2017: Fitzpatrick Voted Against The FY 2018 Republican Study Committee
Budget Resolution Which In Part Called For Fully Repealing Obamacare And
Replacing It With Parts Of AHCA. In October 2017, Fitzpatrick voted
against a budget resolution that would in part, according to
Congressional Quarterly, "provide for $2.9 trillion in new budget
authority in fiscal 2018. It would balance the budget by fiscal 2023 by
reducing spending by $10.1 trillion over 10 years. It would cap total
discretionary spending at $1.06 trillion for fiscal 2018 and would
assume no separate Overseas Contingency Operations funding for fiscal
2018 or subsequent years and would incorporate funding related to war or
terror into the base defense account. It would assume repeal of the 2010
health care overhaul and would convert Medicaid and the Children's
Health Insurance Program into a single block grant program. It would
require that off budget programs, such as Social Security, the U.S.
Postal Service, and Fannie Mae and Freddie Mac, be included in the
budget." The underlying legislation was an FY 2018 House GOP budget
resolution. The House rejected the RSC budget by a vote of 139 to 281.
[House Vote 555,
10/5/17; Congressional
Quarterly, 10/5/17; Congressional
Actions, H. Amdt.
455;
Congressional Actions, H. Con. Res.
71]
2017: Fitzpatrick Voted Against The American Health Care Act That
Which Would Result In 23 Million Fewer Americans With Health Insurance
By 2026. In May 2017, Fitzpatrick voted against the American Health
Care Act which would have significantly repealed portions of the
Affordable Care Act by cutting Medicaid, cutting taxes on the rich,
removing safeguard for pre-existing conditions and defunding Planned
Parenthood. The overall legislation would have in part, also according
to Congressional Quarterly, "ma[d]e extensive changes to the 2010
health care overhaul law, by effectively repealing the individual and
employer mandates as well as most of the taxes that finance the current
system. It would [have], in 2020, convert[ed] Medicaid into a capped
entitlement that would provide[d] fixed federal payments to states and
end[ed] additional federal funding for the 2010 law's joint
federal-state Medicaid expansion. It would prohibit federal funding to
any entity, such as Planned Parenthood, that performs abortions and
receives more than $350 million a year in Medicaid funds. [...] It
would [have] allow[ed] states to receive waivers to exempt insurers
from having to provide certain minimum benefits." The vote was on
passage. The House passed the bill by a vote of 217 to 213. The bill, in
modified forms, died in the Senate. [House Vote 256,
5/4/17; Congressional
Quarterly, 5/4/17; Kaiser Family
Foundation,
5/17;
Congressional Actions, H.R.
1628]
Legislation Would Result In 14 Million Additional Uninsured
Americans In 2018, Rising To 23 Million In 2026. According to the
New York Times, "A bill to dismantle the Affordable Care Act that
narrowly passed the House this month would leave 14 million more
people uninsured next year than under President Barack Obama's
health law --- and 23 million more in 2026, the Congressional Budget
Office said Wednesday. Some of the nation's sickest would pay much
more for health care. Under the House bill, the number of uninsured
would be slightly lower, but deficits would be somewhat higher, than
the budget office estimated before Republican leaders made a series
of changes to win enough votes for passage. Beneath the
headline-grabbing numbers, those legislative tweaks would bring huge
changes to the American health care system." [New York Times,
5/24/17]
Legislation Would Cut Medicaid By $834 Billon Over The Next Ten
Years, Including A Roll Back Of The Medicaid Expansion. According
to the New York Times, "The House repeal bill was approved on May 4
by a vote of 217 to 213, with no support from Democrats. It would
eliminate tax penalties for people who go without health insurance
and roll back state-by-state expansions of Medicaid, which have
provided coverage to millions of low-income people. And in place of
government-subsidized insurance policies offered exclusively on the
Affordable Care Act's marketplaces, the bill would offer tax credits
of $2,000 to $4,000 a year, depending on age. [...] The bill
would reduce projected spending on Medicaid, the program for
low-income people, by $834 billion over 10 years, and 14 million
fewer people would be covered by Medicaid in 2026 --- a reduction of
about 17 percent from the enrollment expected under current law, the
budget office said." [New York Times,
5/24/17]
Legislation Would Give States The Option Of A Per-Capita Cap On
Medicaid Federal Funding Or A Block Grant; Overall Changes Would
Result In 14 Million Fewer Medicaid Enrollees. According to NPR,
Medicaid accounts for by far the biggest spending reductions under
