The Biggest Health Care Winners in the Tax and Omnibus Deal

The package includes funding for NIH and 9/11 responders, and it delays the “Cadillac tax” on pricey health plans.

Comedian Jon Stewart stands with New York City first-responders during a rally on Capitol Hill in Washington, September 16, 2015.
AP Photo/Lauren Victoria Burke
Rachel Roubein
Add to Briefcase
Rachel Roubein
Dec. 16, 2015, 7:17 a.m.

The $1.1 tril­lion spend­ing bill and tax-ex­tenders pack­age un­veiled Tues­day and early Wed­nes­day morn­ing is the fi­nale to weeks of lob­by­ing and spec­u­la­tion on a host of is­sues—par­tic­u­larly health care. There are some big win­ners in the year­end bills, in­clud­ing 9/11 first-re­spon­ders and sur­viv­ors, “Ca­dillac tax” op­pon­ents, and pos­sibly Sen. Marco Ru­bio. Here’s a closer look:

Za­d­roga Act

The om­ni­bus funds the pro­gram provid­ing health be­ne­fits for 9/11 first-re­spon­ders and sur­viv­ors sickened by tox­ic air at the at­tack site through 2090. Also, it reau­thor­izes the Vic­tim Com­pens­a­tion Fund for five years.

Re­new­ing the le­gis­la­tion, known as the Za­d­roga Act, was the cen­ter of a massive lob­by­ing ef­fort in­volving, for one group, at least 22 trips to Wash­ing­ton (with crews of any­where from 12 to 50 people) and an es­tim­ated 600 meet­ings for John Feal, pres­id­ent and founder of the 9/11 ad­vo­cacy group Feal­Good Found­a­tion. It’d been the sub­ject of ral­lies, press con­fer­ences, and a seg­ment on The Daily Show, fea­tur­ing a power­ful ad­voc­ate for the bill, Jon Stew­art.

“We’ve met with some mem­bers of the Sen­ate and Con­gress four, five, six times,” Feal told Na­tion­al Journ­al after a press con­fer­ence last week. “Every time we got close, they move the goal­post back on us. Every time we got to the one-yard line, they just kept mov­ing it back, and this time they can’t go nowhere. We’re con­fid­ent we’re go­ing to get it done.” Feal was right.

Obama­care taxes

Re­peal­ing the Ca­dillac tax levied on pricey em­ploy­er-sponsored health cov­er­age has net­ted bi­par­tis­an and bicam­er­al sup­port—and law­makers look­ing to in­clude a two-year delay of the Ca­dillac tax in an om­ni­bus bill got their wish.

Ori­gin­ally slated to start in 2018, the Ca­dillac tax has seen both Demo­crats and Re­pub­lic­ans op­pos­ing the meas­ure. For ex­ample, an amend­ment to re­peal the tax eas­ily passed the Sen­ate in a 90-to-10 vote earli­er this month (though it was tacked onto a re­con­cili­ation bill, which Obama won’t sign). But as re­cently as last Wed­nes­day, White House Press Sec­ret­ary Josh Earn­est said the ad­min­is­tra­tion strongly op­poses re­peal­ing the Ca­dillac tax.

Sen. Mark Warner’s wor­ries on the Ca­dillac tax fo­cus on mak­ing sure the fin­an­cing re­mains to sup­port the pricey parts of the law, such as Medi­caid ex­pan­sion. “In a state like mine, where we haven’t ex­pan­ded Medi­caid, … you give a lot of fod­der if you start tak­ing away the pay-fors,” the Vir­gin­ia Demo­crat told Na­tion­al Journ­al earli­er this month.

Ad­di­tion­ally, the tax-ex­tenders deal in­cludes a two-year morator­i­um on the med­ic­al-device tax, and the om­ni­bus con­tains a one-year morator­i­um on the an­nu­al ex­cise tax on health in­surers for 2017.

Risk cor­ridors

The risk-cor­ridor pro­gram will again be han­di­capped if the om­ni­bus passes and is signed in­to law as stands, as a pro­vi­sion stuck in last year’s bill was again in­cluded.

Risk cor­ridors com­pensate in­sur­ance com­pan­ies that sign up sick­er pa­tients than they an­ti­cip­ated and, in turn, are faced with hefty costs. In part, this is be­cause the Af­ford­able Care Act con­tains pri­cing re­stric­tions—such as ban­ning in­surers from char­ging more based on a con­sumer’s med­ic­al his­tory. So some com­pan­ies are re­quired to pay in­to the risk-cor­ridors pro­gram, and oth­ers can col­lect.

