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Stephanie Pellitt

Policy and Advocacy Associate

What to Watch for in Health Care in 2018

January 4, 2018 | ACA | Federal Budget | Medicaid | Medicare | Comments
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Members of Congress returned to Capitol Hill this week following a holiday break. Neither chamber starts the new year with a clean slate, however, as Congress faces deadlines on government funding and a host of individual programs after voting to delay those decisions at the end of last month. Congress has less than three weeks to avert another government shutdown as well as sort through several competing health care priorities. Here is a preview of what to watch for in early 2018.

FY 2018 Budget: Bipartisan negotiations between Congressional leaders and White House officials to create a budget deal for Fiscal Year 2018 resumed this week. In these discussions, Democrats hope to use their leverage in preventing a government shutdown to achieve some of their priorities such as raising the domestic spending caps, passing an immigration bill, and finding consensus on a long-term reauthorization of the Children’s Health Insurance Plan (CHIP). With Congress facing a January 19th deadline to avoid a government shutdown, momentum appears to be heading towards another short-term continuing resolution to buy more time for budget negotiations to continue.

ACA Marketplace Stabilization: Washington insiders report that bipartisan efforts to shore up the Affordable Care Act (ACA) health insurance exchanges are losing steam. These bills, known as the Alexander-Murray and Collins-Nelson bills, have faced skepticism from Republicans, and Democrats now want the measures to be revised to address the impact of the individual mandate repeal passed in the tax law last month.

ACA Repeal and Entitlement Reform: House Speaker Paul Ryan (R-WI) has announced that further repeal of the ACA and reform to entitlement programs, like Medicaid and others, would be top priorities for 2018. Despite the House’s eagerness to take on the ACA and Medicaid, Senate Majority Leader Mitch McConnell (R-KY) has warned that the shrinking Republican majority in the upper chamber will make the passage of partisan priorities a challenge as broad changes to entitlement programs would require 60 votes to pass the Senate. Democrats are unlikely to support cuts to Medicaid.

House and Senate Republicans did succeed in passing a repeal of the ACA’s individual mandate in their tax bill just before the holidays. While the repeal of the mandate will not go into effect until 2019, industry experts will be watching how its repeal impacts consumer behavior and health care costs. The Congressional Budget Office estimated that the repeal will result in 13 million fewer people being insured over ten years.

Medicare Extenders: The most recent stopgap spending package did not address any Medicare extenders, which are provisions of Medicare that have to be renewed by Congress regularly. Among these provisions is the popular measure to lift the caps on physical, occupational, and speech therapy for Medicare enrollees. Unlike CHIP and Community Health Center funding, none of the Medicare extenders were given short-term relief in the last continuing resolution, which puts pressure on Congress to address them as soon as possible in the new year.