Washington Summary November 2017

Health Care

Congress continues to discuss ways to stabilize the ACA individual insurance market. More than 200 groups have endorsed the proposal drafted by Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA). Other Senators and Representatives have their own proposals to replace or reform ACA.

Despite rumors about efforts to include an end to the ACA individual insurance mandate in the tax cut proposals (see below), no such action has occurred at this time.

Tax Reform

Congressional committees are moving forward with proposals to change the federal income tax law. Most reports have focused on changes in individual tax brackets, income exemptions, and rates and on reducing corporate income taxes.

However, a final tax bill could impact people with major health conditions in a number of ways. For example, the House Ways and Means Committee’s bill (HR 1) eliminates the medical tax deduction for taxpayers who itemize their deductions. In addition, under HR 1, taxpayers no longer would be able to deduct most of their state and local taxes.

The Ways and Means Committee approved HR 1 on November 9. The House is expected to debate HR 1 under procedures that would restrict or prevent amendments by individual House members. Some changes, however, still are possible before the House vote around November 15 or 16.

The Senate Finance Committee released its tax proposal on November 9. Unlike HR 1, the Senate proposal retains the medical expense deduction. The Finance Committee will take up its proposal on November 13. Given the differences of opinion, some changes to the medical deduction are possible in the final tax bill later this year.

Each taxpayer is unique. Therefore, the impact of tax cuts and deduction changes on people with preexisting conditions like PKD will vary with the taxpayer’s income, family situation, residence, health situation, and other factors.

For more specifics, visit the Ways and Means Committee website at house.gov and the Finance Committee website at senate.gov.

FY18 NIH Funding

In September, the House passed a bill that increases funds for NIH by $1.1 billion over the FY17 funding level. The Senate has not passed its own Labor/HHS bill, but the Senate Appropriations Committee approved a proposal to increase NIH funding by $2 billion in FY18.

The current continuing resolution (CR), which is funding NIH at last year’s level, expires on December 8. Congress may extend the CR until around December 22.

Now is the time for advocates to contact Congress with a simple message: accept the $2 billion Senate increase for NIH in FY18.

New Kidney Bills

On September 28, Sens. Ben Cardin (D-MD), Roy Blunt (R-MO), and Bill Nelson (D-FL) introduced S. 1890, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2017. Among its provisions, the bill would identify issues that prevent kidney transplants, promote access to home dialysis, and guarantee Medigap coverage for all ESRD Medicare-eligible patients.

This is comparable to HR 2644, introduced earlier this year by Reps. Tom Marino (R-PA), John Lewis (D-GA), and Peter Roskam (R-IL).

On October 26, Rep. Jason Smith (R-MO) introduced HR 4143, the Dialysis PATIENTS Demonstration Act. The bill allows medical providers to deliver treatments for other medical needs while the patient is in a dialysis facility.

Bills of Importance to the PKD Community

  • The OPEN Act (HR 1223/ S 1509] would make it easier for companies to repurpose approved drugs for treating rare diseases. Reps. Gus Bilirakis (R-FL), GK Butterfield (D-NC), and Mike McCaul (R-TX) introduced HR 1223.  Sens. Orrin Hatch (R-UT) and Robert Menendez (D-NJ) introduced S 1509.
  • Living Donor Protection Act (HR 1270/no Senate bill yet) would remove barriers to living organ donation. Rep. Jerrold Nadler (D-NY) and Rep. Jaime Herrera Beutler (R-WA) introduced the bill. PKD and several other patient groups have signed a letter urging House Members to cosponsor HR 1270.

Say Thanks to Supporters

Too often we forget to thank those elected officials who support proposals of importance to the PKD community. The following Senators and Members of Congress have cosponsored either the OPEN Act or the Living Donor Protection Act since the previous newsletter.  If any of them represent you, please say “thank you” the next time that you contact them.

HR 1223, OPEN Act

  • No new cosponsors

HR 1270, Living Donor Protection Act

  • Rep. Joe Crowley (D-NY)
  • Rep. Louise Slaughter (D-NY)
  • Rep. Blake Farenthold (R-TX)
  • Rep. James Clyburn (D-SC)
  • Rep. Terri Sewell (D-AL)
  • Rep. Raul Ruiz (D-CA)

S 1509, OPEN Act

  • No new cosponsors

Stay Alert

When the time comes, we will ask PKD advocates to immediately contact their elected officials to protect your interests.  Your voice needs to be heard.

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UPDATED:  November 13, 2017