Delivering for Best-in-Class Wholesaler-Distributors
March 28, 2018

Following an unrelenting seven-year battle waged by Congressional Republicans to repeal/de-fund/delay/alter former President Obama’s signature domestic policy and legislative achievement and the sweeping Republican victory in the 2016 elections, the GOP effort to repeal and replace the Affordable Care Act (“ACA” or “Obamacare”) fell dramatically short during the 115th Congress’ first session (although subsequent enactment of the Tax Cuts and Jobs Act includes repeal of the ACA’s individual mandate penalties).

In the aftermath of an initial false start, the House of Representatives in May 2017 passed the American Health Care Act (“AHCA”) by a vote of 219 to 213 (with 20 Republicans joining all 193 Democrats in opposition).

Senate Republicans were not able to produce a bill capable of garnering the 51 votes needed for passage, and the legislative process aimed at repealing and replacing Obamacare came to a grinding halt prior to Congress’ annual August/Labor Day/ District work period.

Nonetheless, progress was made on building support for several issues long on the NAW agenda in this space. For example, the House-passed AHCA included:

  • Elimination of the employer mandate penalties applicable to employers with 50 or more full-time employees.
  • Extension of the delay in implementation of the 40% excise tax on high-cost employer-sponsored health plans (the “Cadillac Tax”).
  • Full repeal of the annual fee on health insurance providers (the “health insurance tax” or “HIT”).
  • Expanded use of health savings accounts (“HSA”) and flexible spending accounts (“FSA”).

Of crucial importance was the absence of any limitation on the exclusion from income of the value of employer-sponsored health benefits.

Two additional NAW-supported health bills passed the House in the spring: the Small Business Health Fairness Act authorizes the formation and multi-state operation of both self-funded and fully-insured association health plans (“AHP”); and the Self-Insurance Protection Act (“SIPA”) shielding stop-loss insurance from being regulated as health insurance.  SIPA’s enactment would reaffirm long-standing policies to ensure employers can continue to offer workers flexible, more affordable health care plans through self-insurance.  The FY ’18 Continuing Resolution enacted on January 22nd included two items of particular concern to NAW members:  a hiatus in application of the Health Insurance Tax (HIT) for 2019, and an extension to 2022 in the delay of implementation of the Cadillac Tax.

The focus of more recent activity in the Obamacare space has surrounded a desire to stabilize the ACA exchanges. The effort to include a stabilization package in the FY ’18 Omnibus Appropriations Bill enacted on March 23rd came up short. NAW’s focus is fixed on securing an additional pause in the HIT by bringing it forward to 2018 and extending it to 2020.