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house Bill H.R. 4695

Bipartisan Healthcare Stabilization: Funding Subsidies, Improving State Waivers & Revising the Employer Mandate

Argument in favor

This bipartisan bill represents a good faith compromise that will stabilize the individual health insurance market while also easing regulations to reduce healthcare costs, thus helping Americans.

Craig's Opinion
···
01/13/2018
The logical solution is single payer healthcare. But as long as politicians remain puppets of health care companies and special interest groups, that will never happen. At the very least we need to rescue the current system before Trump, Ryan and Mc Connell completely destroy it
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01/13/2018
Just to clarify for all of the naysayers Obamacare and the Affordable Care Act are the same thing. It has always been the Affordable Care Act. It was negative marketing by Republicans that named it Obamacare to try to develop a negative attitude in the public who did not like Obama Obamacare is the Affordable Care Act they are the same exact thing. Republicans educate yourselves. Calling an apple and an orange doesn't make it an orange.
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Evan's Opinion
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01/13/2018
Please vote yes on this measure to stabilize insurance markets and help American families get healthcare. As a pediatrician, I recognize it is not a full solution, but even while we complain that this is a “band-aid”, it’s a band-aid many families need to get affordable insurance. I am personally for single payer healthcare to genuinely reduce costs, but in the meantime this bill will tangibly help families.
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Argument opposed

This bill keeps too much of Obamacare in place by continuing to provide subsidies to health insurance companies, while also undercutting the ACA by repealing the medical device tax.

Moises 's Opinion
···
01/13/2018
I’m a physician. This bill aims to be a band-aid. We need a cure. Single payer system. Everyone to be covered
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John's Opinion
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01/13/2018
Universal single payer healthcare! Cradle to grave!
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IllWill's Opinion
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01/13/2018
Congress needs to stop putting a thousand band-aids over a broken healthcare system. The only serious solution is a single payer healthcare system. The fact that we have to keep messing with this private insurance system just shows that it doesn’t work!
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bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
  • The house has not voted
      house Committees
      Committee on Energy and Commerce
      Health
      Committee on Ways and Means
      Health
    IntroducedDecember 20th, 2017

What is House Bill H.R. 4695?

This bill — known as the Bipartisan Market Stabilization and Innovation Act of 2017 — to stabilize the individual health insurance marketplace and enact reforms aimed at bringing down healthcare costs. It would fund Cost Sharing Reduction (CSR) payments which help low- and middle-income families afford healthcare expenses, create a $115 billion fund for states to stabilize the health insurance marketplace, streamline state innovation waivers, repeal the medical device tax, and modify the employer mandate so it impacts fewer small businesses.

Congress would be given clear authority to appropriate funds for CSR payments, and the Dept. of Health and Human Services (HHS) would be required to report to Congress on:

  • How much is being paid each year;

  • The effects of such payments on the costs of health insurance in the individual market;

  • Projected costs of health insurance in the individual market over the subsequent year.

A Patient and State Stability Fund would provide $115 billion over 10 years beginning in 2019 ($11.5 billion annually) to backstop high-cost health claims for patients. States could use the funds to help patients enroll in coverage, reduce the cost of premiums, reduce out-of-pocket costs, and promote enrollment in the individual and small group markets. States would be required to submit applications detailing their plans to receive funds. If a state doesn’t submit an application, or an application isn’t approved the program will default to a federal backstop, working in conjunction with the state, which will reimburse insurers for patients with especially high medical claims.

Section 1332 State Innovation Waivers would be made more efficient by:

  • Allowing states to access the full amount of federal savings that would be realized via an approved waiver. (States currently only get the savings from reduced spending on premium tax credits and CSRs.)

  • Shortening the approval window for a 1332 waiver from 180 days to 90 days for standard applications.

  • Setting a 45-day time limit for 1332 waiver applications filed in response to an urgent situation in areas at risk of excessive premium hikes or having no insurance plans offered, or requests that are materially identical to an already approved waiver.

The employer mandate imposed by the Affordable Care Act (aka Obamacare), which requires businesses with more than 50 employees to offer their full-time workers health insurance or pay a penalty, would be revised so that it’d only apply to businesses with more than 500 full-time employees. Full-time employees would be defined as working at least 40 hours per week, rather than 30 hours per week as under current law.

Other provisions of this bill would:

  • Repeal the 2.3 percent medical device imposed by Obamacare effective January 1, 2018.

  • Require HHS to issue regulations within one year to allow Section 1333 Health Choice Compacts between states. (This was required by Obamacare, but HHS never issued the regulations.)

  • Express that Congress should offset any projected increases to the deficit caused by this bill with policies to negate the projected increase.

