ACA Repeal Passes Senate, Veto Expected

On Dec. 3, 2015, the Senate voted 52 to 47 to repeal large parts of the Affordable Care Act (ACA)—marking the first time that the Senate has passed a bill that would repeal the ACA. Because the vote was taken under the congressional budget reconciliation process, it needed a simple majority vote rather than the normal three-fifths to avoid a filibuster.

The President has indicated that he will veto the budget reconciliation bill. However, if a Republican wins the White House in 2016, repeal of some or all of the ACA’s provisions could be likely.

The current bill targeted particular provisions of the ACA, such as the employer and individual mandates, Exchange subsidies and the high-cost employer-sponsored health plan excise tax (Cadillac tax), along with funding for Planned Parenthood.

Government Investigating Rising Drug Costs

A U.S. House of Representatives investigative panel plans to hold a 2016 hearing on skyrocketing drug costs. The panel is conducting an investigation into drug pricing and has reached out to drug companies to gather information.

One of the drug companies being investigated is Valeant Pharmaceuticals International. The panel is looking into allegations that the company has been involved in questionable billing practices, as well as examining the company’s relationship with the specialty pharmacy, Philidor Rx Services.

Valeant first disclosed its ties to Philidor late last month, amid concerns over the pharmacy’s tactics to get insurers to pay for Valeant medications. It has since severed ties with the pharmacy, saying it has lost confidence in Philidor after questions about its business practices.

Valeant is also facing investigations by prosecutors in New York and Massachusetts over its drug pricing and its programs that provide financial assistance to help patients cover out-of-pocket expenses for their medications.

DID YOU KNOW?

On Nov. 18, 2015, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) published final regulationsregarding a number of the ACA’s market reform requirements. These final regulations address:

• Grandfathered plans
• Pre-existing condition exclusions
• Lifetime and annual dollar limits on benefits
• Rescissions
• Dependent coverage up to age 26
• Internal and external appeals
• Patient protections

The final rules are effective Jan. 1, 2017.