It’s hard to keep up with all the health care legislative news lately. That’s why we’re providing regular summaries of the latest news, reflecting the current state of health care in the United States or how it may be changing in the not-too-distant future. Here’s a recap of some of this week’s stories:
DOL Fiduciary Rule Inches Closer to a Delay
The Department of Labor submitted a proposed rule that would delay the applicability date of the Fiduciary Rule. Although the text of the proposed rule has not been published in the Federal Register, reports say that the DOL rule would delay the applicability date by 180 days.
The Department’s strategy for addressing the controversial regulation may be clarified when Secretary of Labor nominee Andrew Puzder appears before the Senate Committee on Health, Education, Labor and Pensions on Tuesday, February 16th. The hearing should provide an opportunity to learn more about the nominee’s position on the Fiduciary Rule and his plans for the Department.
Last week, President Trump signed a Presidential Memorandum on the DOL Fiduciary Rule instructing the Department of Labor (DOL) to “determine whether the [Fiduciary Duty Rule] may adversely affect the ability of Americans to gain access to retirement information and financial advice.”
The Memorandum specifically instructs the DOL to investigate the potential harmful effect of the Fiduciary Rule on access to retirement products and advice, the potential disruption of the retirement services industry and the negative impact that could have on investors, and the potential for increased expenses that investors would ultimately bear.
As the Administration worked internally to address the rule, Judge Barbara Lynn from the Federal District Court for the Northern District of ruled that the Fiduciary Rule is legal and within the authority granted to the Department of Labor.
This ruling came despite a request by the defendant, the Department of Labor, to delay judgement. While this is considered a win for President Obama’s Department of Labor, it is another potential hurdle in President Trump’s Department of Labor’s effort to delay or repeal the Rule.
CYC Returns to DC, Joins HSA Council on Capitol Hill
CYC joined with other members of the American Bankers Association HSA Council in Washington, DC this week to advocate for the expansion of HSAs. The HSA Council represents approximately 90% of all HSAs in the United States.
The Council met in Washington to speak with House and Senate leaders about HSAs and about legislative changes that should be considered as Congress debates the repeal and replacement of the ACA. Discussions with legislators and staff included conversations about increasing HSA contribution limits and how HSAs can be used to improve the delivery of Medicaid benefits as has been shown in Indiana.
Senate Votes to Confirm Rep. Tom Price as Secretary of Health and Human Services
On Friday, February 10th, the Senate voted 52-47 along party lines to confirm the nomination of Rep. Tom Price (R-GA) to serve as Secretary of Health and Human Services. Secretary Price’s appointment to head HHS is an important step in repealing and replacing the ACA, as the Secretary of HHS can make changes administratively.
Additionally, as mentioned in a previous post, Secretary Price is seen as an important voice in guiding the Administration’s drafting of potential replacement legislation. In the 114th Congress, then-Rep. Price introduced the Empowering Patients First Act which encouraged expansion of HSAs.
Secretary Price reiterated his support for HSAs during his confirmation hearings before the Senate Finance Committee.
Changing Timelines and Rhetoric on ACA Repeal
President Trump said that the repeal and replacement of the ACA may not happen until 2018. Speaker of the House, Rep. Paul Ryan (R-WI), responded by asserting that repeal and replace would happen this 2017, but the rollout may take a few years. Speaker Ryan also said that confirming HHS Secretary Tom Price was an important next step in repealing and replacing the ACA.
While the timeline for ACA reform is shifting, so too is the Republican rhetoric. Instead of using the “repeal and replace” terminology, certain Republicans have begun to say they are “repairing” the ACA, a softening in their rhetoric.
“I think it is more accurate to say repair Obamacare because, for example, in the reconciliation procedure that we have in the Senate, we can’t repeal all of Obamacare,” Sen. Lamar Alexander, the chair of the Senate Health Committee, said last week.
Bills Introduced in Congress to Improve Benefits and Expand Use of HSAs
Members of both the House and Senate have introduced a flurry of bills that would make changes to the existing laws governing HSAs. These bills seek to expand access to HSAs by allowing more individuals to open and contribute to the accounts, improve the ability to save and spend by increasing the contribution limits, and decrease barriers to use by allowing funds to be spent on more health care expenses.
The following is a list of legislation introduced in the House and Senate. Those bills starting with H.R. are from the House, and those starting with S. are from the Senate. Bills that have both H.R. and S. designations have been introduced in both Houses.
- R. 35 would allow the taxpayer additional deductions for contributions to a child’s or grandchild’s HSA and would allow rollovers from an accountholder to his or her parent, child, or grandparent; increase contribution limits to annual out-of-pocket expense limit; and deem all Bronze, Silver and Catastrophic plans as HSA-qualified plans.
- R. 247/S. 28 would increase maximum contribution to $9,000 for individuals and $18,000 for families; permit health insurance premiums and direct primary care expenses as distributions; repeal the prescription requirement for reimbursement of over-the-counter medicines; eliminate the HDHP requirement; and lower excise tax from 20% to 10%.
- R. 277 would increase maximum contribution to annual limit for out-of-pocket expenses; allow establishment of HSA for minor children and up to $3,000 annual tax free contributions; allow annual minimum distribution from retirement account to be contributed to HSA.
- R. 394/S. 85 would repeal prescription requirement for OTC medicine.
- R. 408 would repeal HDHP requirement; eliminate need to pro-rate contributions for partial year eligibility; increase annual limits to $10,000 for an individual and $20,000 for a family; expand access to Medicare beneficiaries; allow health insurance to be paid with HSA dollars; add an inflation adjustment to the catch-up contribution limit; and allow HSA funds to be rolled over to a Medicare Advantage MSA.
- R. 707 would create an HSA option for Medicare beneficiaries.
- 43 would allow Native Americans to be HSA eligible when using Indian Health Service.
- 191 would eliminate HSAs and rename them Roth HSAs. Roth HSAs would be paired with HDHPs, refundable tax credits would automatically be paid into the accounts, and the account could be used to pay for health insurance premiums.
- 222 would authorize a tax credit of up to $5,000 per taxpayer for contributing to an HSA; allow unlimited contributions to the HSA, eliminate HDHP requirement; repeal prescription for OTC medication requirement; allow HSA to pay for health insurance premiums; allow eligible expenses to be paid as long as account is opened within tax year they were incurred; allow rollover to child, grandparent, or parent; provide bankruptcy protection; allow use for wellness programs.
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