Impact

People buying health insurance on individual market or would be hit by the medical device; employees who work less than 40 but more than 30 hours per week; employers with between 50 and 500 employees; insurers; states; and HHS.

Cost of House Bill H.R. 4695

A CBO cost estimate is unavailable.

More Information

In-Depth: Sponsoring Rep. Kurt Schrader (D-OR) introduced this bill with the bipartisan Problem Solvers Caucus to stabilize the individual health insurance marketplace and bring down healthcare costs:

“Families have been rocked by uncertainty when it comes to health care all year long. At the surface, it can seem as though this year was full of political and partisan nonsense. But I’m proud to be part of a group of individuals from across the political spectrum who have been working together to tackle this extraordinarily vital issue. Legislating on health care — an area that’s incredibly personal and complex — takes time and effort. As with any major piece of legislation, everyone agrees that there are needed fixes to the ACA. At this point, it’s clear that partisan politicking doesn’t lead to solutions for anyone. I’ve been working all year with my colleagues across the aisle, hearing from health care providers, insurers, patients and professionals to develop this bill. The compromise we brokered will bring down costs and provide much needed stability. Now we must work to enact it as soon as possible.”

Original cosponsor Rep. Tom Reed (R-NY) added:

“It is a great day when a bipartisan group of lawmakers can come together on an issue as important as health care. I am proud to stand with my Republican and Democrat colleagues to help improve health care coverage for my constituents in New York and for Americans across the country. These legislative fixes will provide immediate relief and help stabilize the individual market and prove that bipartisan problem solving is the best way to move this country forward in 2018.”

This legislation has the support of 25 bipartisan cosponsors in the House, including 15 Democrats and 10 Republicans.


Of Note: Provisions of this legislation have been introduced as standalone, bipartisan bills to repeal the medical device tax and define “full-time employee” as working 40 hours per week during this session of Congress.


Media:

Summary by Eric Revell

(Photo Credit: ipopba / iStock)

AKA

Bipartisan Market Stabilization and Innovation Act of 2017

Official Title

To amend the Patient Protection and Affordable Care Act to provide for stabilization in the individual health insurance market, and for other purposes.