the American Health Care Act. The bill would roll back the Medicaid
expansion instituted under the Affordable Care Act, which extended
the program to cover some Americans with incomes up to 133 percent
of the poverty line. That expansion increased enrollment by 10
million, as NPR's Alison Kodjak previously reported. Rolling back
that expansion would limit future enrollments. The AHCA would also
give states a choice: Receive Medicaid funding via either a block
grant or a per capita amount per enrollee. Together, these changes
would create major cuts in enrollment for the program: 14 million
fewer people by 2026, and $834 billion in spending cuts over a
decade." [NPR,
5/24/17]
Legislation Would Allow States To Seek A Waiver On Insurance
Requirements. According to the Washington Post, "Congressional
analysts concluded that one change to the House bill aimed at
lowering premiums, by allowing states to opt out of some current
insurance requirements, would encourage some employers to maintain
coverage for their workers and get younger, healthier people to buy
plans on their own. But those gains would be largely offset by
consumers with preexisting conditions, who would face higher
premiums than they do now." [Washington Post,
5/24/17]
About 1/6 OF Americans Would Live In States Receiving Insurance
Waivers On Consumer Protections; These Markets Would Eventually
Destabilize. According to the Los Angeles Times, "The House bill
would be particularly harmful to older, sicker residents of states
that waive key consumer protections in the current law, including
the ban on insurers charging sick consumers more. The budget office
estimates that about one-sixth of the U.S. population live in states
that would seek such waivers, which would be allowed under the House
bill. 'Over time, it would become more difficult for less healthy
people (including people with preexisting medical conditions) in
those states to purchase insurance,' the report notes." [Los
Angeles Times,
5/24/17]
Premiums Would Drop In Some States, But Would Be Driven By
Insurance With Fewer Benefits, Likely Driving Up Consumer Costs For
Sicker Americans Such As Increased Costs For Pregnancy, Mental
Health And Substance Abuse. According to the Los Angeles Times,
"The budget office projected that average premiums for those who buy
their own coverage would be lower in some states after 2020 than
under Obamacare, an estimate quickly hailed by Republicans. [...]
But the decrease would be driven largely driven by the fact that
more people would have plans that cover fewer benefits and shift
more costs to consumers, budget analysts wrote. Healthier consumers
'would be able to purchase nongroup insurance with relatively low
premiums,' the budget office said. But skimpier plans with high
deductibles would be particularly problematic for Americans facing
high medical needs. 'Some people enrolled in nongroup insurance
would experience substantial increases in what they would spend on
healthcare,' the report notes. Out-of-pocket costs for pregnancy,
mental health and substance abuse would likely 'increase by
thousands of dollars' for people in some states, the budget office
said." [Los Angeles Times,
5/24/17]
Americans Who Work At Large Firms Would Be At Risk For Receiving
Insurance Without Essential Health Benefit Requirements. Acceding
to the CBO, "For the large-group market, which generally consists of
employers with more than 50 employees, current regulations allow
employers to choose the EHB benchmark plan of any state in which
they operate. Because of those regulations, a large employer
operating in multiple states, including one that elected an EHB
waiver, could base all of the plans it offers on the EHB
requirements in a state with the waiver. That decision could allow
annual and lifetime limits on benefits not included in the state's
EHBs. However, large employers already have considerable flexibility
in the range of the benefits they include in their plans, so CBO and
JCT expect that their benefit offerings would probably not be
noticeably affected by the actions of states." [CBO,
5/24/17]
A 64 Year Old American Earning $26,500 Annually Would See Their
Annual Premium Increase From $1,700 To $13,600 In Waiver States.
According to the Los Angeles Times, "Older and poorer Americans
would also see higher premiums or lose coverage altogether. For
example, under the House bill, a 64-year-old single American with an
income of $26,500 a year would see his or her annual insurance bill
jump from $1,700 to $13,600 in states that waive protections now
mandated by Obamacare, according to the budget office. By contrast,
a similar consumer who is 21 would see his or her premiums decrease
from $1,700 to $1,250, budget analysts projected." [Los Angeles
Times,
5/24/17]
CBO: States That Opt Out Of Community Rating Protections Would
Lead To Sick Americans Being Priced Out Of The Insurance Market.
