Health Care Legislative Roundup: February 2017

February 2017
© 2017 ConnectYourCare. All Rights Reserved.
Health Care Legislative Roundup

2
Legislation to Repeal HSA, FSA Restrictions on OTC
Drug Purchases Introduced in Congress
Consumers would be able to use health savings accounts (HSAs) and
flexible spending accounts (FSAs) to purchase over-the-counter
medications under bipartisan legislation recently introduced by U.S. Rep.
Lynn Jenkins (R-KS) and U.S. Rep. Ron Kind (D-WI).
Individuals who want to use their HSAs or FSAs to pay for such
medications must present a prescription at the time of purchase. The
Restoring Access to Medication Act would repeal a provision of the
Affordable Care Act (ACA) prohibiting OTC medication purchases with
tax-advantaged medical savings accounts.
Senators Pat Roberts (R-KS) and Heidi Heitkamp (D-ND) introduced
companion legislation in the Senate.

3
ConnectYourCare Goes to Washington
With HSAs poised to be a central component of
any ACA replacement plan, ConnectYourCare
spent time on Capitol Hill educating Congressional
Members and staff about the important benefits
these accounts provide to employers and
employees.
ConnectYourCare met with key Congressional
leaders to discuss not only the benefits of HSAs,
FSAs and other tax-advantaged spending
accounts, but also to promote reform measures to
encourage the expansion and adoption of HSAs.
Pictured below, Harrison Stone, Julie
Cowley, and Meredith Cipriano meet with
Congressman Dutch Ruppersberger (D-
MD) in his Washington, D.C. office on
February 1. ConnectYourCare’s Hunt
Valley, MD headquarters are located
within Congressman’s Ruppersberger’s
Congressional District.

4
Senate Committee Advances the Confirmation of
HHS Secretary, but not without Resistance
On Wednesday, February 1, the Senate Finance Committee advanced the
nomination of Rep. Tom Price (R-GA) to serve as Secretary of Health and
Human Services. Although the Committee was scheduled to vote on
Secretary-Nominee Price’s confirmation on Tuesday, Democrats mounted
a boycott of the committee hearing, effectively delaying the committee vote.
Democrats stayed away from the meeting for a second day running, which
under the committee's rules normally would have prevented the votes from
taking place. But Republicans on Wednesday voted to suspend the rule
that had required at least one Democrat to be present for business to be
conducted.
Republican members of the committee, who were all present, then
approved the nominee14-0. Next up, the Secretary-Nominee’s
confirmation will go to the full Senate for a vote in the coming weeks.

5
January Deadline for ACA Repeal Measure Missed,
Republicans Now Looking to March-April
Congressional Republicans are using the budget reconciliation process
to repeal significant parts of the ACA. Weeks ago, both the House and
Senate adopted a resolution charging certain Congressional committees
to produce a repeal measure for consideration by January 27. However,
January 27 came and went without such a measure being advanced,
and now, Republicans estimate a repeal measure to be considered in
March or April.
Technically, the January deadline is not binding in any meaningful
sense. Legislation produced after January 27 is still eligible for
expedited consideration in the Senate as long as it complies with the
reconciliation instructions included in the fiscal year 2017 budget
resolution.
Republicans remain committed to pushing forward a repeal package,
despite the lack of a concrete replacement plan. Leaders of the caucus
continue to emphasize the need to wrap up the health care reform work
quickly, but in a manner that is likely to consist of a step-by-step
approach of smaller bills, rather than one large bill, which they say would
repeat the mistakes of the ACA.

