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On the Hill: Democrats Respond to ACA Ruling

Congressional Democrats pledged to respond to a court ruling issued late last week that found the Affordable Care Act (ACA) unconstitutional.

On Dec. 14, Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas ruled that Congress’ taxing authority no longer can be the basis of the ACA’s constitutionality after the repeal of the tax penalty for not holding coverage, and that the law cannot stand without the individual mandate. The ruling comes in a lawsuit brought by a group of Republican governors and attorneys general in 20 states. The decision likely will be appealed to the Fifth Circuit Court of Appeals and ultimately could end up at the U.S. Supreme Court.

Rep. Nancy Pelosi (D-CA), House speaker nominee for the 116th session of Congress, and Senate Minority Leader Charles Schumer (D-NY) vowed to pursue legislation to intervene in the lawsuit.

The Trump administration applauded the judge’s decision, but noted that the law remains in place and there will be no immediate impact on health plans or other provisions of the ACA.

America’s Essential Hospitals released a statement expressing concerns that overturning the ACA would leave millions of Americans — including many with pre-existing conditions — little hope for affordable health care coverage and financial stability.

House Clears Bipartisan Medicaid Package

Last week, the House passed H.R. 7217, the Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act, known as the IMPROVE Act. The package includes several Medicaid-related provisions that would:

  • give states the option to establish Medicaid health homes for children with complex medical conditions (based on the Advancing Care for Exceptional [ACE] Kids Act);
  • authorize $112 million for fiscal year 2019 to extend projects funded under the Money Follows the Person Rebalancing Demonstration Grant, which assists Medicaid beneficiaries with chronic conditions and disabilities when transitioning from institutionalized to home- and community-based settings; and
  • impose civil monetary penalties on drug manufacturers that intentionally misclassify outpatient drugs covered by Medicaid.

The bill now heads to the Senate for consideration before the end of the year.

Government Funding

Congress and the administration continue to negotiate a final spending package to fund portions of the federal government before current funding expires on Dec. 21.

Without an agreement, one-quarter of government operations could shut down, impacting the departments of Agriculture, Commerce, Homeland Security, Housing and Urban Development, Interior, Justice, State, and Treasury, as well as smaller agencies such as the Environmental Protection Agency and Food and Drug Administration.

Hospital Preparedness Funding

The Senate also has yet to pass the Pandemic and All-Hazards Preparedness and Advancing Innovations Act (PAHPA). PAHPA must be approved by the end of the year to provide new funding for the Hospital Preparedness Program and other public health–related preparedness and response programs. After the Senate passes the bill, it will go to the president.

Congress Moves Maternal Health Legislation

Last week, both chambers of Congress sent H.R. 1318, the Preventing Maternal Deaths Act of 2017, to the president’s desk. The legislation would require states to establish Maternal Mortality Review Committees to asses pregnancy-related and -associated deaths and develop recommendations to implement prevention plans.

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About the Author

Erin Delaney is the legislative affairs associate at America's Essential Hospitals.