According to the CBO, "Community-rated premiums would rise over
time, and people who are less healthy (including those with
preexisting or newly acquired medical conditions) would ultimately
be unable to purchase comprehensive nongroup health insurance at
premiums comparable to those under current law, if they could
purchase it at all---despite the additional funding that would be
available under H.R. 1628 to help reduce premiums. As a result, the
nongroup markets in those states would become unstable for people
with higher-than-average expected health care costs. That
instability would cause some people who would have been insured in
the nongroup market under current law to be uninsured." [CBO via
Vox,
5/24/17]
The GOP Bill Repealed The 0.9% Medicare Hospital Insurance
Surtax. According to the House Ways and Means Committee,
"Obamacare imposed a Medicare Hospital Insurance (HI) surtax based
on income at a rate equal to 0.9 percent of an employee's wages or a
self-employed individual's self-employment income. This section
repeals the additional 0.9 percent Medicare tax beginning in 2018."
[House Ways and Means Committee,
3/6/17]
The GOP Bill Repealed The 3.8% Net Investment Tax. According to
the House Ways and Means Committee, "Obamacare imposed a net
investment tax, applying a rate of 3.8 percent to certain net
investment income of individuals, estates, and trusts with income
above certain amounts. This section repeals the net investment tax
starting in 2018." [House Ways and Means Committee,
3/6/17]
Legislation Cut Taxes By $662 Billion, Mostly For The Wealthy.
According to Vox, "The House bill would also cut taxes by $662
billion over the next decade, according to a separate analysis
released Wednesday by the Joint Committee on Taxation, mostly by
repealing Obamacare taxes on the wealthy and health care
industries." [Vox,
5/24/17]
Legislation Would Reduce The Deficit By $119 Billion Over Ten
Years. According to NPR, "The $119 billion deficit reduction
represents a decline from previous versions. When the CBO first
scored the AHCA, it said the plan would save $337 billion over 10
years. Later revisions reduced those savings to $150 billion. By
far the biggest savings would come from Medicaid, which serves
low-income Americans. That program would face $884 billion in cuts.
Cutbacks in subsidies for individual health insurance would likewise
help cut $276 billion. But those are offset in large part by bigger
costs, including the repeal of many of Obamacare's taxes. Those tax
cuts would overwhelmingly benefit the highest-income Americans, the
Tax Policy Center, a Washington think tank, reported on Wednesday."
[NPR,
5/24/17]
Legislation Repealed The Individual Mandate And Replaced Subsidies
With Tax Credits Worth $2,000 To $4,000 For Health Insurance Based
On Age. According to the New York Times, "The House repeal bill
was approved on May 4 by a vote of 217 to 213, with no support from
Democrats. It would eliminate tax penalties for people who go
without health insurance and roll back state-by-state expansions of
Medicaid, which have provided coverage to millions of low-income
people. And in place of government-subsidized insurance policies
offered exclusively on the Affordable Care Act's marketplaces, the
bill would offer tax credits of $2,000 to $4,000 a year, depending
on age. A family could receive up to $14,000 a year in credits. The
credits would be reduced for individuals making more than $75,000 a
year and families making more than $150,000." [New York Times,
5/24/17]
Legislation Replaced The Individual Mandate With A Potential 12
Month 30 Percent Premium Surcharge For Those Who Are Without
Coverage For Longer Than 63 Days. According to Vox, "Unlike
Obamacare, the AHCA does not mandate that all Americans be covered
by health insurance or pay a fee. It repeals the individual mandate,
which was one of Obamacare's least popular provisions. Instead, it
has a different way of penalizing people who decide to remain
uninsured: requiring those who don't maintain 'continuous coverage'
to pay a hefty fine when they want to reenter the insurance market.
This continuous coverage policy has shown up a lot in Republican
replacement plans. It was part of Speaker Ryan's A Better Way
proposal and Rep. Tom Price's Empowering Patients First Act. Here's
how it works: If a worker goes straight from insurance at work to
her own policy, her insurer has to charge her a standard rate --- it
can't take the cost of her condition into account. But if said
worker had a lapse in coverage longer than 63 days --- perhaps she
couldn't afford a new plan between jobs --- and went to the
individual market later, insurers could charge her a 30 percent
premium surcharge. She would need to pay that higher premium for a
full year before returning to the standard rate." [Vox,
5/4/17]
Legislation Would Allow Insurance Companies Charge Five Times,
Instead Of Three Times, The Insurance Rate For Older Americans
Compared To Younger Americans. According to CBO, "Relaxing the
current-law requirement that prevents insurers from charging older
people premiums that are more than three times larger than the
premiums charged younger people in the nongroup and small-group
markets. Unless a state sets a different limit, H.R. 1628 would
allow insurers to charge older people five times more than younger
ones beginning in 2018." [CBO,
5/24/17]
Legislation Would Prohibited Funding To Planned Parenthood.
