Health Care Issues Remain Entangled in Congressional Wrangling

(from the December 15, 2017 ACP Advocate)

Though Congress is expected to make decisions before year's end on an array of financial issues, it's still far from clear just how things will turn out. With that as the backdrop, the American College of Physicians is continuing to urge the nation's leadership to protect and support the health care system.

“It remains to be seen what the immediate impact will be from the election of a Democratic senator in Alabama,” said Bob Doherty, ACP's senior vice president for governmental affairs and public policy. “However, one fact remains the same: This is a crucial time for the ACP to raise its voice and be heard as members of Congress make choices that will directly affect both physicians and patients.”

Congress has three major issues on its plate: GOP-led tax reform, the fate of the Children's Health Insurance Program (CHIP) and the possibility of a federal government shutdown.

Tax Reform

The House and Senate both passed extensive tax-reform legislation, and they're now working to reconcile those bills. If they reach agreement, an approved bill would go to the president for a near-guaranteed signature.

There have been disagreements, however, some of which directly affect health care.

“We're not experts on tax policy,” Doherty said, “so the ACP is focusing on matters where the reform efforts endanger patients and affect medicine in other ways.”

On that front, the most significant provision is the Senate bill's elimination of the Affordable Care Act mandate that nearly all people have health insurance.

That provision would likely make premiums skyrocket on the individual market and lead insurers to bolt, Doherty said. As ACP has repeatedly warned, eliminating the individual mandate would allow people to wait to get coverage until they became sick, creating too much risk for insurance companies to bear.

ACP also is concerned about the possible elimination of the deductible for high health care costs, as called for in the House bill. The Senate bill, however, actually lowers the threshold for a deduction to 7.5 percent of income from 10 percent.

In addition, ACP has warned Congress against a provision in the House bill that would make medical tuition waivers and student loan interest payments taxable.

Read the full article in ACP Advocate.

The ACP Advocate is a bi-weekly e-newsletter that provides ACP members with news about public policy issues affecting internal medicine and patient care.

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