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News
from
Representative
Ryan
Costello

Constituent
Survey:
Bipartisan
Problem
Solvers
Healthcare
Reform
Proposal 

As
part
of
the
ongoing
conversation
about
healthcare
reform,
I’d
like
to
take
a
few
minutes
to
provide
you
with
a
quick
update
about
what’s
been
going
on
in
Congress
on
this
topic
and
get
your
feedback
on
a
proposal
that
I
have
been
working
on.

As
you
may
know,
the
Senate
failed
to
pass
the
Better
Care
Reconciliation
Act
in
July
–
thus
ending
the
legislative
effort
to
repeal
and
replace
the
Affordable
Care
Act
(ACA)
for
the
time
being.
As
you
know,
in
May
I
voted
against

similar
legislation
in
the
House
called
the
American
Health
Care
Act
due
to
insufficient
protections
for
those
with
pre-existing
conditions
and
affordable
access
to
coverage. 

What
you
might
not
be
aware
of
is
that
since
then,
I
have
been
working
with
a
bipartisan
group
of
Members
of
Congress,
known
as
the
Problem
Solvers
Caucus,
to
identify
a
set
of
solutions
to
stabilize
health
insurance
markets
that
can
achieve
bipartisan
consensus

in
Congress.
It
is
clear
that
the
individual
health
insurance
market
is
deteriorating
in
some
areas
of
the
country
and
we
must
act
quickly
to
stabilize
it.
We
all
agree
that
the
individual
market
needs
restructuring,
and
we
should
swiftly
implement
changes
in
time
to
take
effect
for
insurance
plans
offered
for
2018.

On
July
31st,
we
released
our
framework
of
principles
that
we
believe
need
to
be
part
of
any
effort
to
stabilize
the
individual
health
insurance
market
and
set
us
on
the
course
to
meaningful
healthcare
reform.
In
short,
these
principles
will
lower
premiums,
increase
coverage,
and
restore
predictability.  
Here
are
some
of
the
realistic
solutions
we
propose
exploring:

Cost
Sharing
Reduction
(CSRs)
Payments:

Bring
CSR
payments
under
the
Congressional
oversight
and
appropriations
process

and
remove
them
from
executive
discretion
.
CSR
payments 
play
a
critical
role
in
helping
low
and
middle-income

households
afford 
low-deductible,
high-quality
health
insurance
.
Bringing
CSR
payments
under
the
appropriations
process 
ends
uncertainty
and
allows
for

proper
oversight.

Stability
Fund

: 
Create
a
dedicated
stability
fund
that
states
can
use
to
reduce
premiums
and
limit
losses
for
providing
coverage—especially
for
those
with
pre-existing
conditions. 

Employer
Mandate
:
Raise
the
employer
mandate’s
employee
threshold
to
500
--
realigning
the
ACA’s
definition
of
“small
business”
with
other
federal
programs
--
and
reestablish
the
employee
expectation
of
the
traditional
40-hour
work
week. 
The
current
employer
mandate

threshold
of
50
employees
 
has
placed

a
regulatory
burden
on
smal
l
businesses 
and 
served

as
a
disincentive
for 
these
job
creators

to
grow
past
50
employees. 

Medical
Device
Tax

: 
Repeal
the
medical
device
tax.
This
tax
adds
a
2.3%
sales
tax
on
medical
device
supplies,
such
as
defibrillators,
hearing
aids,
joint
replacements,
and
pacemakers,
and
impedes
medical
innovation.
The
costs
of
the
tax
are
passed
on
to
consumers
and
it
should
be
repealed.
 

