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Ahead Of Elections, GOP Readies Vote On Repealing Parts Of Health Law

KHN’s Mary Agnes Carey talks with Jackie Judd about two measures from the health law that the House GOP will attempt to roll back in votes this week. Republicans want votes on repeal now, Carey says, to make an economic argument ahead of elections.

> > Listen to the audio of the interview.

Here’s a transcript:

JACKIE JUDD:  Good day, this is Health On The Hill.  I’m Jackie Judd.

The Republican-led House is expected to vote later this week on two measures in the health law that the GOP wants to repeal. What are they and why now? Here to answer those questions, as always, is Mary Agnes Carey of Kaiser Health News. Welcome back, Mary Agnes.


JACKIE JUDD:  One measure has to do with medical devices; the other: over-the-counter medications.  Give us the details.

MARY AGNES CAREY:  The first one would repeal a 2.3 percent tax that’s supposed to be placed on medical devices, starting next Jan. 1. Here we’re talking about things like artificial hips, artificial knees, stents, medical imaging equipment. They would not be taxing things at the retail level. They would not be taxing hearing aids or eyeglasses, that sort of thing.

The second would lift a requirement in the health law that says if you want to use pre-tax dollars to purchase over-the-counter medications, you’ve  got to have a prescription from your doctor to get that tax break. So the prescription requirement would be lifted.

JACKIE JUDD:  Together these measures would generate an estimated $34 billion over ten years. This has to be what they call on Capitol Hill “revenue neutral.” So where would the Republicans come up with that amount?

MARY AGNES CAREY:  Their “pay-for,” another Capitol Hill term, is going to be something that Democrats are really going to dislike. Here’s what it is: Currently in the health law, in 2014 you can qualify for a subsidy to purchase coverage on the exchanges, which are also created in the health law in 2014.

What this provision would do is say, if you receive a subsidy amount in excess of what you should have received – let’s say you got a promotion, you got a new job, you got a bonus, you received more income – you’ve got to pay back that additional subsidy in its entirety.  Current law basically has that payback on a sliding scale. The more you make, the more you’d be required to pay back if you received too much money.  But this would say, if you received too much, you’ve got to pay the entire amount back.

JACKIE JUDD:  Party-line votes expected on all of this?

MARY AGNES CAREY:  Pretty much. You may get some Democrats in states where medical device manufacturers are very strong voting for this. The medical device industry has been very successful in a campaign to say that this tax is going to kill jobs. Not everybody agrees with that.

But in states like Massachusetts, Minnesota, Indiana and California you may have a lot of Democrats  — actually they’re on record, several, of saying they want to lift it. But when they see that pay-for, that new subsidy recapture, that’s going to give them pause. That’s going to say: that’s going after the health law, and we don’t agree with that.

JACKIE JUDD:  And consumers.


JACKIE JUDD:  Very consumer-oriented. The Supreme Court is expected to rule later this month on the entirety of the federal law. So why are Republicans trying to pick apart pieces of the law now?

MARY AGNES CAREY:  It’s no secret they dislike the law. They’ve tried to repeal the whole thing. They’ve gone after the individual mandate. They’ve gone after the prevention fund. This is yet another in a series of steps. And as you mentioned, with the Supreme Court case in the forefront of many people’s minds, this is a topical time to go after this. But also, Republicans are making the case: This is an economic argument.

As we mentioned, the device industry has said this will kill jobs. Not every analysis agrees with that. But Republicans are saying: We’re about jobs. We want to improve the economy. And that’s why we want to repeal this tax.

JACKIE JUDD:  In the context, of course, of an election year.

MARY AGNES CAREY:  Absolutely.

JACKIE JUDD:  All of this dead on arrival in the Democrat-controlled Senate?

MARY AGNES CAREY:  That is the expectation, of course. It’s Congress, and anything can happen. But as things stand now, it looks like it may not even come for a vote.

JACKIE JUDD:  Thanks so much Mary Agnes Carey of Kaiser Health News.

MARY AGNES CAREY:  Thank you, Jackie.

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The Health Law