The House of Representatives passed the Patient Protection and Affordable Care Enhancement Act (H.R. 1425) by a roll call vote (234-179). As noted in our prior summary of the bill (here), the legislation would bolster health care coverage, incentivize Medicaid expansion, and lower prescription drug prices through direct government negotiation. The Republican-controlled Senate is not expected to take up H.R. 1425, but it will likely serve as a messaging bill heading into the November 2020 elections.
In addition, Democratic health leaders continue to call on the Trump Administration to offer a special enrollment period (SEP) to allow uninsured individuals to enroll in coverage. Their most recent push follows the release of the special trends report by the Centers for Medicare and Medicaid Services (CMS) on enrollment data for health insurance exchanges that use the HealthCare.gov platform.
CMS reports that approximately 487,000 consumers gained coverage through the ‘loss of minimum essential coverage’ SEP through May, a 46 percent increase from the same time period last year. Notably, the agency notes a lack of clarity regarding the impact of COVID-19 job losses on the use of HealthCare.gov.
Overall, due to a combination of factors including expectations of eventually returning to work, employers’ ongoing contributions to their furloughed or laid-off employees’ health insurance premiums during the public health emergency, COBRA continuation coverage through their former employer, and access to other coverage such as through a spouse, it remains unclear how many people will eventually look to Exchanges using HealthCare.gov to replace job-based coverage.
Passage of H.R. 1425 follows the Trump Administration’s renewed effort to repeal the Affordable Care Act (ACA). Last week, the Department of Justice filed a brief reaffirming its position that the ACA is illegal in its entirety due to its argument that the law is inseverable from the individual mandate, echoing the sentiments expressed in the latest court case against the ACA (original WHG analysis here). Its reasoning draws on the supposition that “the ACA’s interlocking web of provisions cannot function as Congress intended absent” the individual mandate, along with the guaranteed-issue and community-rating provisions.
The resurgence of this issue comes just months before the November 2020 election, positioning the fate of the ACA again as a major health care issue for the upcoming presidential debates. As for timing, the Supreme Court will begin again hearing oral arguments on October 5 of this year, meaning we may see meaningful action later this fall. Still, many suggest we may not have a final decision on the case until spring 2021, as the Supreme Court typically rules on its most controversial decisions at the end of a term