Yesterday, David Hoppe, former Chief of Staff to House Speaker Paul Ryan, provided some valuable insight on the heels of President Donald Trump’s speech to a Joint Session of Congress. This one hour call covered a range of topics including tax reform, financial services regulatory reform, immigration reform and ACA repeal through reconciliation, the last of those things being critical to the success of all others.
In other words, like it not, for the next few months, people that care about tax reform, immigration reform and financial services reform – which is virtually everyone - care about ACA repeal.
Key Takeaways:
- This year’s priorities are repeal of the ACA and tax reform and because budget reconciliation is the vehicle for making both happen they need to occur in a certain order – ACA repeal as part of FY 2017 budget reconciliation and tax reform as part of FY 2018 budget reconciliation.
- Complicating things is the Senate’s schedule. They are wrapping up confirmations and need to take up about 10 Congressional Review Act bills that roll back Obama Administration regulations. They also need to confirm President Trump’s SCOTUS nominee, Judge Neil Gorsuch.
- Timing is critical. House must pass a bill by third week in March so Senate can take it up before the Easter/Passover recess which begins April 7th. If the House does not act by third week in March, then Senate will not be able to take up ACA repeal/FY 2017 reconciliation until May.
- Repeal of ACA is a top priority for Republicans more so than immigration and tax reform because they have been promising it to their constituents for seven years.
- With President Trump taking the lead on health care in his speech on Tuesday night, he has signaled that the repeal and replace plan of leadership is the Administration’s plan. That plan will use larger and more flexible HSAs and refundable, advance-able tax credits, protect people with pre-existing conditions, give states more flexibility to manage Medicaid programs, implement medical malpractice reform and allow insurers to sell plans across state lines.
- Once the ACA repeal is effectuated through FY 2017 reconciliation, the House can take up tax reform as part of FY 2018 reconciliation.
- The big question on tax reform is whether or not it will be revenue neutral. Key to making it revenue neutral is the Border Adjustment Tax (BAT).
- House Republican Leadership believes that the BAT is the right policy and they believe it is necessary for making tax reform revenue neutral.
- The House may move on financial regulation reform in the next couple of months but Senate will probably not take it up until September - or even later.
- One of the key issues for financial regulation reform is the Durbin Amendment
- The major opening in Trump’s speech was with immigration reform when he introduced the idea of a merit based system which may occur once the issue of border security is settled.
We encourage you to listen to the whole call for the rich detail it provides. You can listen to the call here.
As always, we are here to answer questions.
Emily Evans
Managing Director
Health Policy
@HedgeyeEEvans
