Congress went home for the holidays on December 22 on a disappointing note. The Republican tax cut was passed and signed by the President. Major items of concern:
- The law creates a $1.5 trillion deficit. Republicans are now calling for cuts to entitlement programs such as Medicaid and Medicare to eliminate that deficit.
- The Affordable Care Act's individual mandate, which required virtually all Americans to have health insurance, was repealed. This raises concerns that healthy people will go without coverage and cause increases in costs for those who do buy insurance. However, this was not a repeal of Obamacare, as some have claimed.
The Continuing Resolution (CR) that was passed to continue funding for the government after December 22 will only ensure funding through January 19, 2018. Some health care issues were resolved in the CR but, generally, the important issues were pushed into the new year:
- Under rules adopted in 2010 to attempt to control deficit spending (known as PAYGO for "pay as you go"), automatic cuts in some programs are required if deficit projections hit certain levels. The tax cut law is projected to cause deficits that would trigger automatic cuts in certain programs, including Medicare. The automatic cut in Medicare would have been $25 billion. However, this automatic cut was waived in the CR.
- Funding designed to extend CHIP/HUSKY B and to fund community health centers for about 3 months was included in the CR but stable funding was not achieved. Cuts were made to the ACA's Prevention and Public Health Fund to pay for health care programs.
- ACA market stability measures, including the Alexander/Murray bill to require Cost Sharing Reduction payments and a bill to fund state reinsurance plans, were not included in the CR. These may come up in January.
These results give us plenty to work on in 2018. There are many important gains under the Affordable Care Act that we must continue to protect (the Medicaid expansion, subsidies for people buying health care on health insurance exchanges and required coverage of people with pre-existing conditions, to name a few).
The American people demonstrated the importance of insurance available through the health insurance exchanges. Despite the Trump Administration’s cuts to outreach funding and the shortened enrollment period, insurance exchange open enrollment numbers surpassed expectations, with almost 9 million people enrolling around the country and about 100,000 in Connecticut.
We have shown that we can protect health care programs when we work together. Let's resolve to continue working together in 2018.