(111111;;er at the ?Haitian gvtatez

i??aahingtun, E01 EHEIE
February 8, 2017
Mr. Norris Cochran Mr. Adam Szubin
Acting Secretary Acting Secretary
Department of Health Human Services Department of the Treasury
200 Independence Avenue, S.W. 1500 Avenue, NW
Washington, DC. 20201 Washington, DC. 20220

Mr. Edward Hugler
Acting Secretary
Department of Labor

200 Constitution Ave, NW
Washington, DC 20210

Dear Acting Secretaries,

We are writing to request additional information regarding the agencies? implementation
of the Executive Order, ?Minimizing the Economic Burden of the Patient Protection and
Affordable Care Act Pending Repeal.? As Republicans in Congress simultaneously pursue
repeal of the law without an immediate replacement, we are concerned the recent Executive
Order could sabotage the law?s coverage gains and destabilize insurance markets in the interim.
The rules for health plans for 2018 already are set, and issuers are preparing their initial rate
?lings and making critical decisions about whether to participate in the Marketplace. Changes to
those rules could result in issuers pulling out of the Marketplace, leaving Americans with no
choices nine months from now when the next open enrollment begins.

Therefore, we ask that you provide us with the following information about how your
agency is implementing the Executive Order. We respectfully request:

1) The General Counsel?s analysis of the legality of any agency action to waive, defer, grant
exemption from, or delay the implementation of each provision or requirement subject to
the Executive Order.

2) A list of the statutory provisions or requirements that your agency has identi?ed as being
subject to this Executive Order and whether each such provision will be subject to

waiver, deferral, exemption, or delay. For the provisions or requirements so identi?ed:

a) Indicate which would require a revision of regulations issued through notice-and?
comment rulemaking in order to be modi?ed;

b) Indicate which do not require public notice to be modi?ed; and
c) For both and provide your General Counsel?s analysis about how any proposed

action complies with Administrative Procedures Act requirements and other related
statutory requirements.

PRINTED ON RECYCLED PAPER

3) The analysis (along with supporting data and documentation) by the Of?ce of the
Actuary (OACT) at the Centers for Medicare Medicaid Services (CMS), the Of?ce of
Tax Analysis at the Department of Treasury, or the Of?ce of Policy and Research at the
Employee Bene?ts Security Administration (as appropriate) of the impact of the waiver,
deferral, exemption, or delay of each provision or requirement identi?ed in response to
question (1), including:

a) An analysis of the number of individuals that would either lose coverage or
experience reductions in bene?ts as a result of the proposed change, including those
with employer-sponsored coverage, where nearly 160 million Americans now get
health insurance;

b) The cost of the proposed change to the federal treasury over one, ?ve, and ten years,
as well as the expected cost in any of the subsequent four decades; and

c) The impact of the proposed change on annual out-of?pocket health care costs for
individuals at or below 100% of the federal poverty level (FPL), 200% of the PL,
300% of the FPL, 400% of the PL, and those with family incomes above 400% of
the FPL.

4) For each provision or requirement identi?ed in response to question (1) relating to fees,
taxes, or penalties, the Of?ce of Tax Analysis or OACT estimates of:

a) Characteristics (such as ?rm type, size, or marginal tax brackets) of blisiness entities
projected to reap the greatest ?nancial gain from such waiver, deferral, exemption, or
delay;

b) The median income of individuals expected to reap the greatest ?nancial gain from
such waiver, deferral, exemption, or delay; and

c) Whether any such changes will affect employer?sponsored coverage and whether
such changes would cause people to lose job-based coverage.

5) For any waiver, deferral, exemption, or delay granted with respect to this Executive
Order:

a) The number of insurance companies offering health coverage in a county as of
January 1, 2017 in the individual and small group markets compared to the number of
insurance companies offering coverage in that same county upon effect of the
modi?cation; and

b) How it comports with the Executive Order?s objective of achieving and preserving
maximum options for patients and consumers through the ?development of a free and
open market in interstate commerce for the offering of health care service and health
insurance.?

We appreciate your prompt attention to this matter and ask that you respond to us no later
than February 28th, 2017. Please provide updates on the status of your response.

If you have any questions about this request, please contact Amy Hall at (202) 225-4021 
of the Committee on Ways and Means staff, Una Lee at (202) 225-3 641 of the Committee on
Energy and Commerce staff, Carrie Hughes at (202) 225-3 725 of the Committee on Education
and the Workforce staff, or Erika Appel at (202) 226-7200 of the Committee on Budget staff.

Sincerely,

0mm,


The Honorable Frank Pallon r.
. . Member Ranking Member
Committee on Ways and Means Committee on Energy and ommerce

 

    

 

 


The Honorab Robert C. ?Bobby? Scott fhe Honorable ohn Yarmuth
Ranking Member Ranking Men} 

Committee on Education and the Workforce Committee on Budget