House Committees Approve “America’s Affordable Health Choices Act” Bill with Some Revisions

The three committees in the House with jurisdiction on health care reform released a revised version of the House Democrats’ bill.  These committees are Education and Labor, Energy and Commerce, and Ways and Means, and are using this revised bill as the foundation for the discussions and negotiations in the overall House.  A great deal of the language in the revised bill is similar to what we shared last week, but there are some notable changes including:

• New language regarding health plans to meet a medical loss ratio test in 2013 based on federal definitions and calculations
• Requirement that prohibits states from reducing Medicaid eligibility levels
• Termination of the CHIP program in 2013
• Removal of most people eligible for Medicaid from the Exchange
• New language on the individual market restricting certain underwriting and administrative practices

The Congressional Budget Office (CBO) current estimate of the cost on this version is $1.04 trillion.  The CBO also estimates that this version would still result in 17 million uninsured Americans in 2019. 

To pay for the $1.04 trillion cost, the bill proposes to raise money mostly with about half coming from a surtax on higher income taxpayers (those making $350,000 or more) and about half through several changes to Medicare including:

• Reduce spending in Medicare by changing provider payments in fee-for-service Medicare
• Reduce payments for Medicare Advantage
• Changing the pharmacy rebate program under Medicare Part D for beneficiaries eligible for Medicare and Medicaid

As of today, the Education and Labor Committee has passed the revised bill 13-10 on a straight party vote and the Ways and Means Committee has passed the revised bill 23-18 with all republicans and three democrats voting against the bill.  The bill has not yet been voted on in the Energy and Commerce Committee.  The expectation is that when all three committees have passed the revised bill they will be consolidated and brought to the House Floor for discussion and negotiation in an attempt at passage.