Blog Post

The GOP response: 3 takeaways for the health care industry

January 21, 2015

    Clare Rizer, The Daily Briefing

    "I'd like to have a conversation about the new Republican Congress you just elected, and how we plan to make Washington focus on your concerns again," Sen. Joni Ernst (R-Iowa) said in the 45th official response to the State of the Union address last night.

    From its opening moments, this year's Republican reply was about setting an agenda—not reacting to the president's. "Rather than respond to a speech, I’d like to talk about your priorities," the freshman senator said.

    See our takeaways from Obama's sixth State of the Union

    And while her response only lasted about 10 minutes, Ernst was able to hit on some key issues that could affect the health care industry (and beyond) in the coming months—especially given the new Republican majority in both chambers of Congress.

    1. 'Repeal and replace' the ACA.

    Ernst addressed the Republican commitment to "fighting to repeal and replace" the Affordable Care Act (ACA), which she called "a health care law that's hurt so many hardworking families." That commitment is far from surprising: the House GOP has already voted more than 50 times to repeal or alter the law.

    Ernst did not specify the kind of changes the party might make to the law or outline an alternative health reform plan. But it is likely that Congress will consider changing or eliminating provisions like the medical device tax or the 30-hour workweek trigger for employer coverage.

    In fact, the House voted just last week to approve legislation that would waive penalties for companies that do not offer health coverage to employees working fewer than 40 hours per week. Senate Majority Leader Mitch McConnell (R-Kentucky) has promised the bill will see a vote on the Senate floor as well, but the White House has vowed to veto the legislation.

    Meanwhile, Sen. Orrin Hatch (R-Utah) and Rep. Erik Paulsen (R-Minnesota) this month introduced legislation to repeal the medical device tax. There's a chance for compromise: Sens. Elizabeth Warren (D-Massachusetts) and Al Franken (D-Minnesota) are among the prominent Democrats that support efforts to end the tax.

    It is also possible that the Republican-controlled Congress may also seek changes to the individual and employer mandates, which are not popular with voters. The House this month voted 412-0 to approve a bill that would exempt veterans with health plans through the Departments of Defense or Veterans Affairs from being counted under the employer mandate.

    2. Improving care for veterans.

    Ernst also discussed the need for continued improvement to health care for veterans after a year of controversy over wait times in the VA health system that led to the resignation of the Secretary of Veterans Affairs.

    3. The battle over abortion rights

    Near the close of her speech, Ernst also made a mention of the importance of "defend[ing] life," stating that "protecting the most vulnerable is an important measure of any society."

    The mention is timely, as the House is expected to vote on a measure that would allow abortions after 20 weeks only in certain cases of rape and incest or endangerment to a woman's life. The vote is scheduled for Thursday, the anniversary of the Supreme Court's Roe v. Wade decision.

    McConnell has said he plans to hold a vote on a 20-week abortion ban in the Senate sometime in the coming weeks, according to aides and Republican senators. However, Obama has promised to veto the bill.

    The takeaway: Ernst outlined the Republican health care agenda for the next year, which includes promises to "keep fighting to repeal and replace a health care law that’s hurt so many hardworking families" and efforts to limit abortion access.

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