    The logical solution is single payer healthcare. But as long as politicians remain puppets of health care companies and special interest groups, that will never happen. At the very least we need to rescue the current system before Trump, Ryan and Mc Connell completely destroy it
    Like (189)
    Follow
    Share
    I’m a physician. This bill aims to be a band-aid. We need a cure. Single payer system. Everyone to be covered
    Like (229)
    Follow
    Share
    Universal single payer healthcare! Cradle to grave!
    Like (113)
    Follow
    Share
    Congress needs to stop putting a thousand band-aids over a broken healthcare system. The only serious solution is a single payer healthcare system. The fact that we have to keep messing with this private insurance system just shows that it doesn’t work!
    Like (80)
    Follow
    Share
    Just to clarify for all of the naysayers Obamacare and the Affordable Care Act are the same thing. It has always been the Affordable Care Act. It was negative marketing by Republicans that named it Obamacare to try to develop a negative attitude in the public who did not like Obama Obamacare is the Affordable Care Act they are the same exact thing. Republicans educate yourselves. Calling an apple and an orange doesn't make it an orange.
    Like (66)
    Follow
    Share
    Please vote yes on this measure to stabilize insurance markets and help American families get healthcare. As a pediatrician, I recognize it is not a full solution, but even while we complain that this is a “band-aid”, it’s a band-aid many families need to get affordable insurance. I am personally for single payer healthcare to genuinely reduce costs, but in the meantime this bill will tangibly help families.
    Like (59)
    Follow
    Share
    Get government out of healthcare altogether. Don't you get it? YOU HAVE BEEN THE PROBLEM THE WHOLE TIME. From the first day you gave tax advantage to health insurance through employers you've started us down a road to this wacky insurance-based model we have today that makes everything so expensive. Just EXIT. You've done enough damage. These "reforms" will just cause further damage and drive further "reforms" down the road. Don't you get tired of having to reform your own mistakes?
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    All this bill does is help disassembled the ACA. We are going back to a period prior to the ACA when millions of people had no healthcare and received no medical treatment when sick. So much for vaulted American compassion and our desire to reduce child deaths. Something or someone has to be sacrificed to provide the wealthy and corporations with tax cuts.
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    As an Emergency Resident physician I see many patients without insurance putting off medical visits until it is too late because that cannot afford insurance despite working full time. I have seen patients refuse ambulance rides when they are having serious medical conditions such as heart attacks or strokes because they fear they will die and they will burden their family with massive debt. This is frankly unacceptable in the wealthiest nation on the planet. As billionaires and the very wealthy get trillion dollar tax cuts, the average working American finds him or herself struggling to make ends meet despite working full time. When did this become our value system? At what point did socialism for the very wealthy at the expense of the American tax payer become morally just? The United States of America became the most wealthy and powerful nation in the history of the world on the backs of a strong middle class and a strong public education system. No citizen should have to choose between life and the cost of an ambulance ride because they cannot afford insurance. If we can pay for a massive tax break for the wealthy then given the correct moral priorities we can afford to make sure that every American has adequate access to healthcare. The Donald Trumps of this country do not need bailouts and tax breaks, there can be no more socialism for the wealthy. In the United States of America we are only as strong as our weakest link, it’s time we provided universal health coverage to our people not tax cuts to Donald and friends.
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    Health insurance is immoral. Every company collecting money to “insure” health should be shut down and it’s board members imprisoned. We deserve single payer healthcare. Anything less hurts Americans.
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    Don’t allow this to pass, Obamacare must die and be replaced with something better like health savings accounts and not forcing the American people to purchase if they don’t want it or need it.
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    No thank you. Single payer please. Anything less is just a bandaid.
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    Universal health care. Period.
    Like (17)
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    We need single payer healthcare! Nothing else will do! Now is the time!
    Like (16)
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    Learn from Canada where they do healthcare right
    Like (16)
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    Single payer. It's time. We don't need to keep the ACA on life support.
    Like (15)
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    Please listen to the overwhelming majority of Americans. We have been waiting and waiting to join the rest of the developed world by moving closer to health care for all.
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    Universal healthcare. Get on that.
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    Government cannot fix this, nor has power todo so. The reason healthcare is so out of whack, unaffordable, and being abused is because of government since WWII. England denied 50,000 surgeries this month due to government healthcare. That’s a cost of “cheap” healthcare, those are children, wives, daughters, people “helped” by social insurance. Population-wise that’s over 7 million American surgeries. That’s a state, a major city. Don’t you get it? Government cannot do this, though congress will to gain votes, the costs in money and lives will be after they out of office! Stop the party, care about your children and grandchildren who will be those 7,000,000! READ, WEEP, PRINT AND KEEP! This should be on the front page of every newspaper. Charley Reese's Final column! A very interesting column. COMPLETELY NEUTRAL. Be sure to Read the Poem at the end.. Charley Reese's final column for the Orlando Sentinel... He has been a journalist for 49 years. He is retiring and this is HIS LAST COLUMN. Be sure to read the Tax List at the end. This is about as clear and easy to understand as it can be. The article below is completely neutral, neither anti-republican or democrat. Charlie Reese, a retired reporter for the Orlando Sentinel, has hit the nail directly on the head, defining clearly who it is that in the final analysis must assume responsibility for the judgments made that impact each one of us every day. It's a short but good read. Worth the time. Worth remembering! 