Congress is apparently not done cutting taxes, even after passing a $1.5 trillion tax overhaul last year.

The deal struck by Democrats and Republicans on Monday to end a brief government shutdown contains $31 billion in tax cuts, including a temporary delay in implementing three health-care-related taxes.

Those delays, which enjoy varying degrees of bipartisan support, are not offset by any spending cuts or tax increases, and thus will add to a federal budget deficit that is already projected to increase rapidly as last year’s mammoth new tax law takes effect.

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When Brian Day opened the Cambie Surgery Centre in 1996, he had a simple goal. Dr. Day, an orthopedic surgeon from Vancouver, British Columbia, wanted to provide timely, state-of-the-art medical care to Canadians who were unwilling to wait months—even years—for surgery they needed. Canada’s single-payer health-care system, known as Medicare, is notoriously sluggish. But private clinics like Cambie are prohibited from charging most patients for operations that public hospitals provide free. Dr. Day is challenging that prohibition before the provincial Supreme Court. If it rules in his favor, it could alter the future of Canadian health care.

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Because this exemption applies to employer-sponsored insurance but not individual coverage or out-of-pocket spending, it encourages group plans over consumer control. It should not be seen as sacred. However, the cap imposed by the Cadillac tax will become increasingly tight over time, which risks pushing Americans into public entitlements rather than empowering them as consumers. Policymakers should keep the Cadillac tax from biting too deeply — but a better way to end the tax bias toward employer-based plans would be to extend the tax exemption to health care that individuals purchase by themselves.
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Conservative policy experts and strategists continue to quietly meet and craft a legislative replacement for Obamacare, and with good reason.

People are hurting under the current broken system that denies individuals control over their own health decisions while hugely driving up their costs. Premiums have been rising by ungodly amounts (an average of 37 percent in 2018), while nearly one-third of all counties feature just a single insurer offering coverage in an Obamacare exchange.

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House Republicans are considering adding a six-year extension of the Children’s Health Insurance Program (CHIP), as well as delays of certain ObamaCare taxes, to a short-term government funding bill this week, sources say.

The six-year extension of CHIP would help put to rest a months-long delay in renewing the funding for that program, which has been caught up in a partisan dispute over how to pay for it. There was a breakthrough last week when the Congressional Budget Office revised down the cost so that a six-year extension would essentially cost nothing.
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Congress has no choice but to revisit the issue of health reform, and leaders have the greatest opportunity by tackling Medicaid. In 2016 the federal government spent $42 billion on ObamaCare’s exchanges. It spent $358 billion on Medicaid. States and localities pitched in another $208 billion, for a total national Medicaid expenditure of $566 billion in 2016. The growth in spending on health-care entitlements like Medicaid and Medicare threatens to overwhelm the Treasury, starving the federal government of the funds it needs to pay for everything else, including education, welfare and national defense.

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U.S. House Ways and Means Committee Chairman Kevin Brady said on Thursday getting rid of the so-called “Cadillac” tax on high-cost employer-provided health insurance could be part of the spending deal now under negotiation in Congress.

“We want to get rid of it,” Brady, a Republican, told reporters outside his office, adding that this could “possibly” be part of an agreement lawmakers are seeking to avoid a government shutdown on Jan. 19.

“Even Democrats who put that awful tax in place, believe it needs to be delayed. If we can find some common ground there that would be terrific,” Brady said.

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In a letter to President Trump, Leader McConnell, and Speaker Ryan, a dozen health policy leaders recommend that health reform continue to be a top priority in 2018.  Insurance premiums continue to soar, and millions of people have little or no choice of health insurers. The group says individuals need to be empowered with greater flexibility and choice and that states are better equipped than Washington to oversee their health insurance markets. This requires legislative action from Congress to redirected resources and provide them with greater regulatory flexibility.

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Republicans are under renewed pressure to shore up the fragile US healthcare system after they knocked out a pillar of Obamacare in landmark tax legislation, but did not attempt to stabilise it. Party leaders differ over whether to make healthcare a signature issue, stung by their failure to repeal Barack Obama’s reforms entirely in the summer. But the tax bill has made it harder for Congress to do nothing in the coming election year, say experts.

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Senate Majority Leader Mitch McConnell (R-Ky.) on Friday encouraged two key senators to continue working on legislation to repeal and replace ObamaCare.

McConnell encouraged Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) to keep working to cobble together enough votes to pass their ObamaCare repeal legislation.

“I wish them well,” McConnell said and added that if the senators can get the votes next year, he’d encourage the Senate to vote on the bill.

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