The U.S. House posted a $1.1 trillion, 2,009-page omnibus spending bill early Wednesday morning with many implications in healthcare, including many provisions that would significantly change parts of the Affordable Care Act.
Here are nine things to know about the deal and how it could impact healthcare.
1. The House has yet to vote on the measure and will likely make a decision Friday, according to The New York Times.
2. The package would prevent the federal government from shifting funds to the risk corridor program, part of the ACA that aims to level the playing field for payers taking on newly insured, costlier patients. The risk corridor program, which is meant to be self-sustainable, has fallen short by more than $2.5 billion in 2014, its first year. According to The Hill, this provision was included last year and was expected again this year, despite efforts from some Democrats to include a new tax credit for insurers.
3. Along with two other taxes, the Health Insurance Tax would be frozen for a year. This tax would have brought in about $13 billion in 2018, but opponents say the cost of the tax is passed on to consumers through premium increases, according to The Hill.
4. The "Cadillac tax" will be frozen for two years. This was a priority for House Democrats, according to other coverage in The Hill. The Cadillac tax is the first-ever cap on open-ended tax breaks for employee health benefits. It comes in the form of a 40 percent excise tax on high-cost employer-based health plans and was previously scheduled to go into effect in 2018.
5. The medical device tax will also be put on hold for two years. According to The Hill, this had large support from Republicans. None of the taxes will be fully repealed.
6. The National Institutes for Health received a $2 billion budget boost. This is the biggest boost the medical research center has received in 12 years, putting its total budget at $32 billion. According to Politico, the Food and Drug Administration will receive $2.7 billion, including funds for its Precision Medicine Initiative and drug safety, but blocking gene editing and human embryo creation or modification.
7. The provision permanently extends the Zadroga Act. This act — named for New York City Police officer James Zadroga, who died from a respiratory disease stemming from his work assisting on the Sept. 11 attacks — makes sure 9/11 responders get healthcare for health issues stemming from their work on the day of the terrorist attacks. According to The New York Times, New York lawmakers and Jon Stewart, former host of "The Daily Show," strongly back the measure.
8. Planned Parenthood was not defunded. However, according to The Hill, the United Nations Population Fund was hit with a 7 percent cut in funding. Republicans say this entity supports a "coercive birth limitation policy" in China, according to the report.
9. The Independent Payment Advisory Board took a $15 million cut. The IPAB is a board created under the ACA which is tasked to find ways to cut Medicare spending if it gets too high.
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