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Affordable Care Act Tweak Headed to Obama's Desk

By Melissa Attias, CQ Roll Call

October 2, 2015 -- The Senate quietly cleared legislation Thursday that would amend President Barack Obama's signature health care law to keep midsized employers from having to comply with more stringent insurance coverage requirements, marking one of the relatively few times that Congress has acted on a bipartisan basis to send changes to the overhaul to Obama.

The bill (HR 1624), while a modest change, is a reminder that Congress is occasionally capable of clearing legislation that addresses issues even as controversial as the Affordable Care Act and could possibly signal some willingness among both parties to make fixes.

The Senate cleared the measure by voice vote Thursday after the House passed it under an expedited floor process by voice vote Monday—an impressively fast timeline considering the House Energy and Commerce Health Subcommittee held its hearing on the bill last month. A White House spokeswoman said Obama will sign the bill.

The measure "is a smart health care bill aimed at protecting workers' benefits, lowering premiums and reducing costs to taxpayers," Senate Majority Leader Mitch McConnell, R-Ky., said after clearing the bill.

South Carolina Republican Tim Scott, who sponsored the Senate version (S 1099), also praised McConnell for the quick path to the Senate floor.

"So often we hear in America that we can't get things done in the United States Senate," he said. "Because of your leadership, Sen. McConnell, and because of the good work of Congressman Guthrie on the House side and Sen. Shaheen, we see that we're going to have an opportunity to make sure that small business owners all across America are not more negatively impacted by Obamacare."

Jeanne Shaheen of New Hampshire, the Senate bill's lead Democratic sponsor, also applauded the move in a statement. "While the Affordable Care Act continues to divide Congress, today we've made real progress towards improving this law," she said.

Under the 2010 overhaul, businesses with 51 to 100 workers are categorized as small employers. State regulators, however, have the option of designating them as large employers until 2016, meaning they can offer health coverage through the large group market that does not have to cover specified benefits and meet other requirements that apply to smaller groups.

To prevent midsized employers from being forced to change coverage and possibly absorb premium increases, the bill would automatically place businesses with 51 to 100 workers into the large employer category, while still allowing states to treat them as small employers if they choose.

"Passage of the PACE Act comes at a critical time as health insurance premium rates are being finalized for the upcoming year," Council for Affordable Health Coverage President Joel White, a former House GOP aide, said in a statement praising the measure. "Moreover, employers are already shopping for coverage options and will need to make decisions soon for plans that begin in 2016."

But not everyone was on board. Washington State Insurance Commissioner Mike Kreidler testified against the legislation at the House hearing, saying insurers are counting on an expanded pool of covered people to keep requested premium decreases.

The Small Business Majority advocacy organization, which has defended the law, also wrote to the leaders of the House panel last month urging opposition to the change. The group expressed concern it would hurt small businesses that have been waiting for the small-group health insurance market to grow as scheduled.

"Expanding the small-group market next year will increase the size of the insurance pool, which benefits the healthcare system overall," wrote Founder and CEO John Arensmeyer. "What's more, it will increase the number of lives eligible for the small business health insurance marketplaces, which is good for businesses."

The bill also would put $205 million into a Medicare improvement fund that was cut under the health law.

Other changes to the health overhaul that have been cleared by Congress since enactment include the repeal (PL 112-9) of a provision that required businesses to submit expanded Form 1099 tax reporting of transactions and the elimination of a long-term care insurance program that never took effect (PL 112-240). Congress also tapped a mandatory pool of money in the law for prevention and public health activities as an offset for broader legislation (PL 112-96).

Less than a month after enactment, Congress also cleared legislation (PL 111-159) to clarify that coverage for military families and other groups counts as medical coverage. The health law requires most Americans to be covered or face a penalty.

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