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We welcome autumn in the usual fashion–waiting on Congress to act on a number of important issues. We’ve all watched as the high-level issues such as health care repeal and reform as well as tax reform top the headlines, but there are other key issues that demand their attention before the end of 2017.

As the tax reform debate approaches, DTA is highlighting the issues being considered, along with the views on the subject of tax reform, as the implications of its enactment are immense for businesses in the U.S. DTA will continue to push for inclusion of repeal of the excise tax on medical devices as part of tax reform.

House Tax Priorities

The House Ways and Means Committee has announced its priorities for tax reform. They include:

  • Lowering taxes at every income level.
  • Delivering the lowest tax rates for job creators of all sizes so they can invest more money in growing their businesses and creating jobs.
  • Eliminating the maze of special interest loopholes that keep rates artificially high.
  • Increasing the standard deduction.
  • Separating wage income from small business income.
  • Ending the estate tax (a.k.a. Death Tax) so family-owned farms and businesses can be passed down to the next generation.
  • Repealing the Alternative Minimum Tax.
  • Cutting in half the tax rates on personal savings and investment.

The Senate Health, Education, Labor and Pensions (HELP) Committee has set a series of hearings to gather input from state insurance commissioners and governors, according to a joint statement from Chairman Lamar Alexander (R-TN) and Senator Patty Murray (D-WA). The schedule for the hearings is as follows.

Sept. 6: Stabilizing Premiums and Helping Individuals in the Individual Insurance Market for 2018: Testimony from State Insurance Commissioners

Sept. 7: Stabilizing Premiums and Helping Individuals in the Individual Insurance Market for 2018: Testimony from Governors

House Republican leaders told lawmakers to expect a full September, beginning with action on an eight-bill appropriations omnibus to fund the government and a fiscal 2018 budget aimed at laying the groundwork for a tax code overhaul.

The schedule, laid out by House Majority Leader Kevin McCarthy (R-CA), calls for lawmakers to begin appropriations work shortly after returning Sept. 5. Floor action on the budget is expected to follow shortly afterward, possibly as soon as the week of Sept. 11. Also on tap in September will be a measure to raise the federal debt limit.

The ambitious September schedule reflects how little time lawmakers have to fund the government, raise the debt limit, and prevent twin fiscal crises when they return from recess. Government funds run out Sept. 30. The debt ceiling also is expected to be addressed around the same time.

Around 1:45 a.m. on July 28, the Senate voted on an amendment put forward by Senate Republicans known as the “Skinny Repeal” of the Affordable Care Act. That amendment failed by a vote of 49-51.

The Skinny Repeal would have repealed the employer and individual mandates of the ACA. Also, it would have extended a moratorium on a medical device excise tax--an issue important to DTA members. The slimmed down version of repeal and replace legislation was the only version of reform, it appeared the Senate would be able to pass to get to a conference with the House of Representatives on their version of reform. However, votes against the measure from Sen. John McCain (R-AZ), Sen. Susan Collins (R-ME), and Sen. Lisa Murkowski (R-AK) denied the ability to move a bill to conference. 

On August 3, the Senate passed legislation (H.R.2430) by a vote of 94-1 that extends for five years the FDA’s authority to collect user fees from drug- and medical-device makers for reviewing new products, sending it to President Trump for his signature. The House passed the bill in July.

The bill would reauthorize user fees for prescription drugs, medical devices, generic drugs, and biosimilar products from fiscal 2018 through 2022. They are set to expire on Sept. 30.

The FDA submits recommendations to Congress for each reauthorization cycle based on negotiations with industry over the framework for the fees and performance goals for the agency.

On Thursday, Senate Republicans released their proposal to replace Obamacare. The plan comes after months of highly-secretive, behind-closed-door meetings. Senate Majority Leader Mitch McConnell (R-KY) has previously indicated he would like the Senate to vote on the measure next week ahead of the 4th of July recess, but it’s unclear if it will have the votes to pass the Senate with only 50 votes plus the support of Vice President Mike Pence.

Provisions of the proposed measure include:

The FDA has recently announced a date change for when low risk medical (dental) devices must be UDI compliant. The new implementation date for Class I and unclassified devices is now September 24, 2020. The previous compliance date for Class I devices was September 24, 2018.

Recently the Children’s Dental Health Project released an eye-opening infographic focusing on the future of dental coverage and its effect on spending. The graphic shows that for every 1,000 people who lose dental coverage, nearly $11,000 less is spent on dental supplies.

"The infographic shows the ripple effect if families lose dental coverage. We welcome the opportunity to work with the dental industry to protect the community at-large from potential cuts,” said Children's Dental Health Project Executive Director Meg Booth.

All training funds for oral health professionals are eliminated in the fiscal year 2018 budget proposal.  There is a loss of more than $35 million for oral health training as well. However, the budget proposal increases the National Health Service Corp by $21 million for FY18, a program which places dentists, mental health, and primary care providers in underserved areas of the nation.

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