The draft Resolution has been reviewed by staff in the Health Services Department. They have provided input to the draft Resolution, which is included as Attachment A. Pending input and action by the Legislation Committee, a final draft Resolution may be prepared for the Board of Supervisors' September 19, 2017 agenda.
As additional background, Joe Krahn, the president and managing partner of Waterman & Associates, CSAC’s lobbying firm in Washington D.C. provided the following update on the status of the ACA:
"Senate Majority Leader Mitch McConnell’s (R-KY) effort to bring an Affordable Care Act (ACA) repeal and replacement bill to the floor collapsed in July in the face of opposition from several members of his own party. The development marked a stunning setback – and a potentially fatal blow – for Republicans in their seven-year quest to overturn President Obama’s signature domestic achievement. The continued legislative uncertainty also raises serious questions regarding the long-term future of the American healthcare system.
Shortly after McConnell’s admission that he lacked the votes to proceed to the legislation, President Trump took to Twitter to say that Republicans should simply repeal the ACA and work on a long-term plan – with Democrats – to replace Obamacare. Incidentally, the majority leader endorsed the president’s recommendation in announcing his intention to bring up a bill to repeal the ACA in two years, with a subsequent measure drafted to address health coverage and access. That effort, however, was also doomed as three Republican senators – Shelley Moore Capito, (WV), Susan Collins (ME), and Lisa Murkowski (AK) – all declared that they would oppose a procedural motion to begin debate on a repeal-only bill.
Looking ahead, it remains uncertain whether Republicans will be able to jumpstart a renewed healthcare reform discussion. In the continued absence of achieving critical mass within their own party ranks, Republicans would need to rely on Democrats to come to the table, perhaps to discuss improvements to the existing system, as was suggested by Senate Minority Leader Chuck Schumer (D-NY).
Another potential dynamic is President Trump’s ability to dictate significant changes in the operation of the current healthcare system. For starters, the president has continually threatened to withhold billions of dollars in cost-sharing reduction payments, which are provided to insurance companies in exchange for reducing deductibles for low-income customers. In response to the prospect of such a move, insurers have raised healthcare premiums for 2018 and may pull out of additional markets if the federal payments are ultimately eliminated."
Subsequent to that report, the White House announced in August that the Administration would make the August cost-sharing reduction (CSR) payments, a point of contention in the continued conversation about the ACA repeal efforts. CSRs are payments to insurance plans to help subsidize the costs of people who purchase insurance plans through the marketplaces. The president threatened to withhold the August CSR payments after attempts to repeal the ACA stalled in the Senate in July.
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