenefitMall.com and www.HealthcareExchange.com for further developments.
[1] http://dpc.senate.gov/healthreformbill/healthbill49.pdf.
[9] As reported in Library of Congress, Thomas reporting service. Ibid.
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