545 vs. 300,000,000 People -By Charlie Reese Politicians are the only people in the world who create problems and then campaign against them. Have you ever wondered, if both the Democrats and the Republicans are against deficits, WHY do we have deficits? Have you ever wondered, if all the politicians are against inflation and high taxes, WHY do we have inflation and high taxes? You and I don't propose a federal budget. The President does. You and I don't have the Constitutional authority to vote on appropriations. The House of Representatives does. You and I don't write the tax code, Congress does. You and I don't set fiscal policy, Congress does. You and I don't control monetary policy, the Federal Reserve Bank does. One hundred senators, 435 congressmen, one President, and nine Supreme Court justices equates to 545 human beings out of the 300 million are directly, legally, morally, and individually responsible for the domestic problems that plague this country. I excluded the members of the Federal Reserve Board because that problem was created by the Congress. In 1913, Congress delegated its Constitutional duty to provide a sound currency to a federally chartered, but private, central bank. I excluded all the special interests and lobbyists for a sound reason. They have no legal authority. They have no ability to coerce a senator, a congressman, or a President to do one cotton-picking thing. I don't care if they offer a politician $1 million dollars in cash. The politician has the power to accept or reject it. No matter what the lobbyist promises, it is the legislator's responsibility to determine how he votes. Those 545 human beings spend much of their energy convincing you that what they did is not their fault. They cooperate in this common con regardless of party. What separates a politician from a normal human being is an excessive amount of gall. No normal human being would have the gall of a Speaker, who stood up and criticized the President for creating deficits.. ( The President can only propose a budget. He cannot force the Congress to accept it.) The Constitution, which is the supreme law of the land, gives sole responsibility to the House of Representatives for originating and approving appropriations and taxes. Who is the speaker of the House?( John Boehner. He is the leader of the majority party. He and fellow House members, not the President, can approve any budget they want. ) If the President vetoes it, they can pass it over his veto if they agree to. [The House has passed a budget but the Senate has not approved a budget in over three years. The President's proposed budgets have gotten almost unanimous rejections in the Senate in that time. ] It seems inconceivable to me that a nation of 300 million cannot replace 545 people who stand convicted -- by present facts -- of incompetence and irresponsibility. I can't think of a single domestic problem that is not traceable directly to those 545 people. When you fully grasp the plain truth that 545 people exercise the power of the federal government, then it must follow that what exists is what they want to exist. If the tax code is unfair, it's because they want it unfair. If the budget is in the red, it's because they want it in the red. If the Army & Marines are in Iraq and Afghanistan it's because they want them in Iraq and Afghanistan .. If they do not receive social security but are on an elite retirement plan not available to the people, it's because they want it that way. There are no insoluble government problems. Do not let these 545 people shift the blame to bureaucrats, whom they hire and whose jobs they can abolish; to lobbyists, whose gifts and advice they can reject; to regulators, to whom they give the power to regulate and from whom they can take this power. Above all, do not let them con you into the belief that there exists disembodied mystical forces like "the economy," "inflation," or "politics" that prevent them from doing what they take an oath to do. Those 545 people, and they alone, are responsible. They, and they alone, have the power. They, and they alone, should be held accountable by the people who are their bosses. Provided the voters have the gumption to manage their own employees... We should vote all of them out of office and clean up their mess! Charlie Reese is a former columnist of the Orlando Sentinel Newspaper. What you do with this article now that you have read it... is up to you. This might be funny if it weren't so true. Be sure to read all the way to the end: Tax his land, Tax his bed, Tax the table, At which he's fed. Tax his tractor, Tax his mule, Teach him taxes Are the rule. Tax his work, Tax his pay, He works for peanuts anyway! Tax his cow, Tax his goat, Tax his pants, Tax his coat. Tax his ties, Tax his shirt, Tax his work, Tax his dirt. Tax his tobacco, Tax his drink, Tax him if he Tries to think. Tax his cigars, Tax his beers, If he cries Tax his tears. Tax his car, Tax his gas, Find other ways To tax his ass. Tax all he has Then let him know That you won't be done Till he has no dough. When he screams and hollers; Then tax him some more, Tax him till He's good and sore. Then tax his coffin, Tax his grave, Tax the sod in Which he's laid... Put these words Upon his tomb, 'Taxes drove me to my doom...' When he's gone, Do not relax, Its time to apply The inheritance tax. Accounts Receivable Tax Building Permit Tax CDL license Tax Cigarette Tax Corporate Income Tax Dog License Tax Excise Taxes Federal Income Tax Federal Unemployment Tax (FUTA) Fishing License Tax Food License Tax Fuel Permit Tax Gasoline Tax (currently 44.75 cents per gallon) Gross Receipts Tax Hunting License Tax Inheritance Tax Inventory Tax IRS Interest Charges IRS Penalties (tax on top of tax) Liquor Tax Luxury Taxes Marriage License Tax Medicare Tax Personal Property Tax Property Tax Real Estate Tax Service Charge Tax Social Security Tax Road Usage Tax Recreational Vehicle Tax Sales Tax School Tax State Income Tax State Unemployment Tax (SUTA) Telephone Federal Excise Tax Telephone Federal Universal Service Fee Tax Telephone Federal, State and Local Surcharge Taxes Telephone Minimum Usage Surcharge Tax Telephone Recurring and Nonrecurring Charges Tax Telephone State and Local Tax Telephone Usage Charge Tax Utility Taxes Vehicle License Registration Tax Vehicle Sales Tax Watercraft Registration Tax Well Permit Tax Workers Compensation Tax STILL THINK THIS IS FUNNY? Not one of these taxes existed 100 years ago, & our nation was the most prosperous in the world. We had absolutely no national debt, had the largest middle class in the world, and Mom stayed home to raise the kids. What in the heck happened? Can you spell 'politicians?' I hope this goes around THE USA at least 545 times!!! YOU can help it get there!!! GO AHEAD. . . BE AN AMERICAN!!! SEND THIS TO EVERYONE YOU KNOW Like · · Share · 2 hours ago via mobile ·
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    Obamacare was supposed to be the Best Thing Since Sliced Bread. The American Legal Citizens were Sold a Bill of Goods to say the least. Before Obamacare was Rammed Down Our Throats by Idiot Nancy Pelosi, Satan Harry Reid and Brainless Obama no body was ever denied healthcare by Hospitals. But Idiot Nancy did not even read what was in the bill and Passed this Train wreck called Obamacare. My insurance rates have gone up big time how about Yours??
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