A congressional panel that leads U.S. efforts to shape how the country raises and spends money today gave all House members a few minutes to talk about health care proposals.
In spite of complaints about Republicans’ and Democrats’ inability to work together to get anything done, the House Ways and Means Committee has achieved some major accomplishments in the past two years.
The panel helped shape efforts to fix the Medicare “sustainable growth rate” provider reimbursement problem, and it also helped keep the Social Security Disability Insurance (SSDI) from becoming insolvent sometime around this year’s elections.
Today, Pat Tiberi, the chairman of the committee’s health subcommittee, organized a “member day” hearing. Instead of listening to expert witnesses from outside Congress testify, committee members listened to their colleagues’ thoughts about health-related tax provisions.
Many hearing participants shared ideas for improving health savings accounts (HSA) and other personal health accounts, and improving the Patient Protection and Affordable Care Act (PPACA) provisions related to commercial health insurance.
For a sampling of the proposals lawmakers presented, read on.
1. H.R. 1270: The Restoring Access to Medication Act of 2015
Rep. Lynn Jenkins, R-Kan., says the revenue-raising provision in the Patient Protection and Affordable Care (PPACA) that keeps consumers from using HSA and flexible spending account (FSA) to pay for over-the-counter (OTC) drugs without a prescription has to go.
“It decreases access to OTC drugs, and it increases health care costs all around,” Jenkins said.
Images: All images in this article are screen captures from the House Ways and Means Committee hearing video.
2. H.R. 954: To amend the Internal Revenue Code of 1986 to exempt from the individual mandate certain individuals who had coverage under a terminated qualified health plan funded through the Consumer Operated and Oriented Plan (CO-OP) program
Rep. Adrian Smith, R-Neb., comes from the state that suffered the first CO-OP carrier failure.
Smith said the least Congress can do for the consumers enrolled in CO-OPs that fail is to exempt them from the penalty that PPACA imposes on many people who fail to have minimum essential coverage (MEC).
Smith’s bill, H.R. 954, would exempt enrollees in CO-OPs that fail before October from the PPACA penalty for the remainder of the calendar year. For enrollees in CO-OPs that fail in October, November or December, the exemption would last until the end of the following calendar year.
3. H.R. 4469: Health Savings Act of 2016
Rep. Erik Paulsen, R-Minn., has introduced a bill that would help more people use HSAs, and help HSA holders use the cash in the accounts for more purposes.
One provision in H.R. 4469 would let people ages 65 and older who are still working, but who enroll in the basic Medicare Part A hospitalization plan, continue to contribute to their HSAs.
About 20 percent of Americans ages 65 and older are still working, and the basic Medicare Part A program comes with high hospital deductibles, Paulsen said.
“HSAs should be a central component of health care in the United States,” Paulsen said.
Keeping working people from contributing to HSAs simply because they have Medicare Part A is a bad policy, Paulsen said.
4. H.R.4217: To amend the Internal Revenue Code of 1986 to determine eligibility for health insurance subsidies without regard to amounts included in income by reason of conversion to a Roth IRA
Rep. Ami Bera, D-Calif., a medical doctor, said that under current rules, a PPACA public exchange has to include the income a taxpayer “earns” from converting a traditional individual retirement account (IRA) into a Roth IRA in eligibility calculations.
Bera said one of his constituents, Larry, an early retiree, ran into this problem in 2014.
Larry bought health coverage with a PPACA premium tax credit subsidy through Covered California, converted a traditional IRA into a Roth IRA, and then became ineligible for the premium tax credit in 2015 when Covered California included the IRA conversion income in eligibility calculations.
Larry also had to pay back the tax credit subsidy money he received in 2014.
“Larry never saw any of his income as new money in his pocket,” Bera said.
Counting the IRA conversion money in tax credit eligibility calculations is unfair, Bera said.
See also: Medicare: A liability for Democrats
5. H.R.2911: Small Business Healthcare Relief Act
Rep. Mike Thompson, D- Calif., said current regulations now keep small employers from setting up stand-alone health reimbursement arrangements (HRAs) for employees, even though the employers have no legal obligation under PPACA to offer any health benefits.
Thompson has cosponsored a bill with Rep. Charles Boustany, R-La., that would let small employers sponsor HRAs.
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