House passes bills to protect ACA, including requiring study of state-based health exchanges like N.J.’s

By Anjalee Khemlani
Washington, D.C. | May 17, 2019 at 11:12 am

The U.S. House of Representatives passed bills late Thursday night that would protect Affordable Care Act provisions that have recently been threatened or stripped by President Donald Trump’s administration, as well as promote greater generic drug use.

The bills include the following provisions and amendments:

  • Require the U.S. Department of Health and Human Services to provide outreach and education about federal health insurance exchanges in a variety of languages, extra focus on expanding navigators and outreach in vulnerable populations, including veterans and high health risk regions, set annual enrollment targets, provide annual reports on spending on outreach and enrollment;
  • Prohibit the HHS secretary from ending autoenrollment each year for existing exchange enrollees, and from restricting the practice of insurers adding surcharges to silver-level plans, which in turn boosts subsidies for individuals 400% below the poverty line;
  • Require biweekly public reports on the status of the health insurance enrollment period;
  • Require the Government Accountability Office to do two studies, one on the effects of the administration’s cuts to ACA outreach and navigator efforts on the cost of coverage, and the other on the effects of state-based health exchanges (like the one recently set up in New Jersey);
  • Extend federal assistance for state-based exchanges to 2023 and extend the requirement that state-based exchanges be self-sustaining by 2025;
  • Require HHS to submit a report analyzing how harmful the cost increases of commonly used drugs have been to those who forgo treatment as a result;
  • Direct HHS, the Department of Labor and Department of Education to do outreach to higher education institutions about promoting awareness of use and availability of generic drugs;
  • Commission the National Academy of Medicine to conduct a study of the amount of federal funding and research used in developing drugs by pharmaceutical companies;
  • Require drug companies to provide samples to generic manufacturers.

All 12 representatives from New Jersey voted for the measures in the MORE Health Education Act.

Rep. Andy Kim (D-N.J.) has received some credit for including the provisions, through a bipartisan effort, that address state-based exchanges.

“This is the No. 1 issue on people’s minds in Burlington and Ocean Counties,” he said. “We came together as a Democrat and Republican to introduce this legislation and worked to get it passed. The Senate should look to our example and do the same. Our neighbors don’t have time for partisan games. The time is now to act on lowering health care costs.”

The provision to boost navigators and outreach will reverse the trend of insurers and health care providers picking up the slack from reduced funding in the last few years.

Between 2016 and 2018, federal navigator funding in New Jersey dropped 79 percent — from $1.9 million to $400,000, according to the Kaiser Family Foundation.

“Americans elected the new House to provide a careful balance of oversight combined with an aggressively positive agenda,” said Rep. Bill Pascrell (D-N.J.).

“With today’s vote, the House is fighting back against Donald Trump and Republicans’ repeated attempts to destroy the ACA and weaken health care for millions. Furthermore, for too long, Americans and their families strangled by high drug prices have cried out for their elected leaders to lower prices. Our legislation delivers reforms to ease that burden.”

Rep. Mikie Sherrill (D-N.J.) said people continue to buy drugs from outside the country because of the high cost.

“When sick, the ability to afford a prescription — or whether your plan offers the coverage you need — should be the last thing on your mind,” she said.

“This bill takes credible steps to improve our health care system and restore critical funding to help New Jersey families sign up for the health care plan that best represents the needs of our families.”

The measures must next be voted on in the Senate.

“There is broad, bipartisan support for efforts to increase the availability of generic drugs by increasing competition — and I’m relieved we voted to advance these common sense proposals,” said Rep. Donald Norcross (D-N.J.).

“Plus, we’re proactively making fixes to help keep premiums low and the number of uninsured Americans down. I strongly urge the Senate to put partisan politics aside and vote for these measures that help save lives.”

Anjalee Khemlani | akhemlani@roi-nj.com | AnjKhem