House Passes Spending Measure That Would Delay ACA for One Year
On Sunday, the House passed an amended Senate-approved continuing resolution that contained new provisions targeting the Affordable Care Act, despite opposition from Senate leaders and a White House veto threat, the New York Times reports.
House lawmakers first voted 248-174 to include language that would repeal the ACA's 2.3% medical device tax, which was included as a revenue generator to help pay for the law. Lawmakers then voted 231-192 to delay ACA implementation by one year (Weisman/Peters, New York Times, 9/28).
Specifically, the measure would impose a one-year delay on implementation of the law's individual mandate and health insurance exchanges. GOP aides said that most portions of the ACA that have gone into effect would remain unchanged, such as provisions prohibiting insurers from denying coverage to individuals with pre-existing conditions, allowing children to remain on their parents' health plans until age 26 and reducing the cost of prescription drugs for Medicare beneficiaries (Espo, AP/Boston Globe, 9/28).
Further, the delay included language that would allow employers and health care providers to opt out of mandatory contraceptive coverage under the ACA (New York Times, 9/28). It also would allow insurers and others not to provide abortion coverage if such coverage conflicts with their religious or moral beliefs (AP/Boston Globe, 9/28).
Senate To Reject House Bill
The Senate on Monday is expected to reject the new House-approved CR and send the chamber back a "clean" budget bill, devoid of any provisions targeting the ACA, the New York Times reports.
Senate Majority Leader Harry Reid (D-Nev.) likely has the 51 votes needed to strip the CR of the House-added ACA provisions (Peters/Weisman, New York Times, 9/29).
The Senate is not scheduled to meet until mid-afternoon, which would leave the House fewer than 10 hours to either accept the clean version or respond with new provisions targeting the ACA, essentially guaranteeing a federal shutdown on Oct. 1 (AP/Boston Globe, 9/28).
According to the Times, GOP leaders on Sunday suggested they would amend any bill the Senate sends back. According to some Republican lawmakers, House GOP leaders are considering an amendment that would disqualify the White House, members of Congress and their staffs from receiving an employer contribution for health coverage (New York Times, 9/29).
White House Threatens Veto
Meanwhile, White House spokesperson Jay Carney on Sunday in a statement said, "Any member of the Republican party who votes for this bill is voting for a shutdown." The White House also said President Obama would veto the House bill in the unlikely event it made it to his desk (New York Times, 9/28).
What Happens After a Shutdown?
The potential government shutdown could have an effect on several facets of health care, while leaving other aspects untouched.
For example, President Obama in a speech on Friday said that the new state insurance exchanges are a "done deal" and would open on Tuesday as scheduled regardless of a federal shutdown, Reuters reports (Krauskopf, Reuters, 9/27).
However, a federal shutdown could put more than 800,000 federal workers at risk of being furloughed and could disrupt some non-essential government services (Washington Post, 9/29).
- CDC would suspend its seasonal influenza program, reduce its outbreak detection efforts and stop helping states with infectious disease monitoring;
- CMS would suspend certain health care fraud and abuse detection efforts;
- FDA would halt safety activities, including routine inspections, import monitoring and laboratory research needed to inform public health decision making;
- HHS would furlough 40,512 of its 78,198 employees;
- Medicare and Medicaid providers would complete fewer recertification and entry surveys, which CMS says could put "beneficiaries at risk of quality of care deficiencies;"
- NIH would not accept new clinical care patients or award new grants; (Bunis, CQ HealthBeat, 9/27); and
- Veterans' benefit checks -- including disability claims -- would be disrupted if a shutdown goes beyond two or three weeks (Vogel, "Federal Eye," Washington Post, 9/27).