Devices & Diagnostics

What’s really next for medical device tax, Obamacare in budget shutdown debate

The latest ultimatum is in: delay the Obamacare health law for one year and repeal the medical device excise tax or face a government shut down. The U.S. House of Representatives passed their budget with those caveats on Saturday – with little indication the U.S. Senate, which will now reconsider the House’s legislation, would accept […]

The latest ultimatum is in: delay the Obamacare health law for one year and repeal the medical device excise tax or face a government shut down.

The U.S. House of Representatives passed their budget with those caveats on Saturday – with little indication the U.S. Senate, which will now reconsider the House’s legislation, would accept it. Even if the proposed delays did pass the Senate (they won’t), President Obama said soon after the House passed its budget legislation on Saturday that he would veto such a bill if it crossed his desk.

It puts the United States less than two days away from a government shutdown and keeps the stability and future of healthcare the most high-stakes bargaining chip in the debate over a federal budget.

Everything seems set to a perilous script: Obamacare implementation or government shutdown. Yet there are a series of fascinating wrinkles that came out of the news of the House vote on the federal budget on Saturday that are intriguing or disturbing. Take your pick.

After everything, the medical device excise tax may die as an afterthought. The medical device tax, which has a lot of haters who have produced very little progress, could be removed as the final throw-away, face-saving bargaining chip to appease hard-line Republicans.

Veteran House Republicans say there is still one plausible way to avoid a shutdown. The Senate could take up the House spending bill, strip out the one-year health care delay and accept the medical device tax repeal as a face-saving victory for Republicans. The tax, worth $30 billion over 10 years, has ardent opponents among Democrats as well. Its repeal would not prevent the law from going into effect. Consumers can begin signing up for insurance plans under the law beginning on Tuesday.

Mr. Reid has already said he would not accept even that measure as a condition to keep the government operating. Special parliamentary language in the House measure provided for rapid action Monday in the Senate that would once again most likely leave House Republican leaders with the option of approving a spending bill without policy prescriptions. But there was little indication they would accept it.

Implemented parts of healthcare law remain, except… The portions of healthcare reform already enacted would remain in this latest House version, except for a new exception that would allow insurers and others the right to not provide abortion coverage for religious or philosophical reasons.

Republicans are adamant that hatred of Obamacare will shield them from political fallout. Most polls have Americans blaming the Republicans if the government shuts down. Other polls have most Americans – no matter what you call it – backing the health law. But many Republicans think they’ll be forgiven for a government shutdown because they’re fighting for the delay (and ultimate scuttling) of the Affordable Care Act. Here’s a pair of fascinating quotes from House Republicans after their maneuvers on Saturday.

“When people understand what the House of Representatives is doing, in that we are willing to fund 99 percent of the federal government that all parties agree of funding, then the American people are going to see that we’re not the obstructionists — the Senate is,” said Rep. Mo Brooks (R-Ala.).

And, more to the point.

In a statement, Boehner and his deputies said, “The American people don’t want a government shut down and they don’t want ObamaCare…We will do our job and send this bill over, and then it’s up to the Senate to pass it and stop a government shutdown.

Another compromise: Obamacare would cover Congress. Another compromise would to let Obamacare pass, but to force members of Congress and their staff to be covered under the law.

One option, members said, is to revise the CR yet again—this time to include an amendment from Sen. David Vitter, R-La., that would prevent members of Congress and their staffers from receiving exemptions from key Obamacare measures.Rep. Trent Franks, R-Ariz., said he would support that strategy, because it would “make them live under this hellish law.”

Other Republicans, however, were noncommittal on that approach. “It just depends on how many people are controlled by Ted Cruz,” sniped Rep. Peter King, R-N.Y., a moderate who has vocally opposed of the campaign against Obamacare mounted by the junior Republican senator from Texas.

Contraception mandate also in the mix. The bill passed out of the House would delay Obamacare for a year. However, House Republicans have also built in language that would delay the requirement businesses pay for contraception into 2015.

The real changes come later? Are the real changes to the health law coming after the budget is approved?

The White House and congressional Democrats are opposed to delaying the health law but have indicated they would entertain changes to improve the bill. But they have firmly opposed talking about even modest changes as part of negotiating the government funding bill.

[Photo from Bigstock]

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