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Democrats Aim to Put ACA in the New House Rules

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Democrats have put a section related to Affordable Care Act litigation in their proposed House Rules document for the 116th Congress.

Democrats will control at least 235 of the 435 seats in the House when the 116th Congress opens for business Thursday.

When the House majority adopts a set of rules for a congress, the rules document helps frame how the House operates during the two-year period when that congress is Washington.

In the new draft rules document, for example, House Democrats have proposed that former House members who are now registered lobbyists should stay out of the House gym; that the House Committee on Education and the Workforce should return to calling itself the House Committee on Education and Labor; and that a bill or resolution will need at least 290 cosponsors before House leaders will put the measure on the “Consensus Calendar,” or list of measures that can pass with a quick voice vote.

Title III in the draft rules document would cover how the House handles the Texas v. United States litigation, and other litigation related to the Affordable Care Act.

Republicans were in control of the House from 2010 through 2018.

House Republicans have filed one major federal lawsuit in opposition to Affordable Care Act subsidy spending.

(Related: ACA Cost-Sharing Reduction Deal Helps States’ Suit Proceed)

House Republicans have also supported ACA opponents in other anti-ACA litigation, including Republican state officials’ effort to have a major part of the ACA, the Patient Protection and Affordable Care Act (PPACA), nullified through the Texas v. United States suit.

(Related: Judge Keeps PPACA in Effect While Appeal Is Under Way)

Title III of Democrats’ proposed House Rules document for the 116th Congress would authorize the House speaker to intervene in ACA-related litigation.

The House speaker could take steps to protect the institutional interests of the House, and to defend the ACA and ACA-related amendments to other laws, “including the provisions ensuring affordable health coverage for those with preexisting conditions,” according to the proposal text.

The Office of General Counsel of the House would represent the House in any such litigation, and that office could bring in outside experts and outside lawyers, including unpaid outside lawyers, to help it.

The House Administration Committee would have to give quarterly reports on spending on the outside lawyers and experts used in ACA-related litigation.

Here are three other health and benefits matters observers are watching as the 116th Congress prepares for its debut.

1. Medicare for All

In 2018, the main health policy conflict in the House was between Republicans who wanted to kill the Affordable Care Act-based health care finance system and the Democrats and moderate Republicans who wanted to shore up the ACA-based system.

This year, the main conflict in the House could be between Republicans and moderate Democrats who want to shore up the ACA-based system, and Democrats who want to replace the ACA-based system with a government-run health care finance system.

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In July, for example, Rep. Pramila Jayapal, D-Wash., co-founded a Medicare for All Congressional Caucus. The caucus started out with 70 members.

Rep. Mark Pocan, D-Wis., co-chair of the Congressional Progressive Caucus, joined the Medicare for All Congressional Caucus.

Pocan will continue to be the co-chair of the Congressional Progressive Caucus in the 116th Congress, and members of that caucus have elected Jayapal to be the other co-chair.

The number of Democratic members of the House is now much higher than it was in July, and many of the new Democratic members said during their campaigns that they support Medicare for all proposals.

The proposed House Rules document does not mention Medicare, or Medicare for all proposals.

2. A Hope for Bipartisanship

President Donald Trump has made holding down prescription drug costs a focus.

Alex Azar II, Trump’s Health and Human Services secretary, has announced a number of initiatives in that area.

(Related: Trump Proposes Tying Some Drug Prices to Global Index)

House Democratic Leader Nancy Pelosi, who is on track to be the new House speaker, said in November, during a press conference, that she hoped Democrats would be able to work with Republicans on efforts to control prescription drug costs.

The proposed House Rules document does not mention prescription drug costs.

3. House Employee Benefits

Congress has employees of its own.

In the proposed House Rules for the 116th Congress, House Democrats propose that Congress should set up a Select Committee on the Modernization of Congress.

One charge for the select committee would be developing recommendations for the modernization of efforts related to “staff recruitment, retention, and compensation and benefits.”

House members could then decide whether or not to adopt the recommendations.


Links to documents related to the proposed House Rules for the 116th Congress are available here.

— Read Divided Congress’ First Task: Tussle With Trump Over Shutdownon ThinkAdvisor.

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