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US House

A Closer Look
at Healthcare Issues...

For constituents seeking to dig deeper into their representative's stands on healthcare issues, this page provides additional detail on eight key House votes from 2019-2020, including pro-and-con quotes that cut to the heart of partisan and ideological differences in this policy area.
1. Defending Affordable Care Act in Court
(Votes lookup at Roll Call #19)

The House on Jan. 9, 2019, voted, 235 for and 192 against, to join the defense of the Affordable Care Act in the lawsuit Texas v. United States. In that case, brought by Republican attorneys general in 20 states, a federal judge in Texas ruled in 2018 that the healthcare law was rendered unconstitutional when Congress, as part of the 2017 tax-cut package, repealed the law's individual-mandate tax penalty on those who choose not to obtain health insurance.

Floor Debate, Pro & Con:

Jim McGovern, D-Mass., said the measure "will allow this House to legally intervene to protect pre-existing condition coverage in the Affordable Care Act. If you support coverage for pre-existing conditions, then you will support this measure to try and protect it. It is that simple."

Greg Walden, R-Ore., said: "Democratic attorneys general from intervening states are already defending the law in the case, and the judge's ruling has already been stayed and appealed. So this is an unnecessary waste of time, paper and ink."

A yes vote was to adopt the Democratic-sponsored resolution (H Res 6).

2. Barring Waivers That Raise Cost of Pre-Existing Conditions Coverage
(Votes lookup at Roll Call #193)

Voting 302 for and 117 against, the House on May 9, 2019, adopted a Democratic-sponsored amendment to HR 986 that would prohibit the Trump administration from granting Affordable Care Act waivers that would result in higher costs for comprehensive coverage on state-run insurance exchanges for individuals with pre-existing conditions, thereby imperiling their ability to keep or obtain affordable health insurance.

Floor Debate, Pro & Con:

Supporter Frank Pallone, D-N.J., said that "by encouraging states to promote and expand short-term insurance plans, the administration is giving insurers a green light to directly discriminate against people with pre-existing conditions."

Opponent Greg Walden, R-Ore., quoted the Centers for Medicare & Medicaid Services as stating the administration's policy on ACA waivers "does nothing to erode pre-existing conditions. [They] cannot be waived...."

A yes vote was to adopt the amendment.

3. Prohibiting Administration Policies That Raise Healthcare Premiums
(Votes lookup at Roll Call #194)

Voting 308 for and 112 against, the House on May 9, 2019, adopted a Democratic amendment to HR 986 that would prohibit Trump administration policies that change the Affordable Care Act (ACA) in ways that raise premium costs for individuals who need comprehensive coverage, including access to the law’s Medicaid expansion and affordable pre-existing conditions protections.

Floor Debate, Pro & Con:

Susan Wild, D-Pa., said the administration "has unilaterallymade healthcare more expensive andless accessible for the American peopleby taking actions that run contrary tothe spirit and purpose of the ACA. That has resulted in higher premiums andreduced enrollment."

Greg Walden, R-Ore., said Republicans have "always protected people with preexisting conditions -- always, period, hard stop....We want innovation. We want choice. We believe in our states having the opportunity to innovate and do it even better."

A yes vote was to adopt the amendment.

4. Prohibiting Sale of Diluted Healthcare Policies
(Votes lookup at Roll Call #196)

The House on May 9, 2019, passed, 230 for and 183 against, a bill that would prohibit state-run health-insurance exchanges from offering diluted versions of coverage required by the Affordable Care Act (ACA). The bill (HR 986) would bar the Trump administration from granting waivers allowing states to offer short-term policies -- called “junk insurance” by critics -- that omit or weaken ACA requirements. Backers say the waivers enable states to offer much-needed lower-priced coverage, while critics say they siphon off healthy and younger policy holders vital to ACA risk pools.

In addition, the amendment would remove the requirement that individuals carry health insurance or pay a tax penalty, the mandate that large employers provide workers with health coverage, and tax provisions that fund the healthcare law.

Floor Debate, Pro & Con:

Jan Schakowsky, D-Ill., said: "You can sign up for one of these what we call 'junk policies,' and you're perfectly well, and then all of a sudden you have some kind of an illness that -- guess what -- is not covered and won't be covered because by then you'll have a pre-existing condition. [This bill] would protect pre-existing conditions, no questions, period, end of story."

Greg Walden, R-Ore., said no member of Congress wants to eliminate coverage of pre-existing conditions, but "what we're arguing about here is [whether] health insurance is affordable for Americans, and are there better ways using states as laboratories to innovate and bring down the cost of care and the cost of insurance...."

A yes vote was to send the bill to the Senate.

5. Reversing Administration Changes to Affordable Care Act
(Votes lookup at Roll Call #214)

Voting 234 for and 183 against, the House on May 16, 2019, passed a bill (HR 987) that would restore provisions of the Affordable Care Act (ACA) the Trump administration allowed to deteriorate while attempting to dismantle and repealthe law. The bill would restore the ACA's three-month limit on short-term health insurance that does not meet core coverage requirements, including protections for people with pre-existing conditions. The bill also would authorize $100 million annually over 10 years for advertising campaigns and "navigator" programs to reduce the number of people uninsured.

