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A key House committee may mark up an Affordable Care Act reconciliation bill as soon as next week, several committee members and Republican lawmakers said March 2.
The House Energy and Commerce Committee is expected to hold hearings on a bill to repeal the ACA. Committee leaders have a draft of a repeal bill they’re showing Energy and Commerce members, but not Democrats or other Republicans.
Democrats and some Republicans detractors complained about being left in the dark about the committee’s plans. Sen. Rand Paul (R-Ky.) told reporters he’s concerned the House will try to pass an “Obamacare-lite” bill, which replaces the ACA’s tax credits with similar ones.
Liberals said the committee was hiding the bill to avoid criticism. Rep. Lloyd Doggett (D-Texas) told reporters March 2 that the House bill will leave millions of Americans without health insurance.
“The real question is: what are they hiding?” Rep. Joe Crowley (D-N.Y.) said.
Rep. Greg Walden (R-Ore.) defended the decision not to share details of the bill as “regular process” in a March 2 statement.
Rep. Chris Collins (R-N.Y.), a member of Energy and Commerce, told reporters the panel may mark up the bill as early as next week.
Energy and Commerce leaders are keeping details of the repeal bill close to the vest, not revealing what, if anything, has changed since a draft repeal bill was leaked in February. However, committee members and some Republican staffers have shared some details of the draft bill.
The leaked draft called for replacing the ACA’s premium support and refundable tax credits with new ones. The tax credits in the draft, which House leaders have said is outdated, were age-based, unlike the ACA’s income-based tax credits.
Republicans will retain many provisions of their 2015 reconciliation bill, vetoed by President Barack Obama. That bill lifted the ACA’s penalties for not having insurance as well as several of the health law’s taxes and fees.
The Energy and Commerce Committee’s repeal bill will try to strike a compromise for states that expanded their Medicaid programs and those that didn’t expand, Rep. Michael Burgess (R-Texas), chairman of the Energy and Commerce health subcommittee, told Bloomberg BNA March 1.
Republicans want to freeze expansion funds, meaning states that expanded under the ACA will continue to get added Medicaid funding from the federal government in coming years. But no new states will get additional funds to expand their programs and anyone who became newly qualified for Medicaid under expansion who falls out of Medicaid won’t be permitted back.
States that didn’t expand Medicaid could see more funding from the federal disproportionate share hospital program, which pays hospitals that care for the uninsured.
Conservatives are still debating when the freeze will start and if the bill will eventually end expansion funds, according to a Republican staffer. Some members are asking for an immediate freeze of expansion funding and for an end to the funds completely by 2020.
The House Ways and Means Committee, which is writing its own repeal bill that will be combined with the Energy and Commerce bill, won’t move forward with its legislation next week, committee leaders said March 2. The House’s tax writers are still working with the Congressional Budget Office to ensure their bill is budget neutral.
“We don’t have a bill,” Ways and Means Committee Chairman Kevin Brady (R-Texas) told reporters. “We’re continuing to work with CBO and our members on the final policy decisions.”
The two committees’ bills will need to be reconciled before a measure could go to the full House for a vote. The filibuster-proof reconciliation process will allow Republicans to rewrite the ACA without the backing of Democrats.
Rep. Phil Roe (R-Tenn.) told reporters March 2 he expects to get a bill to the Senate in the next three weeks.
Though some lawmakers are bullish on timing of a repeal bill, many have said they are undecided about certain elements, such as a cap on the tax exemption for employer-sponsored health insurance. Other members have come out this week vehemently opposed to a Feb. 10 draft that leaked last week.
And if committees do hold markups next week, they may be doing so without estimates of the bill’s budget impacts.
Ways and Means, which has authority over the tax and revenue provisions of the law, is still waiting for scores from the Congressional Budget Office. Members of Energy and Commerce said they’re prepared to vote on a bill without those scores, and some members are reviewing an updated draft March 2 in a secret meeting.
“They have not moved forward on a CBO score,” Ways and Means ranking member Richard Neal (D-Mass.) told Bloomberg BNA March 2. Without one, “How can you do something as substantive as health care?” he said.
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