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Bill With Fiduciary Rule Ban, ACA Defunding Nears House Floor

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Members of the House Rules Committee are preparing to review a bill that could nullify the U.S. Department of Labor’s fiduciary rule and eliminate federal funding for the Affordable Care Act.

The bill could also keep private insurers from using user fees to keep the ACA public health insurance exchange program alive.

The bill also could cut off all federal funding for any ACA programs.

Leaders of the House Rules Committee posted a copy of its version of the bill, H.R. 3354, the Make America Secure and Prosperous Appropriations Act, 2018, on the committee website earlier this week. Analysts at the Congressional Budget Office posted a report on the possible budget effects of the bill Friday.

(Related: ACA Exchange Programs Pass 11.5 Million 2017 Signups)

The House Rules Committee “is likely to meet the week” starting Sept. 4 to structure the process for bringing H.R. 3354 to the House floor, Rep. Pete Sessions, R-Texas, the committee chairman, writes in an announcement posted on the committee website.

The House Rules Committee develops the guidelines that determine how much time the House floor will devote to debate on a bill, and what kinds of amendments House members will debate on the House floor.

The House Rules PDF version of the bill, which has a date of Aug. 14 in the page footers and a date of Aug. 16 at the start of the text, is 1,305 PDF pages long.

The bill incorporates eight other budget bills. Division F, the section that covers federal spending on health, labor and human services programs, is based on the text of H.R. 3358, an appropriations act introduced by Rep. Tom Cole, R-Okla. The House Appropriations Committee approved the bill July 24.

DOL headquarters (Photo: Michael A. Scarcella/ALM)

DOL headquarters (Photo: Michael A. Scarcella/ALM)

The DOL fiduciary rule provision, on page 733 of the House Rules PDF version of the bill, states that, “Notwithstanding any other provision of law, the final rule issued by the Department of Labor entitled ‘Definition of the Term ‘Fiduciary’; Conflict of Interest Rule-Retirement Investment Advice’ and published by the Department of Labor in the Federal Register April 8, 2016… shall have no force or effect.”

An ACA defunding provision that starts on page 842 of the PDF would prohibit the government from spending any money on provision in the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010, except for the Medicare rate-setting process for 2018 and 2019, and for applying a Medicaid prescription drug rebate provision and a Medicaid pharmacy reimbursement provision in 2018.

A second ACA defunding provision, on page 757 of the PDF, would prohibit the government from using fees collected from the health insurers that use the ACA public exchange system to operate such an exchange.

Another section, on page 788, would require the secretary of the U.S. Department of Health and Human Services (HHS) to send the House and the Senate detailed monthly reports on ACA public exchange enrollment and grant awards.

Still another section would prohibit the Centers for Medicare and Medicaid Services, a division of HHS, from making the payments owed to insurers that participated in the ACA risk corridors program in 2014, 2015 and 2016. The program was supposed to use cash from ACA exchange plan issuers that thrived in 2014, 2015 and 2016 to help struggling issuers. The program was never able to collect much cash from thriving issuers and has paid only about 15% of the payments owed for 2014, and none of the payments owed for 2015 and 2016.

Insurers are fighting for the right to collect payments from the program in federal court.

Insurers say the government has an obligation to live up to its commitments. Lawyers for the U.S. government have argued that the insurers did not have a formal contractual relationship with the risk corridors program.

CBO analysts say they have not yet analyzed the effects of the ACA provisions in H.R. 3354 but believe the provisions would lead to significant reductions in federal spending and revenue.

— Read Colorado Brokers Increase ACA Exchange Volume 62% on ThinkAdvisor.


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