2. Government Affairs Update
Elizabeth P. Hall
Vice President, Federal Affairs

3. Finishing the 112th Congress
9/22/2018
Finishing the 112th Congress
House of Reps: 233 Republicans, 200 Democrats
Senate: 45 Republicans, 53 Democrats, 2 Independents (Caucus with Dems)
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4. Closing out the 112th Congress

5. Closing out the 112th Congress
Finished Business:
Permanent Tax Extenders
Rates for Individuals and Couples with income below $400,000 and $450,000 respectively
Capital Gains
Alternative Minimum Tax
Estate Tax
Other Tax Extenders
Benefits for the long-term unemployed through December 2013

6. Closing out the 112th Congress
Health Related/Medicare Extender Package:
Community Living Assistance Services and Supports (CLASS) program repeal and establishment of Commission on Long Term Care
Consumer Operated and Oriented Plan (CO-OP) program rescission
Medicare Special Needs Plan and Cost Plan extensions  
Medicare Advantage “Coding Intensity Adjustment” increase
Medicare physician payment reimbursement temporary fix (“doc fix”)
Qualifying Individual (QI) program and Transitional Medical Assistance (TMA) program extensions

7. Closing out the 112th Congress
Unfinished Business:
Debt Ceiling Increase*
Sequestration post March 1
Funding the Government…
Hurricane Sandy Recovery**
Immigration Reform
Energy Policy
*subsequently extended through May 19th
**subsequently passed

8. Launching the 113th Congress
9/22/2018
Launching the 113th Congress
House of Reps: 233 Republicans, 200 Democrats
Senate: 45 Republicans, 53 Democrats, 2 Independents (Caucus with Dems)
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9. 113th Congress: Younger & More Diverse
9/22/2018
113th Congress: Younger & More Diverse
The 113th Congress has 12 Freshman Senators and 67 Freshman Representatives
35% of Members in Congress (House and Senate have served less than two terms.
78 Female Members in the House, 20 in the Senate
40 African American Members in House, 1 in Senate
28 Hispanic Members in House, 3 in Senate
7 Openly Gay or Bisexual Members in House and Senate
33 Members under age of 40 in House, 1 in Senate
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10. 113th Congress: Professional Make-Up
9/22/2018
113th Congress: Professional Make-Up
85 Former or Active Military Serving in House, 19 in Senate
54% of House of Representatives is comprised of Businesspeople and Lawyers
29 Medical Professionals
Source: Business Week, 1/10/13
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11. Launching the 113th Congress
9/22/2018
Launching the 113th Congress
Unfinished Business:
Debt Ceiling Increase
Sequestration post March 1
Funding the Government…
Hurricane Sandy Recovery
Immigration Reform
Energy
New Business:
Gun Control/Mental Health
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12. Launching the 113th Congress
9/22/2018
Launching the 113th Congress
Where is Health?
Entitlement Reform
Tax Reform
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13. Launching the 113th Congress
9/22/2018
Launching the 113th Congress
Where is Health?
Entitlement Reform
Tax Reform
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14. Obama Cabinet Staying for a 2nd Term Kathleen Sebelius
Secretary of Health and Human Services
Tom Vilsack
Secretary of Agriculture
Gen. Eric Shinseki
Secretary of Veterans Affairs
Eric Holder
Attorney General
Janet Napolitano
Secretary of Homeland Security
Arne Duncan
Secretary of Education

15. Secretary of Transportation White House Chief of Staff
Obama Cabinet
Moving On
State
Out: Hilary Clinton
In: John Kerry
Ray LaHood
Secretary of Transportation
Treasury
Out: Tim Geithner
In: Jack Lew
White House Chief of Staff
Out: Jack Lew
In: Denis McDonough
Defense
Out: Leon Panetta
In: Chuck Hagel
Dr. Steven Chu
Secretary of Energy

16. Policy & Advocacy Priorities
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17. Policy & Advocacy Priorities
ACA Implementation
Access
Affordability
Telehealth

18. Policy & Advocacy Priorities
Regulations Released Since November:
“Market Reform”
Essential Health Benefits
More Exchange Guidance (FFE, MSP, etc.)
3Rs Guidance
PCORI (Comparative Effectiveness Fee)
Wellness Programs
Actuarial Value
Employer Mandate
Individual Mandate
Regulations Still Needed:
Cost-Sharing Reductions
Mental Health Parity Final Rules
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19. Policy & Advocacy Priorities
Remaining Guidance on Employer Requirements (as of Jan. 14, 2013):
Employer notice of Exchanges (ACA Section 1512)
Reporting on health coverage quality, including improved outcomes and wellness activities, to IRS and participants (PHSA Section 2717)
Final reporting requirements to IRS and participants (ACA Section 1514, IRC Section 6056)
Nondiscrimination (classing) of coverage (ACA Section 2716)
Protections for employees (ACA Section 1558)
Auto-enrollment (ACA Section 1511)
90 day waiting period limit (PHSA Section 2708)
High cost plan tax (effective 2018)

20. Exchange Implementation Status
State Exchange: 19
Partnership Exchange: 7
Default to Fed Exchange: 25
Source: Kaiser Family Foundation, 1/30/13
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21. State Intentions on Medicaid Expansion Status
Source: The Advisory Group, 1/30/13
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22. Essential Health Benefits Implementation Status
Source: Kaiser Family Foundation, 1/30/13