Day of Action

The Senate today followed the House of Representatives by passing the $1.1 trillion omnibus appropriations bill that funds the federal government through the end of the current fiscal year on September 30, 2017. The BNA report on the action is here. The President is expected to sign the bill.

Speaker of the House Paul Ryan (R Wisc) finally had the votes today for the House to pass the American Health Care Act (H.R. 1628) by a narrow 217-213 margin.  All of the Democrats and 20 Republicans voted against the bill. (The Republicans have a 22 seat majority in the House; four House seats currently are vacant.) The House Energy and Commerce Committee’s section by section analysis of the bill (only 15 pages) is here.

If this were a Medicaid blog the AHCA discussion would continue at length. But this is the FEHBlog and in the FEHBlog’s view the law would not have a significant effect on the FEHBP.

The bill focuses on reforming Medicaid and attempting to stabilizing the individual market, both heavy lifts. It also lifts the individual and employer mandates and virtually all of the ACA taxes. (The Cadillac tax effective date is pushed back to 2026).  The law leaves the large group market alone. It’s up to the Administration to inject more flexibility in the group market by sensibly loosening ACA regulations and sub-regulatory guidance.

The bill goes over to the Senate now. The bill is structured as a reconciliation measure so that it can be enacted with 51 votes. The Senate Parliamentarian plays a role in determining reconciliation status but the Parliamentarian must report to the Senate leadership. The Republicans have a two seat majority in the Senate so the Republicans could afford to lose two of its own assuming that the Democrats and independents who caucus with the Democrats remain united against the bill. Of course, Vice President Pence is the Senate President who can cast a tie breaking vote.  

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