6
Affordable Care Act Repeal Bill
On January 23, four Republican Senators – Senators Bill Cassidy (R-LA), Susan Collins
(R-MN), Shelley Moore Capito (R-WV), and Johnny Isakson (R-GA) – introduced the
Patient Freedom Act of 2017 under which the ACA would be partially repealed and
replaced and each state could choose between three vastly different options:
• Option 1 – A state could elect to keep in place Title I of the ACA, and continue to
receive federal premium tax credits, cost-sharing subsidies, and Medicaid dollars, to
the extent that those subsidies do not exceed the contributions that would have been
made under Option 2.
• Option 2 – A state could elect a new “market-based system” under which the state
could receive funding equal to 95% of federal premium tax credits and cost-sharing
subsidies, as well as the federal match for Medicaid expansion. An electing state
could choose to receive funds in the form of per beneficiary grants or advanceable,
refundable tax credits, with the funds in both cases deposited directly in a “Roth Health
Savings Account” that would be coupled with a high deductible health plan and a basic
pharmacy plan.
• Option 3 – A state could design an alternative solution and regulate insurance market
rules without any federal assistance.

7
Affordable Care Act Repeal Bill, continued
For Options 2 and 3, the proposal would generally repeal the insurance market reforms in Title I of the ACA,
except for the following provisions:
 Prohibitions on annual and lifetime limits;
 Dependent coverage to age 26;
 Prohibition of pre-existing condition exclusions;
 Prohibitions on discrimination based on health status;
 Preventive service coverage requirements;
 ACA section 1557 non-discrimination in health care provisions; and
 Coverage of mental health services and substance use disorders and applicability of mental health parity
rules.
On January 24, Senator Rand Paul (R-KY) also introduced the Obamacare Replacement Act. The bill does
not have any cosponsors, and it is unclear at this point whether it will move forward, although it does contain
many of the elements long called for by Republicans in the area of health care reform. Senator Paul has
touted the bill as being ready for an immediate vote after the ACA is repealed.
The Obamacare Replacement Act has three main objects: (i) increasing consumer choice by permitting less
comprehensive coverage; (ii) permitting unlimited amounts to be saved in HSAs and allowing increased
options for using those funds; (iii) expanding Association Health Plans (“AHPs”); and (iv) encouraging the sale
of insurance across state lines. Among other aspects, the legislation proposes to expand HSAs by authorizing
a tax credit (up to $5,000 per taxpayer) for individuals and families that contribute to HSAs; removing the
annual cap on HSAs so individuals can make unlimited contributions; and allowing HSA funds to be used to
purchase insurance, cover premiums, and OTC drugs, dietary supplements, nutrition and physical exercise
expenses, and direct primary care.

8
No Action by President Trump to Halt the DOL’s
Fiduciary Rule, Yet
Nearly two weeks after President Trump was sworn into office, the
Department of Justice continues to defend the Department of Labor’s
Fiduciary Rules in a lawsuit filed in a Texas federal court. While many in
the investment or financial services industry have speculated that a
Trump Administration would abandon the Rule in court, and eventually
repeal the regulation, President Trump has yet to indicate his posture on
the Rule which has an April 2017 deadline for compliance.
But across the Mall, some Republicans are not waiting on the White
House to take action. Congressman Joe Wilson (R-SC) introduced the
Protecting American Families’ Retirement Advice Act which would
provide a two-year delay of the Fiduciary Rule. Rep. Wilson noted that
his legislation would “delay the implementation of this job-destroying rule,
giving Congress and President-elect Donald Trump adequate time to re-
evaluate this harmful regulation.”

9
Series of Executive Orders Impose Regulatory
Uncertainties
President Trump on January 30, 2017, signed an executive order that will
seek to dramatically pare back federal regulations. The executive order
includes a provision that requires agencies to cut two existing regulations
for every new regulation introduced.
On January 20, the White House issued a memorandum to the heads of
executive departments and agencies describing a “regulatory freeze”
process under which, subject to limited exceptions, no regulations are to
be submitted to the Office of the Federal Register until they have been
reviewed and approved by an appointee or designee of President Trump.
The memo also orders certain regulations that have been filed with OFR,
but not yet published, to be withdrawn.

10© 2016 ConnectYourCare. All Rights Reserved.
Attend Our Webinar for the Latest News
Join Harrison Stone, ConnectYourCare’s Chief Counsel, on Thursday,
February 23, 2017 at 1PM EST for the first informative webinar in our
Legislative Landscape 2017 Series, in which he'll highlight the key
health care legislative updates you need to watch for in 2017.

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Health Care Legislative Roundup: February 2017

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