What's In? What's Out? Tracking The Health Law Changes And The Budget Talks

After playing a central role in the negotiations, two health law tax provisions -- one related to reinsurance and the other a levy on medical devices -- appear to be off the table as of Wednesday morning. News outlets explained both in stories filed Tuesday night.

Politico: Obscure Obamacare 'Reinsurance' Fee Takes On Big Role In Spending Deal Talks
The Senate’s proposal to end the shutdown and debt stalemate would delay private sector payments to the health care law’s temporary reinsurance program, which is meant to stabilize the new health insurance marketplaces that opened for enrollment Oct. 1. The House counter-proposal doesn’t have it, so its inclusion in any final deal is looking less likely (Millman, 10/15).

CQ HealthBeat: Reinsurance Fee Delay In, Then Out, Of Emerging Senate Deal
Negotiators appear to have removed a provision from the latest deal to lift the debt ceiling and reopen the federal government that would have delayed a fee designed to cushion insurers against early losses in the exchange markets. Lawmakers reportedly were looking at a one-year delay as a way to address union concerns about the impact of the health care law on the health plans they offer to their membership (Reichard, 10/15).

Kaiser Health News: FAQ: The Senate Is Looking At The ACA's 'Reinsurance Tax.' What Is That?
One provision of the Senate's emerging deal to reopen the federal government and extend the federal debt ceiling includes a one-year delay of a tax to help provide relief to insurers which cover large numbers of high-cost medical cases. Here are some frequently asked questions about the health law’s temporary 'reinsurance tax' and how it would work (Carey, 10/15).

Politico: Talking About The Medical Device Tax
The tax has been in and out and in and out of several offers from both Republicans and Democrats to smooth a deal to re-open government and lift the debt ceiling. As of late on Tuesday, it was cut from the latest House Republican offer. It also fell out of a Senate offer from earlier this week. But the repeal’s staying power in the debate highlights a typical Washington confluence of money and local politics (Bade and Dixon, 10/15).

Los Angeles Times: Medical Device Makers See An Opening In Budget Impasse
Leaders from the medical device industry listened when President Obama vowed in 2009 that there would be shared sacrifice and "no sacred cows" to help pay for his healthcare law. But unlike the pharmaceutical industry, insurers and others at that healthcare summit, the device makers never shook hands on a deal. Instead, after a 2.3 percent tax on their revenue was included in the 2010 Affordable Care Act, they started a drive to repeal it. Now, with Washington paralyzed in a government shutdown and a fight over the debt limit, the device makers have seized on the impasse as a chance for victory (Tanfani, 10/16).

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