Health care reform US - Latest developments

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Congress has a heavy health care policy agenda ahead of the start of a two-week recess that begins Friday. House lawmakers will focus on a vote on a fiscal 2015 budget blueprint and the development of some fiscal 2015 spending bills. The House budget plan, authored by Budget Committee Chairman Paul Ryan (R-WI), is similar to prior Republican budget proposals, calling for the repeal of most of the ACA and comprehensive reforms to address the fiscal sustainability of Medicare and Medicaid. The House is expected to pass the plan this week, but the effort will be mostly about election-year messaging since many of its proposals are non-starters in the Senate.


Meanwhile, a House Ways and Means Committee panel will hold a hearing on implications of recently released final regulations implementing the ACA’s employer responsibility and reporting requirements. Panel members plan to ask Treasury Department official J. Mark Iwry about how the Administration reached its decision to delay the employer responsibility provisions as well as explain related regulations.


The House may also soon pass a bill to generally exempt expatriate plans from the ACA’s requirements. The legislative initiative comes after the release of guidance by the Department of Health and Human Services that explains which expatriates must have minimum essential coverage (MEC) to avoid individual-mandate penalties and which types of expatriate coverage are MEC.


On Monday, the Senate approved a long-term unemployment benefit extension bill that includes a provision to codify a Treasury Department announcement that the work hours of volunteer firefighters and emergency medical personnel need not be considered for purposes of the ACA's employer responsibility rules. Although the House earlier approved the provision as a stand-alone bill, whether it can reach the president’s desk as part of the unemployment extension measure is uncertain.