H.R. 1628: 3 ways House Rules warmed things up

Rep. Greg Walden said he thinks existing benchmarking rules will keep mental health benefits in Medicaid plans. (Photo: Walden)

2. Details

The House Rules debate on H.R. 1628 seemed to focus more than earlier ACA change hearings on the actual provisions in the bill and the proposed amendments, and less on general attacks on the motives of the people on the other side.

Democrats on the committee said they had major concerns about Medicaid mental health benefits, commercial health coverage premiums for older consumers, and proposed commercial health insurance market stabilization funds for the states.

The Democrats noted that it appeared that the amended version of H.R. 1628 might eliminate the need for state Medicaid programs to meet ACA major medical essential health benefits requirements, including the ACA mental health benefits coverage requirements put in the EHB package by the U.S. Department of Health and Human Services.

Pallone said governors will see that change as invitation to cut expensive mental health, substance abuse and prescription drug benefits from their programs.

Rep. Greg Walden, R-Ore., an architect of the bill, said other Medicaid benchmarking rules, tied to state or federal employees’ health benefits, will keep mental health benefits in most states’ programs.

Democrats also suggested that changes could let insurers charge adult enrollees ages 50 to 64 as much as six times as much as they charge their youngest adults enrollees, up from the maximum ACA age band ratio of three to one.

Rep. Richard Neal, D-Mass., scoffed at the idea that states will use the stabilization grant money H.R. 1628 provides, as an alternative to ACA subsidy programs, to stabilize insurance markets.

“They’re going to use it to path highways,” Neal said.

But Rep. Kevin Brady, R-Texas, had stories of his own about problems with the current ACA benefits.

In rural areas, for example, the ACA push for commercial plans to shift to narrow networks means that many ordinary Americans in rural parts of Texas no longer can use local doctors or hospitals, Brady said.

3. Personal stories

Democrats talked about constituents who were helped by the ACA coverage expansion programs, and what they might lose if H.R. 1628 becomes law.

Sessions talked about his own experiences using the ACA coverage that members of Congress get through DC Health Link.

The premiums are twice as high as what his family had before the ACA came along, the deductible is twice as high, and the children’s hospital he would want to use in Dallas if his son were still young is not in the plan’s network, Sessions said.

Moreover, the ACA exchange plan reimbursement rate is so low in his area that providers would prefer to treat Medicaid patients than exchange plan enrollees, Sessions said.

The age-based tax credit in H.R. 1628 may have problems of its own, but it would give moderately high-income Americans who are now uninsured a way to pay for coverage, Sessions said.

Rep. Jared Polis, D-Colo., talked about his own frustration about an inability to get serious consideration for ACA improvement proposals. He said he hoped that Democrats and Republicans could eventually work together to talk about the many changes that members of both parties want to make.

“We’re spending all of our time on exactly what this insurance part looks like, without getting at the cost drivers,” Polis said.

Related:

Trump says GOP must pass AHCA or risk losing seats

Health age band may narrow

Are you following us on Facebook?