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CBO says repealing Obamacare’s individual mandate penalties would save $338 billion. The Congressional Budget Office on Wednesday said that repealing Obamacare’s individual mandate penalties would save $338 billion over the next decade, providing a boost to conservatives pushing Republicans to include repeal in tax reform. The CBO also acknowledged Wednesday that it was revisiting its methodology on the repeal of the individual mandate but that changes would not be included in a full report set to be released later in the afternoon. CBO Director Keith Hall said in a blog post that the evaluation was underway by his agency and by the Joint Committee on Taxation. “The agencies are in the process of revising their methods to estimate the repeal of the individual mandate,” he said. “However, because that work is not complete and significant changes to the individual mandate are now being considered as part of the budget reconciliation process, the agencies are publishing this update without incorporating major changes to their analytical methods.” News of rumors about the change in CBO’s methodology had been reported Tuesday in the Washington Examiner. In past reports, CBO has said that the decrease in deficits would be a result of fewer people signing up for Medicaid, lower enrollment in Obamacare’s subsidized private plans, and a reduction in the number of people buying tax-advantaged health insurance plans through their employers. In total, an earlier CBO report found that health insurance coverage would fall by 15 million people.
CBO report will increase pressure on Republicans to include repeal of penalties in tax bill. The CBO report will help conservatives, who are increasing the pressure on House and Senate leaders to ensure that the Republican tax reform plan repeals penalties associated with the requirement to purchase health insurance. The provision isn’t in the House tax reform plan now churning through the Ways and Means Committee, but some lawmakers are hoping it will make it into the House bill or otherwise be part of a Senate tax reform plan expected later this week. At a Senate press conference on tax reform Tuesday, Sen. Ted Cruz, R-Texas, said eliminating the mandate “makes it much easier” to pay for tax reform. Cruz noted that instead of taking that course, the House bill offsets tax cuts with the elimination of popular tax deductions, such as the one for state and local taxes. “There are some taxpayers who are losing exemptions, particularly in high-tax states, that could be paying higher taxes,” Cruz said. “I think that is a mistake. Tax reform needs to cut taxes for everybody.” President Trump has publicly said that repealing the mandate penalties should be part of tax reform. The House Ways and Means Committee is expected to approve the GOP tax bill by Thursday, which is when the Senate GOP is expected to make public its own tax proposal. House conservatives told the Washington Examiner they want the Senate to include a provision to repeal the mandate penalty.
Exit poll shows healthcare top priority for Virginia voters. Virginia voters chose healthcare as the top priority when they went to the polls, and those who did went overwhelmingly for Democrat and Gov.-elect Ralph Northam, who won the race by 9 percentage points. An NBC News exit poll found that 39 percent of those surveyed listed healthcare as the issue that mattered most in deciding how they voted for governor. Voters who listed healthcare went for Northam by an enormous 54 percentage point margin over Republican Ed Gillespie. The second biggest issue was gun policy with 17 percent, taxes (15 percent), immigration (12 percent) and abortion at 8 percent.
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Paul Ryan defends repeal of adoption tax credit. House Speaker Paul Ryan on Wednesday pushed back against criticisms of the provision repealing the adoption tax credit in the Republican bill to overhaul the tax code, saying the bill overall would benefit families. “It is a tax credit that goes to higher-income individuals. Middle and low income people don’t get it today,” the Wisconsin Republican said at an event on the tax bill held by the Washington Examiner. The bill, the Tax Cuts and Jobs Act, is being marked up by the House Ways and Means Committee. Anti-abortion groups have called for restoration of the adoption tax credit, and conservatives also are calling for it to be dropped from subsequent versions. Repealing the credit is expected to save the government $13,570 per adopted child. Ryan argued other parts of the bill would result in better savings for families and overall it would result in $600 returned to families per child each year. “The general philosophy of this is: Instead of giving you a tax break for one thing you do at one time, we want to give you a tax break for anything you do for all time, meaning lower your taxes always, you do what you want with your money,” he said. “Instead of saying, ‘We’ll give you a one-time break if you do something we approve of,’ let’s just give you your money back in the first place.” House Ways and Means Chairman Kevin Brady, who has adopted two children, also has pushed back against restoring the adoption tax credit, saying few people have been able to use it and it goes to wealthier people who itemize their deductions.
