What’s Coming for Health Care This Fall

• The last few months of this year will be filled with health care developments.

• An approaching set of Obamacare deadlines will begin to do even more harm to hard-working Americans.

• The fall presents opportunities for Republicans to push forward conservative health care priorities.

Higher premiums. Families this fall will learn how much higher their Obamacare premiums will be next year. In June, the federal government released data on the substantially higher rates that health insurers requested in 45 states and the District of Columbia. President Obama assured the public that insurance commissioners would not approve these higher rate requests. Despite these promises, Americans in some states are seeing approved rates that are much higher than they had been paying.

Small group markets. Obamacare changes the definition of “small group market” starting on January 1, 2016. Employers with 51 to 100 employees will be placed into a new insurance category with dramatically different mandates and benefit requirements. In many cases, these employers will not be able to continue to offer their current plans. The new plans are likely to be significantly more expensive. In August, Senator Tim Scott introduced legislation to protect small businesses. The Protecting Affordable Coverage for Employees Act would restore the ability states had before Obamacare to define a “small group market” in the best way for that state. A bipartisan group of 42 Senators have cosponsored this bill, and more than half of the House has cosponsored the companion bill.

Employer mandate. Companies with 100 workers or more have had to deal with the burdens of the employer mandate since January. Starting next January, employers with 50 to 99 workers will be subject to this mandate as well. The requirements will put increased pressure on small business owners and their employees. With wages stagnant across the economy, this will be even more bad news for millions of workers.

Reconciliation. In May, the Senate and House passed a joint budget resolution that included reconciliation instructions. It was the first joint, 10-year, balanced-budget resolution in more than a decade. While the contours of a reconciliation package are still being decided, it is expected to focus on Obamacare. There also has been discussion of including measures to defund Planned Parenthood. The House most likely will take up the reconciliation bill before the Senate.

Better Health Care for Americans

Beyond Obamacare, there are other initiatives underway and looming deadlines for major action in health care. Some of these present new opportunities for congressional Republicans to improve the quality of health care for Americans.

Innovation package. The Senate Health, Education, Labor and Pensions Committee is working on a package of measures designed to speed medical innovation. The ideas would expedite Washington’s approval process for new medical cures and devices; promote precision medicine; and improve health IT. They would also make sure that federal agencies are equipped to review the new products and processes. The Senate effort is parallel to the House-led 21st Century Cures project, which resulted in a bill that passed 344-77 in July.

Planned Parenthood. Efforts to investigate and defund Planned Parenthood are under way in the wake of videos showing the organization may be engaged in the illegal practice of harvesting and selling organs from unborn children. Defunding efforts will ensure that women have access to health care without providing funds to Planned Parenthood.

Medicare Part B. Beginning in 2016, about 30 percent of those enrolled in Medicare Part B could see a 52 percent increase in their Part B premiums. People who have their Medicare premiums deducted directly from their Social Security checks, who are not considered high-income earners, and who are already in the program are protected from rate hikes above a small cost-of-living increase. For dual-eligibles, state Medicaid programs will cover the additional cost. Those who do not fall into these categories will face a rate hike in January.

9/11. The James Zadroga 9/11 Health and Compensation Act of 2010, which provides health care for responders and survivors who developed health conditions related to the September 11 attacks, is up for reauthorization this year. The Centers for Disease Control and Prevention has the authority to use unexpended funds to continue the program into 2016. The Senate Health, Education, Labor and Pensions Committee is exploring options for extending the program.