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U.S. House

Top Healthcare Votes 2019-2020 (cont'd)

4. Democratic Stance on Pre-Existing Conditions
(Votes Lookup at Roll Call #193)
Voting 302-117, the House on May 9, 2019, adopted a Democratic-sponsored amendment to HR 986 (above) 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 those patients' ability to keep or obtain affordable health insurance.

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.

5. Republican Stance on Pre-Existing Conditions
(Votes Lookup at Roll Call #195)
Voting 182-231, the House on May 9, 2019, defeated a Republican-sponsored motion to HR 986 (above) asserting that neither the Affordable Care Act (ACA) in its existing form nor Trump administration healthcare decisions would allow state-run ACA insurance exchanges to sell policies that weaken protections for those with pre-existing conditions.

Supporter Greg Walden, R-Ore., said Republicans "will always protect people with pre-existing conditions....You can run your ads, you can deceive people, you can mislead people, but we will always fight to protect people with pre-existing conditions."

Elissa Slotkin, D-Mich., said "it is not enough to say that you protect pre-existing conditions, it is what happens on the ground that matters....The administration has tried every play in the book to undercut [and] sabotage...protections for pre-existing conditions," along with joining a lawsuit "to invalidate the entirety of the ACA."

A yes vote was to adopt the motion.

6. Reversing Administration Changes to ACA
(Votes Lookup at Roll Call #214)
Voting 234-183, the House on May 16, 2019, passed a bill (HR 987) that would restore provisions of the Affordable Care Act (ACA) the Trump administration had allowed to deteriorate while attempting to dismantle and repeal of the 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 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 terms of the law. A yes vote was to send the bill to the Senate.

7. Shifting ACA Funds to Cancer Research
(Votes Lookup at Roll Call #213)
Voting 188-228, the House on May 16, 2019, defeated a GOP-sponsored motion to HR 987 (above) that attempted to shift millions of dollars from Affordable Care Act (ACA) enrollment accounts to National Institutes of Health research into childhood cancer. The measure targeted the ACA's "navigator" program, in which the government funds grass-roots efforts to help individuals and small businesses sign up for insurance in federally run marketplaces. The Trump administration had cut the navigator budget by nearly 90 percent while presiding over a 7.3 percent decline since 2016 in enrollment in state and federal marketplaces. A yes vote was to adopt the motion.

8. Shifting ACA Funds to Mental Health Programs
(Votes Lookup at Roll Call #284)
Voting 186-237, the House on June 13, 2019, defeated a GOP-sponsored amendment that sought to transfer $90 million from the Affordable Care Act (ACA) "navigator" program to the National Institute of Mental Health budget. The amendment would further the Trump administration's deep cuts in the program to help individuals and small businesses and their employees sign up for ACA coverage in the 34 states where marketplaces are federally run. This vote occurred during debate on the fiscal 2020 Department of Health and Human Services budget (HR 2740). A yes vote was to adopt the amendment.

9. Repealing Health Law's 'Cadillac Tax'
(Votes Lookup at Roll Call #493)
Voting 419-6, 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. A yes vote was to pass the bill.

10. Requiring Negotiation of Medicare Drug Prices
(Votes Lookup at Roll Call #682)
Voting 230-192, the House on Dec. 12, 2019, passed a bill (HR 3) that 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 health plans. The negotiated U.S. retail price of a covered drug could not exceed 120 percent of the average price that Australia, Canada, France, Germany, Japan and the United Kingdom have negotiated for their residents. Manufacturers declining to negotiate the price of specific drugs would be subjected to excise taxes of up to 95 percent on sales of that drug.

The bill would cap Medicare Part D out-of-pocket costs at $2,000 per year and add dental, vision and hearing benefits to Medicare Part D. Manufacturers and the Department of Health and Human Services would start negotiations in 2021, with Medicare Part D receiving its first price cuts in 2023. Negotiators would add at least 50 reduced-price drugs to Medicare Part D and commercial plans each year, with the conversion completed by 2026. Negotiated prices would be indexed for inflation and remain in effect until a generic or biosimilar competitor emerges. Lower insulin prices for seniors would be negotiated in the law's first year. A yes vote was to pass the bill.

11. Defeating GOP Plan for Medicare Drug Prices
(Votes Lookup at Roll Call #676)
Voting 201 for and 223 against, the House on Dec. 12, 2019, defeated a Republican version of HR 3 (above) that omitted the requirement for manufacturers to negotiate drug prices with the Department of Health and Human Services. In addition to this free-market provision, the GOP substitute would cap Medicare Part D out-of-pocket costs at $3,100 per year; expand financial incentives for drug companies to discover cures; cap the cost of insulin for seniors at $50 per month; require drug advertising to list retail prices; expand the use of Health Savings Accounts for drug purchases; and require the U.S. trade representative to ensure U.S. taxpayers do not subsidize the drug costs in foreign markets. The GOP bill also would permanently cap the IRS threshold for deducting medical expenses at 7.5 percent of adjusted gross income, averting a scheduled increase to 10 percent in 2020. A yes vote was to adopt the Republican alternative.

Copyright 2020, Thomas Voting Reports, Inc.