The Senate’s Health Care Freedom Act

At 10:00 p.m. on July 27, 2017, Senator McConnell introduced his Health Care Freedom Act. The bill is indeed skinny, only eight pages in length. It would:

• Repeal the individual mandate penalty effective December 31, 2015;
• Repeal the employer mandate penalty (but not reporting requirements) effective December 31, 2015;
• Extend the moratorium on the medical device tax from December 31, 2017 to December 31, 2020;
• Increase maximum contributions to health care savings accounts (HSA) to the amount of the deductible and out-of-pocket limitations for HSA-eligible high-deductible health plans ($6650 individual, $13,300 families for 2018) for three years, 2018 to 2020;
• Ban payments for one years to Planned Parenthood and any Planned Parenthood clone that received federal and state payments in 2014 that exceeded $1,000,000;
• Repeal the Prevention and Public Health Fund after 2018;
• Increase Community Health Center Funding by $422 million for 2017;
• Amend ACA section 1332, which governs state innovation waivers to:
  • Add $2 billion to pass through funding for states that submit and implement state innovation waivers;
  • Provide that HHS and the IRS “shall” instead of “may” approve a 1332 waiver if (not “only if” as in the current legislation) the secretaries determine that the application meets the benefit comprehensiveness, cost sharing, enrollment, and budget neutrality guardrail requirements;
  • Require a secretarial determination within 45 instead of 180 days;
  • And extend waivers from 5 to 8 years with unlimited renewals for 8 year periods and no cancellation by the secretaries.

The legislation makes no changes in Medicaid or CHIP and repeals no other taxes. It has presumably been cleared by the Parliamentarian for Byrd compliance.

The Senate is now debating a Democratic motion to commit to the HELP committee. If the motion fails, and the bill passes, it will go to conference with the House, although the House could simply adopt it and send it to the President.

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