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NLN Capitol Connection - March 2017

Title VIII Nursing Workforce Reauthorization Act
March 7, 2017

Senate Finance Committee Approves Seema Verma for CMS
Seema Verma, nominated as Administrator for the Center for Medicare and Medicaid Services (CMS), won approval from the Senate Finance Committee on March 2. She was approved on a 13-12 vote. Her nomination now goes before the full Senate for approval.

If confirmed as the CMS administrator within the Health and Human Services Department, Verma will play a large role in reforming the programs as well as efforts on repealing and replacing the Affordable Care Act.

ACA Repeal Bill Moves Forward in the Legislative Process
The House of Representatives are expected to debate the Affordable Care Act (ACA) repeal bill this month. On March 8, the House Energy and Commerce Committee and the Ways and Means Committee will mark up the American Health Care Act. This is the first step in a long process to repeal the ACA and we expect many other ACA repeal bills to be introduced as the legislative process moves forward. The NLN is still reviewing the bill in detail; however, below are the ACA provisions to be eliminated or retained after an initial review of the American Health Care Act. The NLN will continue to keep you updated on this legislation and any other ACA repeal bills that may be introduced.


ACA Provisions Repleaded in the American Health Care Act<
red-x4 Enhanced funding for Medicaid expansion
red-x4 Cost-sharing subsidies
red-x4 Most ACA taxes, including the health insurance tax, medical device tax, chronic care tax,
tanning tax and Medicare tax increase
red-x4 Tax penalties used to enforce the individual mandate and employer mandate
red-x4 Funding for the Prevention and Public Health Fund
red-x4 Reductions in Disproportionate Share Hospital payments

ACA Provisions That Remain in the American Health Care Act
checkimages Ban on insurers charging more or denying coverage based on preexisting conditions
checkimages Insurance actuarial value requirements
checkimages Requirement that insurance plans cover dependents up to age 26

The American Health Care Act includes:
bullet “Continuous Coverage” Requirement - The American Health Care Act will replace the ACA’s individual mandate with a “continuous coverage” requirement that allows insurers to impose a penalty of 30% on individuals who have allowed their insurance coverage to lapse.
bullet States Decide Coverage Requirements - The ACA required insurance plans to cover 10 essential health benefits. The American Health Care Act Act allows states to determine the health benefits that must be included in insurance plans offered in their respective states.
bullet Insurance Subsidies Based on Age Rather than Income - The American Health Care Act eliminates the ACA’s income-based subsidies and replaces them with new subsidies based on age. The subsidies are intended to account for higher insurance costs for older individuals. The age-based subsidies phase out for individuals who earn $75,000 a year and $150,000 a year for joint filers. Additionally, the American Health Care Act would allow insurers to charge older enrollees up to five times as much for premiums rather than the current ACA requirement of only three times more than a younger person.
bullet Increase Use of Health Savings Accounts (HSAs) - The American Health Care Act could emphasize greater use of HSA accounts (HSAs), a tax-advantaged savings account that individuals can withdraw from to pay for certain out-of-pocket health expenses such as prescription medicine.

The next edition of the Capitol Connection will be published on April 4, 2017.

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