Week Ending August 4, 2017
President Trump is Sabotaging the Affordable Care Act
Following the collapse of legislation in the Senate to repeal the Affordable Care Act (ACA) and gut Medicaid, President Trump and other administration officials urged Senate leaders to continue to work on the health care overhaul. However, it appears that Senate Republican leaders believe that they are too divided to move forward on a comprehensive bill. While the immediate push to repeal the ACA and cap Medicaid is over, it is likely that GOP leaders will look for opportunities to pursue changes to these programs in a more piecemeal fashion. Those threats could emerge during debate over the renewal of the Children’s Health Insurance Program (CHIP), spending bills, legislation to raise the debt ceiling and in tax cut legislation.
For now, bipartisan discussions are taking place in the House and Senate over ways to stabilize the individual insurance market through which many obtain coverage when it is not available through an employer. A bipartisan House group issued proposals following the defeat of the Senate bill and Sen. Lamar Alexander (R-TN), Chair of the Health, Education, Labor and Pensions (HELP) Committee, announced that he and the Ranking Democrat, Sen. Patty Murray (WA), would hold hearings in early September to start work on a proposal to stabilize and strengthen the market.
The effort to shore up the individual market has become urgent as a result of efforts by the Trump administration to sabotage the ACA. For example, President Trump has repeatedly threatened to end cost sharing reduction payments to insurance companies that provide ACA coverage. Under the ACA, insurance plans are required to reduce deductibles and copays for those with incomes below 250% of poverty. Insurance companies are reimbursed by the federal government for these cost sharing reductions. Uncertainty over whether the administration will continue to make these payments has led some insurance companies to decide not to offer coverage in a few markets next year and to propose dramatic increases in premiums for 2018. Uncertainty has also been created over whether the administration would enforce the ACA requirement that most people obtain health coverage.
While it is necessary to ensure that cost sharing reduction payments are made and to take other steps to eliminate uncertainty and stabilize insurance markets, it is likely that Republican leaders will push for other changes to weaken the ACA. For example, the House bipartisan group included proposals to severely weaken requirements that employers provide health coverage for their workers. It’s likely that the Senate will move legislation in September. AFSCME will be working to keep harmful provisions out of the bill, such as the employer mandate proposals by House members.
NLRB Inches Toward Anti-Labor Majority
Despite a lack of experience and a hostility towards the mission of the National Labor Relations Board (NLRB), former Republican congressional staffer Marvin Kaplan was confirmed by the Senate to serve on the Board. The vote was 50 to 48, along party lines. William Emanuel, an employer-side attorney nominated by President Trump, is waiting for approval by the Senate. Emanuel’s confirmation would give the board a 3-2 anti-worker majority.
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