November 20, 2015

In This Issue
NAHU Testifies on MLR at NAIC Meeting; Commissioners Consider Network Adequacy
Final Market Reform Rule Clarifies Standalone HRA Requirements and Finalizes Other Sub-Regulatory Guidance
An Update on NAHUís Legislative Agenda
Full Speed at Futility
Come for the Bowling, Stay for the Speakers and Lobbying
LIVE FROM NAHU! ACA Employer Reporting Ė Form Completion How-Tos
The ShiftShapers Podcast with David Saltzman
HUPAC Roundup
What Weíre Reading
Tools
E-mail the Editor
Visit the NAHU Website
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An Update on NAHUís Legislative Agenda

As we approach the Thanksgiving holiday, we are also approaching the end of the year and the rapidly closing window for Congress to pass legislation before the end of this session of the 114th Congress. Both the House and Senate are scheduled to adjourn for the year on December 18. The major legislative items that they need to address are: funding bills for the various government agencies (either full appropriations bills or another continuing resolution before December 12); a long-term highway bill by December 4; and a tax extenders bill before the current ones expire on December 31. Looking ahead to 2016 as a presidential election year, in addition to their traditional August recess, both the House and Senate will be taking off the month of October to reserve extra time for campaigning, which will mean fewer days in the chamber for legislative issues. As we look ahead at the remaining legislative days of the year and towards 2016, we are optimistic about the possibilities for many of our legislative objectives.

NAHU’s top policy priority remains removing agent/broker compensation from the Medical Loss Ratio (MLR) Requirement in the individual and small group markets. We have worked with our supporters in both chambers to get legislation re-introduced this year, H.R. 815 by Reps. Billy Long (R-MO) and Kurt Schrader (D-OR) and S. 1661 by Sens. Johnny Isakson (R-GA) and Chris Coons (D-DE). The House bill currently has over 100 co-sponsors, and we are working to add bipartisan co-sponsors to the Senate companion bill. We are in the process of working with leadership and the House Energy and Commerce Committee to get a hearing scheduled, possibly before the end the year. You can help to make your voice heard by telling your member of Congress to support agents and brokers here and telling your senators here.

The next major priority legislative item is legislation to repeal the "Cadillac” excise tax on middle class Americans' health plans. NAHU is a leading advocate, along with our partners in the Alliance to Fight the 40 and the National Coalition on Benefits, of repealing the Cadillac/excise tax, which would impose a 40% excise tax on health plans that exceed certain cost thresholds beginning in 2018. There are two bills in each chamber that would repeal this tax: H.R. 879 by Rep. Frank Guinta (R-NH) and H.R. 2050 by Rep. Joe Courtney (D-CT) in the House, and S. 2045 by Sens. Dean Heller (R-NV) and Martin Heinrich (D-NM) and S. 2075 by Sen. Sherrod Brown (D-OH) in the Senate. The Cadillac tax shows some promise for potentially being repealed before the end of the year as leadership from both parties and both chambers have indicated their support for the legislation, including those who have typically not supported piecemeal repeals or any changes to the ACA, depending on the party.

Even the White House, where President Obama is among the few remaining supporters of the tax, has indicated that they are willing to accept changes so long as they don’t undermine the law overall. The biggest hurdle would be finding a pay-for to offset the $87-91 billion that the tax would generate in its first eight years. NAHU has voiced its skepticism of the score, as most of the revenue that is brought in is not due directly to the tax, but due to employers scaling back health plans and instead grossing up salaries dollar-for-dollar, which would then be taxed. However, there has been nothing to support the claim that employers would replace lose benefits with increased wages. Should the legislation move before the end of the year, the most likely path would be for a repeal to be included in an end-of-the year tax extenders bill in early to mid-December. Tell your representative to repeal the tax here and your senators here.

Another item that we are hoping to move before the end of the year is legislation to address the Medicare open enrollment period (OEP). Before the ACA was signed into law, Medicare enrollees had the benefit of an annual OEP following their annual election period (AEP). This OEP gave seniors enrolled in Medicare Advantage (MA) plans the ability to make a one-time switch to another MA plan or original Medicare if they realized their plan benefits did not meet their needs in their first 90 days of coverage. Unfortunately, the ACA removed the OEP and replaced it with a more limited option to simply switch to original Medicare. NAHU members have been working to restore the OEP since the protection was taken from senior clients, and in June the House Ways and Means Committee passed H.R. 2581, which included language that would have restored the OEP. Unfortunately, due to internal politics within the chamber and unrelated to the OEP issue, that language was stripped from the bill while the rest of the bill was passed. Thankfully, leadership in the House has been willing to reconsider the issue and has indicated their support for bringing it up again and we are working with the new Ways and Means chairman and committee staff to get this passed before the end of the year.

We are also continuing to make our push on a number of employer-related fixes to the ACA. This includes repealing the ACA’s Health Insurance Tax (HIT), which is estimated to cost each family about $5,000 in higher premiums over the next decade. The House bill, H.R. 928, has the support of over half of the chamber—235 bipartisan co-sponsors, but has yet to be taken up by leadership, while the Senate bill, S. 183, has the support of 40 senators. We are working with our partners in the Stop the HIT Coalition with small businesses and other industry and trade groups to repeal the provision. You can help us to encourage other members to join the push by sending an Operation Shout to your representative here and to your senators here.

Finally, we are also working on restoring the traditional 40-hour workweek, which the ACA effectively replaced with a 30-hour workweek with health insurance eligibility for employees under the employer mandate. It reached a major legislative milestone in January when the House of Representatives voted to pass their bill. Unfortunately, despite the strong bipartisan House vote and having support from 42 of the chamber’s 100 senators, the Senate has yet to take up their bill, S. 30. You can tell your senators to take up their bill here. We also are working on legislation to streamline the employer reporting requirements with H.R. 2712 and S. 1996, as well as legislation to expand and modify the small business tax credit (SBTC). While these issues are not as high on the radar for Congress as others, we are continuing to build support for them with our allies in Congress and our coalition partners, and are looking at any potential routes to pass the legislation, including adding the language in relevant legislative packages that are likely to pass.

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