Re­pub­lic­ans view this as a bail­out for in­sur­ance com­pan­ies. Last year’s crom­ni­bus con­tained re­stric­tions for the pro­gram, which is slated to last un­til 2016. And in Oc­to­ber, the Cen­ters for Medi­care and Medi­caid Ser­vices an­nounced it would be dol­ing out only a frac­tion of what in­sur­ance com­pan­ies asked for: $362 mil­lion of the $2.87 bil­lion in in­sur­ance claims.

Sen. Marco Ru­bio’s cam­paign is tout­ing last year’s risk cor­ridors re­stric­tions as a Ru­bio vic­tory. A tweet last week from Ru­bio’s ac­count read: “Every­one run­ning wants to dis­mantle Obama­care. I’ve ac­tu­ally done something to­ward achiev­ing that goal,” link­ing to a post on his site with a New York Times story titled, “Marco Ru­bio Quietly Un­der­mines Af­ford­able Care Act.”

But an As­so­ci­ated Press story has a dif­fer­ent take. It looks at last year’s crom­ni­bus ne­go­ti­ations, say­ing that al­though Ru­bio was one of the first law­makers to rail against risk cor­ridors, he wasn’t solely or ne­ces­sar­ily the one re­spons­ible for last year’s deal.

A sum­mary of the om­ni­bus bill praises last year’s bill for be­ing “able to save over $2.5 bil­lion from po­ten­tially be­ing trans­ferred out of pri­or­ity dis­cre­tion­ary HHS pro­grams fund­ing in the Labor/HHS ap­pro­pri­ations bill to bail­out the Risk Cor­ridor pro­gram es­tab­lished by the Af­ford­able Care Act.”

Na­tion­al In­sti­tutes of Health

The na­tion’s med­ic­al-re­search agency could see the largest boost in fund­ing since fisc­al 2003 with the in­clu­sion of a $2 bil­lion in­crease in funds.

While fund­ing NIH isn’t gen­er­ally con­ten­tious, how much the agency re­ceives comes down to Con­gress’s pri­or­it­ies. Over the course of five years, Con­gress doubled NIH’s fund­ing to $27.1 bil­lion in fisc­al year 2003, ac­cord­ing to the Con­gres­sion­al Re­search Ser­vice. But fund­ing hasn’t in­creased at the same pace since, and some Demo­crats and Re­pub­lic­ans alike had called for that to change, a call that was answered in the om­ni­bus bill with NIH slated to re­ceive $32 bil­lion.

What We're Following See More »
19 FACE-TO-FACE MEETINGS
Latest Count: 12 Trump Campaign Staffers Had Contact with Russians
19 hours ago
THE LATEST
AT ISSUE: COMEY FIRING, SESSIONS’S RECUSAL
Mueller Seeks Documents from DOJ
3 days ago
THE LATEST

Special counsel Robert Mueller "is now demanding documents from the department overseeing his investigation." A source tells ABC News that "Mueller's investigators are keen to obtain emails related to the firing of FBI Director James Comey and the earlier decision of Attorney General Jeff Sessions to recuse himself from the entire matter."

Source:
MULVANEY SAYS PROVISION ISN’T A DEALBREAKER
Trump May Be OK with Dropping Mandate Repeal
3 days ago
THE LATEST

"President Donald Trump would not insist on including repeal of an Obama-era health insurance mandate in a bill intended to enact the biggest overhaul of the tax code since the 1980s, a senior White House aide said on Sunday. The version of tax legislation put forward by Senate Republican leaders would remove a requirement in former President Barack Obama’s signature healthcare law that taxes Americans who decline to buy health insurance."

Source:
FRANKEN JUST THE BEGINNING?
Media Devoting More Resources to Lawmakers’ Sexual Misconduct
3 days ago
THE LATEST

"Members of Congress with histories of mistreating women should be extremely nervous. Major outlets, including CNN, are dedicating substantial newsroom resources to investigating sexual harassment allegations against numerous lawmakers. A Republican source told me he's gotten calls from well-known D.C. reporters who are gathering stories about sleazy members."

Source:
STARTS LEGAL FUND FOR WH STAFF
Trump to Begin Covering His Own Legal Bills
5 days ago
THE DETAILS
×
×

Welcome to National Journal!

You are currently accessing National Journal from IP access. Please login to access this feature. If you have any questions, please contact your Dedicated Advisor.

Login