State
Innovation
Waivers
:
Encourage
states
to
use
existing
innovation
programs
to 
make
the
most
out
of
available
federal
healthcare
dollars.
To
date,
a
lack
of
clear
regulatory
guidance
from
the
federal
government
and
a
failure
to
provide
necessary
technical
assistance
has
prohibited
states
from
realizing
this
potential.
In
particular,
Section
1332
of
the
ACA
allows
states
to
innovate
and
share
in
health
savings
while
offering
strong
plans
with
all
essential
health
benefits.
Some
states
have
begun
to
experiment
in
this
regard,
with
great
potential
for
success.
Similarly,
Section
1333
of
the
ACA
allows
states
to
enter
into
Health
Care
Choice
Compacts,
which
allow
insurers
to
sell
across
state
lines
in
participating
states.
However,
the
U.S.
Department
of
Health
and
Human
Services
has
not
yet
released
regulations
on
Section
1333.

To
learn
more
about
what
is
included
as
part
of
this
effort
to
provide
relief
to
individuals,
families,
and
small
businesses,
I
encourage
you
to
read
the
full
press
release

on
the
Problem
Solvers
Caucus’
proposal
and
read
my
op-ed

 about
my
work
to
refocus
the
healthcare
debate
on
these
patient-centered
solutions
that
ran
in
Philadelphia
Inquirer.

Now
that
you
know
a
little
more
about
the 

bipartisan
Problem
Solvers
Healthcare
Reform 

proposal,
I
would
like
to
get
your
feedback. 

1. What is your position on the
Affordable Care Act (ACA) generally? The ACA should be:

Fully repealed now without a
concurrent replacement plan

Repealed and replaced concurrently

Fixed to ensure the success of the
ACA but it should remain

Left "as-is" with no
changes except more funding is needed

Other

 

2. What is your position on the
role of the federal government in healthcare, generally:

"As Is" - I support
federal government healthcare programs in their current
state

I believe we should have a
universal, single payer healthcare coverage system for all
Americans

I support limited federal government
involvement in healthcare to ensure assistance and coverage
for those populations of Americans who are most vulnerable
(e.g. disabled, elderly, below poverty level)

I do not believe the federal
government should be involved in healthcare or health
insurance at all

Other

 

3. Do
you support the bipartisan Problem Solvers Caucus Healthcare
Reform proposal?

Yes

No

Parts of it

Unsure

 

4. Do
you support bringing cost-sharing reduction (CSR) payments
under the Congressional oversight and appropriations
process?

Yes

No

Yes, so long as CSR payments are
"mandatory" and made without limitations or delay

Unsure

 

5. Do
you support creating a dedicated stability fund that states
can use to reduce premiums and limit losses for providing
coverage?

Yes

No

As long as they support those with
pre-existing conditions

Unsure

 

6. Do
you support the ACA's employer mandate - the requirement
for employers to provide insurance of 50 employees or
more?

Yes

No

Unsure

 

7. Do
you support adjusting the employer mandate by raising the
threshold to businesses of 500 employees or more?

Yes

No

Something higher than 50 but lower
than 500

Unsure

 

8. Do
you support adjusting the definition of a "full
time" work week under the employer mandate from 30
hours to the traditional and long-established 40 hours?

Yes

No

Unsure

 

9. Do
you support repealing the ACA's 2.3% excise tax on
medical devices?

Yes

No

Unsure

 

10. Do you support mandating
technical changes and clear guidelines for states to be able
to use Sections 1332 and 1333 for the purposes of innovating
the delivery of healthcare?

Yes

No

Unsure

 

Click
to open in a separate window

By
completing
this
e-survey,
please
note
that
you
are
opting
in
to
my
weekly
e-newsletter.

I
will
continue
to
work
on
pragmatic,
market-based
solutions
to
the
significant
challenges
that
our
current
healthcare
system
faces,
and
I
look
forward
to
your
continued
input. 

Best
wishes,

Ryan
Costello

Member
of
Congress

Washington
DC

326
Cannon
H.O.B.

Washington,
DC
20515

Phone:
(202)
225-4315

Fax:
(202)
225-8440

West
Chester
Office

21
West
Market
Street

Suite
105

West
Chester,
PA
19382

Phone:
(610)
696-2982

Fax:
(610)
696-2985

Wyomissing
Office

840
North
Park
Road

Wyomissing,
PA
19610

Phone:
(610)
376-7630

Fax:
(610)
376-7633

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