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Republican Victories to Restore Freedom, Competition, and Balance in Health Care

May 14, 2018

When liberals first rammed Obamacare into law, Democrats in Congress and the Obama Administration made three central promises: there would be universal coverage, lower premiums, and, as President Obama infamously said, “if you like your health care plan, you can keep it.” It’s safe to say those predictions have not come to pass.

Since Republicans retook control of the House in 2010, we have worked closely with federal, state, and local partners in the public and private sectors to help bring choice, stability, innovation, and common-sense policies that increase access and lower cost back into health care.

Democrats have resisted these efforts every step of the way.  Despite that, here are some of the key victories Republicans have achieved in health care:

  • More freedom, by repealing Obamacare’s harmful and ineffective individual mandate;
  • Greater choice and flexibility, by helping more businesses avoid Obamacare’s expensive rules and mandates such as allowing small employers to continue to provide health care through health reimbursement accounts (HRAs);
  • Help for children, by passing the longest and largest extension of the Children’s Health Insurance Program;
  • Lower costs, by reducing the burden of several harmful Obamacare taxes, including the Cadillac tax, medical device excise tax, and health insurance tax;
  • Relief for job creators, by repealing the Obamacare requirement that certain employers must automatically enroll new full-time employees in health insurance and continue coverage for current employees; and
  • Protection of access and choice for seniors through repealing the Independent Payment Advisory Board (IPAB) that gave unprecedented authority to unelected bureaucrats to alter Medicare policy, which could ultimately reduce seniors’ access to health care and put the government—rather than the patient—at the center of our health care system.

And that’s just the start.

Republicans know that there is still more we must accomplish to help families get better and more affordable health care plans that fit their needs, not Washington’s mandates. The Ways and Means Committee is working hard to enact policies that create a truly patient-centered health care system.

While we continue our work, here is the longer list of health care victories achieved by Republicans to repeal and minimize the harm of Obamacare’s most egregious provisions:


  • Repealed the 1099 provision of Obamacare that would have required businesses to file additional IRS forms when they pay a vendor more than $600 for goods in a single year – saving job creators time and money.
  • Saved taxpayers billions by adjusting eligibility for Obamacare programs including repealing the Obamacare-mandated 3 percent withholding on certain payments and modifying Modified Adjusted Gross Income to include Social Security benefits, which saved seniors from potential tax hikes.
  • Rescinded $10 million in funding for Obamacare’s Independent Payment Advisory Board.
  • Cut $2.2 billion from Obamacare’s consumer-operated and oriented plan (CO-OP) program (a “stealth public plan”), froze the IRS budget for Obamacare enforcement, and eliminated a provision that would have weakened the employer-provided insurance system.


  • Slashed billions from Obamacare’s Prevention and Public Health Fund, an annual mandatory appropriation “slush” fund.
  • Amended Obamacare to phase down the Medicaid disaster-recovery federal medical assistance percentage adjustment, cutting down on waste and abuse of federal dollars by states that don’t need it.
  • Adjusted Medicaid federal medical assistance percentages under Obamacare.


  • Repealed Title VIII, the Community Living Assistance Services and Supports (CLASS) Act of Obamacare, an unworkable and unaffordable long-term care entitlement program.
  • Reined in unnecessary Obamacare spending to reduce long-term deficits and cut down on government overreach, including:
    • Repeal of Obamacare’s appropriation for the National Clearinghouse for Long-Term Care Information, including rescinding all unobligated funds.
    • Rescinded 90 percent of the remaining funds for Obamacare’s CO-OP program (and transferred the remaining 10 percent to a new CO-OP contingency fund).


  • Eliminated an Obamacare provision that capped cost-sharing levels for small group plans, single individuals, and families, offering more flexibility in health plan design.
  • Increased funding for important family-based programs, including the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program.
  • Protected taxpayers from bailing out unprofitable Obamacare insurers by making the risk corridor program budget neutral, saving taxpayers more than $12 billion.


  • Terminated the application of Obamacare’s physician value-based payment modifier (VBM), so that starting in 2019 VBMs will be used as a component of the Merit-Based Incentive Payment System, helping to ensure funds are spent on outcomes instead of simply the number of inputs.
  • Enacted the Hire More Heroes Act, which excludes employees receiving health care through the VA or TRICARE from being counted toward the Obamacare employer mandate, helping more veterans find work while using health care plans that suit their needs best.
  • Changed the Obamacare definition of large and small employers to help more businesses avoid Obamacare’s costly rules and government-mandated benefit packages.
  • Repealed the Obamacare requirement that employers with more than 200 employees automatically enroll new full-time employees in health insurance and continue coverage for current employees.
  • Extended Obamacare’s Medicaid Emergency Psychiatric Demonstration program on the condition it was budget neutral.
  • Delayed harmful Obamacare tax provisions, including a two-year delay of the Cadillac tax and the medical device excise tax.


  • Amended Title XIX of the Social Security Act to improve the ability of states to identify providers terminated from participating in Medicare or another state’s Medicaid or CHIP program.
  • Reduced the Prevention and Public Health “slush” Fund by $3.5 billion, helping to rein in unnecessary spending and reduce long-term deficits.
  • Allowed certain employers to continue to use Health Reimbursement Accounts, preserving more choices and access to health care for their employees without incurring penalties under Obamacare.
  • Reformed the composition and duties of the expert panel established to review demonstration grant applications, helping to rein in costs and cut down on Washington overreach.


  • President Trump issued an executive order seeking repeal of Obamacare, aiming to minimize economic burden of this law through regulatory and procedural relief.
    • The order instructed agencies to defer and/or grant exemptions or delay implementation of any Obamacare requirements that would impose a fiscal burden on individuals or families; granted flexibility to states to implement healthcare programs; sought an open health insurance market across state lines; and otherwise sought to reduce health care costs and offer flexibility to those seeking health insurance.
  • President Trump issued an additional executive order aimed at expanding access to affordable health care options and increasing health care competition.
    • The order instructed agencies to pursue policies that would allow for the sale of insurance across state lines and expand the availability of various other health insurance options (such as association health plans, short-term limited duration insurance, and health reimbursement arrangements).
  • President Trump signed the Tax Cuts and Jobs Act into law, restoring choice in the purchase of health insurance by repealing the individual mandate beginning in 2019.
    • The bill also temporarily lowered the threshold for the medical expense deduction back to the pre-Obamacare level of 7.5 percent of adjusted gross income for 2017 and 2018.


  • Repealed Obamacare’s IPAB that put 15 unelected bureaucrats in charge of cutting Medicare spending, potentially limiting seniors’ access to care.
  • Reauthorized the CHIP program for 10 years, providing states stability and resources to provide coverage for low-income children.
  • Reduced funding for the Prevention and Public Health “slush” Fund.
  • Extended temporary relief from three of Obamacare’s costly taxes:
    • Continued relief from the 2.3 percent medical device excise tax for 2018 and 2019.
    • Delayed implementation of the Cadillac tax on high cost employer health plans until 2022.
    • Lowered premiums in 2019 through a one-year suspension of Obamacare’s health insurance tax.