Maine governor pushes back as voters choose to expand Medicaid. Maine voters approved a ballot initiative to become the 32nd state to expand Medicaid under Obamacare, but Republican Gov. Paul LePage said Wednesday that he would not approve any expansion until lawmakers find a way to pay for it. “Credit agencies are predicting that this fiscally irresponsible Medicaid expansion will be ruinous to Maine’s budget,” LePage, a Republican, said in a statement. “Therefore, my administration will not implement Medicaid expansion until it has been fully funded by the legislature at the levels DHHS has calculated, and I will not support increasing taxes on Maine families, raiding the rainy day fund or reducing services to our elderly or disabled.” LePage pointed to an expansion of Medicaid tried in 2002 under then-Gov. Angus King, now an independent in Congress, as evidence to support his concerns about costs to the state. “It created a $750 million debt to hospitals, resulted in massive budget shortfalls every year, did not reduce emergency room use, did not reduce the number of uninsured Mainers and took resources away from our most vulnerable residents — the elderly and the intellectually and physically disabled,” LePage said. LePage vetoed expansion efforts five times, arguing they would be too costly. The Medicaid expansion is expected to cover about 80,000 residents. Other results could affect whether more states decide to expand Medicaid under Obamacare.
More states could use ballot box to expand Medicaid. Maine isn’t the only state that was pushing for a ballot initiative to expand Medicaid. Idaho advocates submitted paperwork last month to put expansion on the ballot, according to the Associated Press. Advocates still need to get at least 48,000 signatures to make the issue on the ballot, but it would join Utah in using a ballot initiative to bypass a reluctant state legislature, the Associated Press said.
Fate of Medicaid expansion could hang on close Virginia House races. Virginia Democrats made massive gains in the state House Tuesday, winning aboubt 15 seats, according to the Washington Post. Four races that are too close to call will determine control of the chamber. Going into election night, Republicans held 66 seats. Control of the chamber could have a major impact on whether Virginia successfully expands Medicaid. Current Democratic Gov. Terry MacAuliffe tried to expand the program under Obamacare but has been stymied by the GOP-controlled legislature. The GOP retains a 21-19 majority in the state Senate, where all seats are up for re-election in 2019. If Democrats take the House, which remains a big if as the closest races are headed for recounts, they would need to persuade one Republican to flip and support expansion since newly elected Democratic Lieutenant Gov. Justin Fairfax can break a 50-50 tie.
Ohio voters soundly defeat drug price ballot measure. Ohio resoundingly defeated a ballot measure aimed at reducing drug prices after a $49 million opposition campaign by the pharmaceutical industry. About 80 percent of Ohio voters decided against the measure and 20 percent for it. It is the second major defeat after California voters defeated a similar measure last year. The Ohio measure would have required state health agencies such as the state’s Medicaid program to buy prescription drugs at prices that aren’t any higher than those paid by the Department of Veterans Affairs, which negotiates steep discounts with drug companies. Officials with the “yes” campaign conceded defeat and said that they were still able to raise awareness about the issue. The “no” campaign said the ballot measure was deceptive and seriously flawed. Adoption would have “increased bureaucracy and raised costs for Ohio Medicaid and other state agencies that provide prescription drugs to Ohioans,” said Curt Steiner, campaign manager for Ohioans against the Deceptive Rx Ballot Issue. “And passage would have led to healthcare cost increases for the two-thirds of Ohioans who are not covered by state programs — including military veterans using VA benefits, those on Medicare and families with private or employer-based insurance.”
RUNDOWN
The Hill Push to restore adoption tax credit gains steam
Axios Medicaid’s big night
Politico The case against hospital beds
NPR You can get your DNA tested at an NFL game. Should you?
STAT News Risky stimulants turn up again in weight loss and workout supplements
New York Times Cancer doctors cite risks of drinking alcohol
Wall Street Journal GOP senators aim to keep medical expenses deduction
Associated Press Notre Dame employees keeping free birth control coverage
Washington Post In clinical trials, medications show promise for treating heroin addiction
Calendar
WEDNESDAY | Nov. 8
Nov. 4-8. American Public Health Association 2017 Annual Meeting and Expo. Theme: Creating the Healthiest Nation: Climate Changes Health. Details.
Nov. 6-8. Mandarin Oriental. 18th Annual Pharmaceutical and Medical Device Compliance Congress. Details.
Nov. 6-8. National Association of Medicaid Directors fall conference. Details.
3 p.m. 1330 G St. NW. Kaiser Health News discussion on “Advance Care Planning: What You Need To Know Now.” Details.
3:30 p.m. National Constitution Center. Philadelphia. Axios event on “A New Era in Cancer Innovation” including former Vice President Joe Biden. Details.
THURSDAY | Nov. 9
8:30 a.m. 500 5th St. NW. National Academy of Medicine Culture of Health meeting. Details.
8:30 a.m. 1801 K St. NW. Alliance for Health Policy event on “Care Delivery in the Future: The Role of the Health Care Workforce.” Details.
FRIDAY | Nov. 10
Federal government closed in observance of Veterans Day.
MONDAY | Nov. 13
Nov. 13-15. Crystal Gateway Marriott. National Alliance of Healthcare Purchaser Coalition. Details.
9 a.m. National Press Club. 529 14th St. NW. Alliance for Health Policy event on “Navigating Next Steps on Payment Reform: A Breakfast for Reporters.” Details.
