HOLD STILL This Won't Hurt a Bit! 116th Congress Tries Healthcare Cures as Rhetorical Fever Soars.

Author:Singleton, Marilyn M.

The 116th Congress has rolled out new health care legislation. The Republicans squandered their chance to repeal the ACA or otherwise bring medical care back into the hands of patients and physicians.

One could look at the push for Medicare for All as an acknowledgement that the ACA was not a success. The House Medicare for All caucus is in the process of revising the prior Medicare for All bill that had been floating around since 2003. Apparently, the new bill will track Bernie Sanders' Senate bill, S. 1804 (https://www.congress.gov/bill/115th-congress/senate-bill/1804) which is more fleshed out. Sanders plans to finance his bill with the following:

* 7.5 percent income-based premium paid by employers; 4 percent income-based premium paid by households;

* make the personal income tax more progressive;

* taxing capital gains and dividends the same as income from work;

* limit tax deductions for the wealthy;

* make the estate tax more progressive;

* establish a wealth tax on the top 0.1 percent;

* close the Gingrich-Edwards Loophole and create parity for wealthy business owners. Corporations would be made to pay their "fair share" by imposing a one-time tax on currently held offshore profits; imposing a Fee on Large Financial Institutions; ("This option closes the Gingrich-Edwards loophole which allows individuals who own and run an S-Corporation to game the system and avoid paying payroll taxes by claiming some income as business profits.");

* repealing corporate accounting gimmicks. ("This option would eliminate the "last-in, first-out" (LIFO) accounting method that allows corporations to manipulate their inventory and make it appear like they have lower profits.") (Sanders' white paper, "Options to Finance Medicare for All" can be downloaded here: https://www.sanders.senate.gov/download/options-to-finance-medicare-for-all?inline=file)

Out-of-Network Medical Billing

As the AAPS lawsuit against California's AB 72 works its way through the courts, the federal government is addressing the issue. Sen. Bill Cassidy, MD (R-LA) along with Sens. Tom Carper (D-Del.), Todd Young (R-Ind.), Michael Bennet (D-Colo.) and Chuck Grassley (R-Iowa) have produced a draft bill, the Protecting Patients from Surprise Medical Bills Act, that would prevent an out-of-network health care provider from charging additional costs for emergency services to patients beyond the amount usually allowed under their insurance plan. The proposal would have the insurer pay any additional charges--which would be limited by law. The bill would also require health care providers to give written notification to patients who receive emergency care at an out-of-network facility before they receive any follow-up nonemergency care. That move is intended to warn patients before they are subject to additional costs at an out-of-network hospital. Patients also could not be charged more for care from out-of-network doctors at an in-network hospital.

(Full text: https://www.cassidy.senate.gov/imo/media/doc/Discussion%20Draft-%20Protecting%20Patients%20from%20Surprise%20Medical%20Bills%20Act.pdf)

On January 30, 2019, H.R. 861, a bill to amend title XVIII the Social Security Act to prevent surprise billing practices was introduced by Rep. Lloyd Doggett (D-TX) and referred to the House Energy and Commerce and Ways and Means Committees.

The text is not available and this title on the surface applies only to Medicare.

The ACA Lives On

On January 3, 2019, H.R. 83, Responsible Path to Full Obamacare Repeal Act was introduced by Rep. Andy Biggs (R-AZ) and referred to the House Appropriations Committee, the Education and the Workforce, and six other committees. This bill would repeal the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, effective at the beginning of FY2020. Provisions of law amended by those Acts would be restored.

(Full text: https://www.govtrack. us/congress/bills/116/hr83/text)

On January 3, 2019, H.R. 185, the ObamaCare Repeal Act, was introduced by Rep. Steve King (R-IA) and referred to the House Committee on...

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