AFFORDABLE CARE ACT & EMPLOYER-BASED COVERAGE
Voting 220 for and 209 against, the House on June 21, 2023, passed a bill (HR 3799) that would write into law a Trump administration rule making it easier for companies to use voucher-style plans to deliver medical insurance to workers. Known as Individual Coverage Health Reimbursement Arrangements, these entities enable companies to replace group health insurance with employer-funded accounts that workers use to purchase individual policies in Affordable Care Act (ACA) marketplaces. They reduce employers’ medical costs and administrative burdens while shifting to workers the task of navigating the federal health law.
The bill also would expand the availability of “association health plans,” which allow trade associations and professional groups to band together to offer medical insurance as though they were large employers, reducing costs as they scale up coverage. Such plans are exempt from compliance with many of the ACA’s essential health benefits, which apply primarily to the individual and small-group markets.
Backers said the expansion would give small firms relief from the rigidity of the federal health law, while critics said it would siphon younger and healthier workers from ACA marketplaces that depend on broadly representative enrollee pools to control premium costs.
Floor Debate, Pro & Con:
Supporter Jason Smith, R-Mo., said: “Today, we are taking another step forward to cut the bureaucratic red tape holding back small businesses. We should make it easier, not harder, to give America’s workers, families, farmers, and small businesses access to flexible healthcare options.
Opponent Robert Scott, D-Va., called the bill “yet another recycled, futile attempt to sabotage the Affordable Care Act and actually make it harder for workers and families to find affordable, high-quality health insurance.”
A yes vote was to send the bill to the Senate, where it was likely to fail.
ENDING VACCINE MANDATE FOR FOREIGN TRAVELERS
Voting 227 for and 201 against, the House on Feb. 8, 2023, passed a bill (HR 185) that would immediately terminate a Centers for Disease Prevention and Control requirement that airline travelers from abroad show proof of vaccination against COVID-19 to enter the United States. The bill would prevent any similar mandates in the future. The Biden administration plans to lift national COVID emergency declarations on May 11 while retaining the foreign travelers’ vaccine requirement.
Floor Debate, Pro & Con:
Supporter Nicholas Langworthy, R-N.Y., said: ’’Life has returned to normal across the country. Yet despite the world moving on from the pandemic, this administration persists in retaining an unnecessary vaccination requirement for those visiting the United States….It is time that we acknowledge that these vaccine mandates do not definitively stop the spread of COVID. It is time for Congress to act where this administration refuses and finally end this mandate.”
Opponent Mary Gay Scanlon, D-Pa., said: “This is just the latest bill inspired by anti-vax conspiracy theories that has been rushed to the floor….It is dangerous to repeatedly mislead the public about the efficacy of these vaccines that are proven to save lives. This bill increases the risk of spreading new variants, just as hospitals and public health infrastructure are trying to rebuild. Once again, an extremist fringe is putting politics over science and undermining public health experts….”
A yes vote was to send the bill to the Democratic-led Senate, where it was likely to fail.
ENDING VACCINE MANDATE FOR HEALTHCARE WORKERS
Voting 227 for and 203 against, the House on Jan. 31 passed a bill (HR 497) that would immediately terminate a federal mandate that healthcare workers at Medicare- and Medicaid-funded hospitals, nursing homes, clinics, surgery centers and other treatment facilities be vaccinated against COVID -19. The directive by the Centers for Medicare & Medicaid was put into effect in September 2021 and upheld by the Supreme Court in January 2022.
Floor Debate, Pro & Con:
Kat Cammack, R-Fla., said: “The Biden administration’s authoritarian COVID-19 vaccine mandate on our dedicated medical professionals is an absolute abuse of power. It is an attack on the personal freedoms of our frontline workers and it has certainly unnecessarily exacerbated the healthcare workforce shortage. This bears repeating: We are not anti-vaccine. We are anti-mandate.”
Opponent Frank Pallone, D-N.J., said: “COVID-19 vaccines are safe and effective, and they have been essential to saving lives, rebuilding our economy, and protecting the health of our communities. More than 668 million COVID-19 vaccine doses have been administered here in the United States, which has resulted in 120 million fewer COVID–19 infections, 18.5 million fewer hospitalizations, and 3.2 million lives saved.”
A yes vote was to send the bill to the Democratic-led Senate, where it was likely to fail.
REVOKING COVID EMERGENCY DECLARATIONS
Voting 220 for and 210 against, the House on Jan. 31 passed a bill (HR 382) that would immediately revoke two COVID-19 emergency declarations that were put into effect by the Trump administration in 2020 and renewed 12 times by the Biden administration. The day before this vote, President Biden announced he would revoke the declarations on May 11, 2023. They have expanded social programs including food stamps; required Medicare Advantage to reimburse COVID patients for out-of-network treatments; raised Medicare reimbursements to hospitals; expanded telemedicine; and required Medicare, Medicaid and most private plans to provide free or low-cost COVID vaccinations, testing and therapeutic care to millions of Americans. In addition, ending the emergencies would remove up to 15 million individuals from Medicaid in certain states that have agreed to boost Medicaid enrollment in exchange for increased federal matching funds.
Floor Debate, Pro & Con:
Sponsor Brett Guthrie, R-Ky., said his bill “sends a loud and clear message to President Biden: The American people are tired of living in a perpetual state of emergency, and it is long overdue for Congress to take back the authorities granted under Article I of the Constitution.”
Opponent Earl Blumenauer, D-Ore., asked: “Why are we spending time abruptly ending this declaration, which is going to end in three months anyway, when we could have instead had a serious conversation about making this as smooth a transition as possible?”
A yes vote was to send the bill to the Democratic-led Senate, where it was likely to fail.
PROTECTING MEDICARE BENEFITS
Voting 210 for and 220 against, the House on Jan. 31 defeated a Democratic motion that sought to ensure there would be no immediate cuts in Medicare payments to hospitals or reductions in Medicare coverage for seniors if HR 382 (above) became law.
Floor Debate, Pro & Con:
Sponsor Jared Moskowitz, D-Fla., asked: “What would an instant cut to the social safety-net mean for Medicare beneficiaries and their families? The American family could face an abrupt increase in costs and decrease in care. What would this mean for your local hospital back home? Hospitals could see a cut of 20 percent for care of COVID patients.”
No member spoke against the motion.
A yes vote was to adopt the Democratic motion.