Ways and Means Marks-up Health Care Bills

July 11, 2018

On July 11, the House Ways and Means Committee will hold a full committee markup on a series of measures that will delay several Affordable Care Act (ACA) provisions and expand tax-favored health savings accounts (HSA’s).

Introduced by Rep. Devin Nunes (R-Calif.) and Mike Kelly (R-Pa.), the committee will consider H.R. 4616. If passed, it would provide for a temporary moratorium on the employer mandate until Jan. 1, 2019 and delay for one year– until after Dec. 31, 2020—the implementation of the Cadillac Tax. The Cadillac Tax is a 40 percent excise tax on employer plans exceeding $10,200 in annual premiums for individuals and $27,500 for families.

NSBA has long advocated for an end to the employer mandate, as well as opposing the Cadillac Tax because it would punish small businesses with plans that cost more simply due to the make-up of their workforce. The employer mandate creates greater uncertainty, enormous administrative burdens and financial unpredictability for both firms and employees—while doing virtually nothing to expand coverage—and NSBA believes it should be repealed. Similarly, in an NSBA survey, over a quarter of small-business respondents indicated the Cadillac Tax would impact their business somewhat to very significantly.

The committee will also examine, H.R. 6305, a bipartisan bill sponsored by Reps. Mike Kelly (R-Pa.) and Earl Blumenauer (D-Ore.) which would amend the tax code to try and make it easier to fund HSAs. Specifically, the Bipartisan HSA Improvement Act of 2018 would allow eligible individuals to make HSA contributions if a spouse has a flexible spending account and permit flexible spending accounts and health reimbursement account terminations or conversions to fund HSA’s.

Other bills of interest that will be marked up include:

Sponsored by Health Subcommittee Chairman Peter Roskam (R-Ill.) and Rep. Mike Thompson (D-Calif.), H.R. 6301 expands access and enhances the utility of HSAs by offering health plans a certain amount of flexibility in their plan design while still maintaining eligibility for HSA contributions. This flexibility will allow insurers to offer coverage for high-value, low-cost services like telehealth, chronic disease management (e.g. diabetic testing strips), or primary care visits below the deductible.

H.R. 6306, introduced by Rep. Erik Paulsen (R-Minn.) expands access and enhances the utility of HSAs by: (1) increasing the contributions limits for HSAs; (2) permitting spousal catch-up contributions into the same account; and (3) creating a grace period for medical expenses incurred before the establishment of an HSA.

Introduced by Rep. Michael Burgess (R-Texas) and Health Subcommittee Chairman Peter Roskam (R-Ill.), H.R. 6314 expands eligibility and access to HSAs by allowing plans categorized as catastrophic and bronze in the individual and small group markets to qualify for HSA contributions.

H.R. 6199, sponsored by Reps. Lynn Jenkins (R-Kansas) and Grace Meng (D-N.Y.) which reverses the ACA’s exclusion of using tax-favored health accounts to purchase over-the-counter (OTC) medical products and adds feminine products to the list of qualified medical expenses for the purposes of these tax-favored health accounts.

Several other measures will also be considered that aim to increase flexibility and expand the scope of HSA’s to encourage “consumer-directed health care.”

The small-business community needs substantial relief from health care costs and many of the burdens imposed by the ACA. At NSBA, we believe that this level of relief can only be achieved through a broad reform of the current health care system with a goal of reducing the cost of coverage, providing universal access, focusing on individual responsibility and empowerment, creating of the right market-based incentives, and a relentless focus on improving quality while driving out unnecessary, wasteful and harmful care.