According to Congressional Quarterly, "It would, in 2020, convert
Medicaid into a capped entitlement that would provide fixed federal
payments to states and end additional federal funding for the 2010
law's joint federal-state Medicaid expansion. It would prohibit
federal funding to any entity, such as Planned Parenthood, that
performs abortions and receives more than $350 million a year in
Medicaid funds." [Congressional Quarterly,
5/4/17]
Legislation Repealed Cost-Sharing Subsidies In 2020. According
to the Kaiser Family Foundation, "ACA cost sharing subsidies are
repealed effective January 1, 2020." [Kaiser Family Foundation,
5/17]
Legislation Repealed A Ten Percent Tax On Tanning Services.
According to CNN, "The replacement health care plan proposed by
Republicans would eliminate a 10% tax on indoor tanning services.
The tax was introduced in 2010 as part of the Affordable Care Act.
If the Republican plan becomes law, the tax will be phased out at
the end of this year." [CNN,
3/7/17]
Legislation Repealed A Limitation On How Much Insurance Companies
Can Deduct Executive Pay As A Business Expense. According to CNBC,
"The proposed tax break, buried in cryptic language in the
Republican plan, would allow health insurers to more fully deduct
the value of their executives' compensation on their taxes. That
compensation can be as high as tens of millions of dollars, in the
case of CEOs of insurers. Those deductions currently are sharply
limited by the Affordable Care Act, which caps at a maximum of
$500,000 the amount of an individual executive's compensation that
an insurer could deduct as a business expense. The cap applies to
any executive, not just to CEOs." [CNBC,
3/8/17]
LA Times: The Legislation "Encourage[d] Health Insurance
Companies To Pay Their Top Executives More." According to the Los
Angeles Times, "Concealed within the 123 pages of legislative
verbiage and dense boilerplate of the House Republican bill
repealing the Affordable Care Act are not a few hard-to-find
nuggets. Here's one crying out for exposure: The bill encourages
health insurance companies to pay their top executives more. It does
so by removing the ACA's limit on corporate tax deductions for
executive pay." [Los Angeles Times,
3/7/17]
CBO Estimated That Repealing The Health Insurance Executive Tax
Limitation Would Reduce Revenue By $500 Million Over Ten Years.
[CBO,
5/24/17]
The House Voted On The Legislation Without Receiving An Updated
CBO Score. According to The Hill, "House Republicans are once
again fast-tracking consideration of their ObamaCare replacement
bill without knowing the full impact of the legislation they'll vote
on Thursday. The nonpartisan Congressional Budget Office (CBO) is
not expected to have completed its analysis detailing the effects of
the latest changes to the legislation overhauling the nation's
healthcare system in time for the Thursday vote. Leadership's
decision to press ahead with the floor action means lawmakers will
be voting on the bill without updated figures from their nonpartisan
scorekeeper on how many people would lose coverage under the bill or
how much it would cost." [The Hill,
5/3/17]
2017: Fitzpatrick Voted To Require Applicants To Provide A Social
Security Number. In June 2017, Fitzpatrick voted for legislation that
would have, according to Congressional Quarterly, "amend[ed] both
current law and the American Health Care Act (AHCA; HR 1628) passed by
the House on May 4 to prohibit the advance payment of health care
premium tax credits to individuals unless the Treasury receives
confirmation from the Health and Human Services Department that the
individuals' status as citizens or lawfully present aliens has been
verified. The process to verify an individual's status must [have]
include[d] the use of information related to citizenship or
immigration status, such as Social Security numbers. The measure [would
have made] verification of an individual's status mandatory for the
current law's premium tax credit and, contingent on enactment of the
AHCA, makes verification for the new tax credit under AHCA mandatory
after 2017." The vote was on passage. The House passed the bill by a
vote of 238 to 184. The Senate took no substantive action on the
legislation. [House Vote 306,
6/13/17; Congressional
Quarterly,
6/9/17;
Congressional Actions, H.R.
2581]