Health policy priorities passed as part of shutdown deal

While the stopgap spending measure passed by Congress and signed by President Donald Trump only funds the federal government through Feb. 8, several long-term health policy priorities were addressed as part of the short-term solution.

Healthcare measures in the bill included:

• A six-year renewal of the Children Health’s Insurance Program (CHIP).
• Delaying the Affordable Care Act (ACA)’s medical device tax through 2019.
• Delaying the ACA’s health insurance tax through 2019.
• Delaying the ACA’s “Cadillac tax” on generous employer-sponsored plans through 2021.

Congress had failed to reauthorize CHIP after its funding expired at the end of September 2017. States had been warning CHIP recipients that children could soon lose their benefits with congressional action, though the cost of renewal dropped after Republicans repealed the ACA’s individual mandate at the end of 2017.

While criticizing Democrats for “needless obstruction” in opposing the short-term funding bill while pushing for immigration policy, Republicans touted its passage as a victory for recipients of CHIP, noting the program has never had such a long extension of its funding.

“Today is a win for the millions of kids and their families that rely on CHIP and its vital services. After a completely unnecessary and avoidable shutdown, families across the country can breathe a sigh of relief knowing they will continue having access to affordable, quality health insurance,” said Rep. Greg Walden, R-Oregon, chair of the House Energy and Commerce Committee and Michael Burgess, MD, R-Texas, chair of the health subcommittee.

The extension was also applauded by healthcare groups like the American Academy of Pediatrics and the American College of Physicians (ACP), which noted other healthcare programs, such as community health centers and Teaching Health Center Graduate Medical Education, remain unfunded. Additionally, both groups encouraged Congress to address the immigration concern which drove the shutdown—protections for undocumented immigrants brought to the U.S. as children, known as “dreamers.”

“ACP calls on Congress to pass legislation, and for President Trump to sign into law, protecting Deferred Action on Childhood Arrivals (DACA) recipients,” ACP president Jack Ende, MD, said in a statement. “Every day that goes by without a permanent solution puts Dreamers at risk of losing jobs or having to drop out of school, this includes medical students and physicians in training. Many medical students and residents are DACA recipients, and enacting legislation that will allow them to remain in school, residency training or practice will only benefit patients and our entire health care system.”

Groups which had advocated for delays of the ACA’s taxes were also pleased with the short-term spending bill. The Advanced Medical Technology Association (AdvaMed) noted medical device companies were days away from “cutting checks to the IRS.”

What the industry really wants, AdvaMed president and CEO Scott Whitaker said, is get rid of the device tax permanently.

“While the two-year suspension is welcome, it is only an interim step toward the truly needed action by Congress to fully repeal this tax and unleash the promise of medtech innovation,” Whitaker said in a statement. “We look forward to continuing to work with the Hill on a bipartisan basis to drive towards permanent relief.”

The tax delays do come at a cost. The Joint Committee on Taxation estimated suspending the three ACA taxes will add a total of $31 billion to the federal deficit over the next decade.