Enrollment in federal and state ACA exchanges, or marketplaces, peaked at 12.7 million in the last year (2016) of the Obama administration, and when this vote occurred, it had declined by 930,000 enrollees, or 7.3 percent, during the Trump administration, according to the Government Accountability Office. Unofficial tallies show that in 2018, about 25 million individuals received coverage in ACA exchanges or as a result of the law's expanded Medicaid eligibility, while 2.6 million young adults were covered by their parents' health plan under the law.

Floor Debate, Pro & Con:

Mary Gay Scanlon, D-Pa., said the bill would "reverse the sabotage of the ACA by this administration with respect to marketing and outreach, and rescind the Trump administration's efforts to promote junk plans that lack the protections of the Affordable Care Act."

Phil Roe, R-Tenn., said that by scaling back short-term, non-ACA compliant coverage, the bill would "double down on trying to force Obamacare on people who don't want it and can't afford it....If (Democrats) want to get rid of junk plans, they can start by working with us to get rid of Obamacare."

A yes vote was to send the bill to the Senate.

6. Repealing Affordable Care Act 'Cadillac Tax'
(Votes lookup at Roll Call #493)

Voting 419 for and six against, the House on July 17, 2019, passed a bill (HR 748) that would permanently remove from the Affordable Care Act the "Cadillac tax" on employer-sponsored health plans with particularly high costs and generous benefits. Scheduled to take effect in 2022, the 40 percent excise tax, to be paid by employers and insurers, would be levied initially on the value of plans costing more than $11,200 for individuals and $30,000 for families. The tax is intended to contain medical costs while generating revenue to finance the health law.

Floor Debate, Pro & Con:

Richard Neal, D-Mass., said: "At a time when American families are already worried about the healthcare costs that apply to them, the 'Cadillac tax' has had the effect of increasing deductibles and out-of-pocket costs as employers make changes in their plans designed to avoid the tax."

No member spoke against the bill.

A yes vote was to pass the bill.

7. Expanding Affordable Care Act
(Votes lookup at Roll Call #124)

Voting 234 for and 179 against, the House on June 29, 2020, passed a Democratic bill (HR 1425) that would reshape the Affordable Care Act by steps such as broadening its Medicaid expansion, capping expenditures for certain coverage levels and lowering the cost of prescription drugs. The bill would raise the national debt by at least $50 billion over 10 years while extending coverage to four million Americans in addition to the 23 million already using the law to cover a large share of their medical expenses.

The bill would require states that have not yet joined the ACA's Medicaid expansion to do so or face a cut in the federally paid share of their basic Medicaid program. For newly joining states, the federal government would cover 100 percent of added costs for three years and 90 percent thereafter. In addition, the bill stipulates that enrollees in ACA Silver plans could not be charged more than 8.5 percent of their annual income for premiums, deductibles and related charges. The bill also would require pharmaceutical companies to negotiate with the federal government the prices of approximately 250 top-selling prescription drugs offered in Medicare Part D and employer plans.

Further, the bill would nullify an executive order by President Trump that allows the sale of plans that do not meet ACA requirements such as coverage of pre-existing conditions and the provision of "essential health benefits" including maternity and pediatric care.

Floor Debate, Pro & Con:

Frank Pallone, D-N.J., said the bill "lowers Americans' healthcare costs by reversing some of the worst sabotage from the Trump administration. It reverses the…expansion of junk insurance plans that leave patients saddled with thousands of dollars in medical debt. It restores critical outreach in enrollment funding that was gutted by the Trump administration, and it reduces racial and ethnic healthcare disparities."

Michael Burgess, R-Texas, said: "The Affordable Care Act, for the last 10 years, really has been anything but affordable. Prices have gone up every year in spite of what we were promised. It has only been the last two years that premiums have actually begun to reduce, and that is because of some of the policies enacted by the [Trump] administration, expanding the usability of limited-duration plans, expanding association health plans."

A yes vote was to send the bill to the Senate.

8. Blocking Funding of GOP Lawsuit Against Health Law
(Votes lookup at Roll Call #175)

The House on July 30 voted, 234 for and 181 against, to deny funding of the Department of Justice's participation in a lawsuit brought by Republican attorneys general in 20 states to overturn the Affordable Care Act. The suit was pending before the Supreme Court, and the Trump administration had filed a brief there calling for the law to be struck down. The defunding language was added to a HR 7617, a bill later passed and sent to the Senate.

Floor Debate, Pro & Con:

Lauren Underwood, D-Ill., said "over four million Americans have been diagnosed with the coronavirus, a new pre-existing condition. Over 30 million...have lost their jobs, and over five million have lost their health insurance at the worst possible time. And while this health crisis has been unfolding, the Trump administration will not stop until they destroy the Affordable Care Act."

Robert Aderholt, R-Ala., said: "Unfortunately, Obamacare has been an unlawful failure, but fortunately, this administration remains committed to providing more affordable healthcare options to all Americans....It is not appropriate for Congress to tell the executive branch what position it should take in court. Litigation strategy is [the] responsibility and prerogative of the Department of Justice."

A yes vote was to block the funding.

Copyright 2020, Thomas Voting Reports, Inc.