Healthcare Reform

House bill may provide insight into coverage priorities if White House and Senate flip in November’s election

June 18, 2020 2:22 pm
  • The House will vote the week of June 29 on a bill aimed at improving the Affordable Care Act (ACA), House Majority Leader Steny Hoyer (D-Md.) said [June 11, 2020], according to an article in The Hill
  • Hoyer said the measure would help improve the affordability of plans under the law, according to The Hill
  • The legislation is more of a messaging bill and might offer a preview of healthcare legislation that might be advanced if Vice-President Biden wins the White House, the Democrats retain the House and the Senate were to flip, according to HFMA’s Chad Mulvany.

The Hill is reporting: “The House will vote the week of June 29 on a bill aimed at improving the Affordable Care Act (ACA), House Majority Leader Steny Hoyer (D-Md.) said [June 11, 2020]. Hoyer said the measure would help improve the affordability of plans under the law. The exact details of the measure are not yet clear, though sources said the bill will increase the subsidies that help people afford premiums, as well as other items aimed at strengthening the law. The measure is not likely to go anywhere in the Senate, given the Republican opposition to the ACA.” 

Takeaway

The legislation is more of a messaging bill and might offer a preview of healthcare legislation that might be advanced if Vice-President Biden wins the White House, the Democrats retain the House and the Senate were to flip.

Right now, polling and the electoral college (EC) map seem to favor Biden (232 EC votes projected compared to President Trump’s 204, with 102 rated as “toss-up”). Nationally, Biden has an 8-point lead.

  • However, that lead narrows in key swing states:
  • Michigan – 16 EC votes +7 Biden
  • Wisconsin – 10 EC votes, +4 Biden
  • Florida – 29 EC votes, Pennsylvania – 20 EC votes, Arizona – 11 EC votes, with all three states +3 Biden
  • North Carolina – 15 EC votes, dead-heat

However, this is probably worth taking a with a grain of salt given the predictability of polls in the last presidential election. And given the high degree of uncertainty currently in many Americans’ day-to-day lives, I’m not sure any margin is safe.

The path to flipping the Senate is, at this moment, far more challenging for Democrats. Of the 35 Senate seats, it’s projected the incumbent party will retain 31 one of them after election night. Of the four rated as a toss-up, one is held by a Democrat (Doug Jones, Alabama) and three are held by Republicans (Susan Collins, Maine; Corey Gardner, Colorado; Martha McSally, Arizona).

Assuming all states break as projected, the best-case scenario for Democrats is to come out of election night with a 50-50 split of the senate (requires they hold Alabama and pick up the three toss-up states currently held by Republicans). At that point, they could pass a package of tweaks to the ACA with the Vice-President (assuming Biden wins) casting the deciding vote that is narrowly tailored to move under budget reconciliation instructions. This would allow legislation to be passed with only 51 votes in the senate instead of the normal 60 vote majority.  That’s an unlikely scenario; so regardless of who wins the White House in November, we may be facing more gridlock in Congress.

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