100+ Business Leaders Going to D.C. This Week for Chamber Fly-in

A record group of more than 100 of the state’s top business leaders and government affairs executives will be attending the Indiana Chamber’s annual D.C. Fly-in on September 27 and 28. The timing couldn’t be more perfect with a potential health care reform vote, rollout of a tax reform plan and the end of the fiscal year all taking place.

This year, legislative briefings will be conducted by congressional members, who will be highlighting key public policy areas that line up with their committee assignments and expertise:

  • Tax reform – Indiana 2nd District U.S. Rep. Jackie Walorski
  • Regulatory reform – Indiana 9th District U.S. Rep. Trey Hollingsworth
  • Health care reform – Indiana 8th District U.S. Rep. Larry Bucshon
  • Infrastructure and transportation policy – Indiana 4th District U.S. Rep. Todd Rokita
  • Education policy – Indiana 6th District U.S. Rep. Luke Messer

There is still time to register for the D.C. Fly-in; go to www.indianachamber.com/specialevents.

Make sure to follow us on Twitter at @IndianaChamber or #ICCinDC for up-to-the-minute important information on what’s happening in Washington.

Zimmer Biomet is the Fly-in’s dinner sponsor. Allegion is the cocktail reception sponsor. Build Indiana Council is the legislative briefing sponsor.

Event sponsors are AT&T, The Boeing Company, Duke Energy, The Kroger Co., Old National Bank and Wabash Valley Power.

New Senate Health Care Bill An Improvement for Employers

The U.S. Senate appears to be gearing up for another health care vote, with a measure from Sens. Bill Cassidy (R-LA) and Lindsey Graham (R-SC) headed to the floor as soon as the middle of next week.

At its core, the Graham-Cassidy proposal creates a block grant program, taking much of the funding provided in the Affordable Care Act (ACA) and sending it to the states for them to set up their own health care systems and determine where to direct the funds.

It also does away with several pillars of the ACA, including the mandate for individuals to have insurance or pay a penalty. The true ramifications of that are uncertain, but could mean higher premiums for those in the health care exchanges (aka those who don’t have insurance through their workplace).

From the standpoint of employers, the Indiana Chamber believes Graham-Cassidy is an improvement over the ACA. This is primarily due to two changes:

  1. The removal of the employer mandate to offer coverage. If that goes away, so too does the ACA’s definition of a full-time employee as someone working an average of 30 hours per week; this has negatively impacted businesses and workers – many of whom saw their hours reduced.
  1. The permanent elimination of the medical device tax, which is detrimental to vital Hoosier employers like Cook Medical in Bloomington, Zimmer Biomet in Warsaw and many others.

Overall, those in favor of increased state control are more receptive to the Graham-Cassidy effort.

As Vice President Mike Pence put it on Fox News yesterday: “…The question that people ought to ask is, who do you think will be more responsive to the health care needs in your community? Your Governor and your state legislator, or a congressman and a President far off in the nation’s capital?…”

 What has opponents worked up is two-fold: affordable coverage for pre-existing conditions isn’t specifically guaranteed; and population size will determine the amount of the block grant, which will reduce funding for a number of states – including some in the Rust Belt and more rural states in general.

Republican Sen. Jeff Flake of Arizona told MSNBC on Thursday he has absolute faith that governors will keep pre-existing condition protections, because of the severe political cost if they don’t. Opponents are less convinced.

At this point, Kentucky Sen. Rand Paul is the lone Republican who has sworn opposition to the Graham-Cassidy bill publicly – in part because his state appears to be set to lose funds in this model.

Likewise, Indiana is expected to see less federal dollars, but the Hoosier state has been preparing for what it saw as an eventuality for several years – setting aside hundreds of millions of dollars to subsidize its Healthy Indiana Plan (HIP) 2.0.

The HIP model is unique in the country; it requires participants to have “skin in the game” with their health care decisions and allows for capping the number of participants. Both of these make it an inherently more nimble program. And ultimately, the state Legislature can also determine to put more funds into HIP 2.0, if it’s deemed necessary.

These facts and the lure of more state control were likely factors in Gov. Eric Holcomb’s decision to sign a letter supporting Graham-Cassidy; he was one of 15 state executives to do so. The reality is other states may not be as fiscally prepared for a possible funding reduction as Indiana is.

That leads us to who may end up being the pivotal figure in the floor vote: Sen. Lisa Murkowski of Alaska. She joined Sen. Susan Collins (Maine) and Sen. John McCain (Arizona) in voting no on the last health care reform measure. Collins is seen as a likely “no” again, joining Paul, while McCain is a predicted (or at least hoped for) “yes.”

As a result, the bill authors are pulling out all the stops and making special accommodations for Alaska in the bill to woo Murkowski’s vote – because they can’t lose her and have the bill survive for Vice President Pence to break the tie. If no specific provisions for Alaska are made, the state would be a big loser in the bill in funding because of its size vs. population and geography.

The Indiana Chamber plans to talk about health care reform with Sen. Joe Donnelly, who has announced his opposition to Graham-Cassidy, and Republican Sen. Todd Young during Wednesday’s D.C. Fly-in event.

UPDATE: This afternoon, McCain announced he would oppose the Graham-Cassidy bill, making passage of the bill seemingly very difficult.

National Emergency Declared for Opioid Crisis; Donnelly and Walorski Applaud President’s Action

Building upon the recommendations in the interim report from the President’s Commission on Combating Drug Addiction and the Opioid Crisis, President Trump recently instructed his administration “to use all appropriate emergency and other authorities to respond to the crisis caused by the opioid epidemic.”

Both Sen. Joe Donnelly and Congresswoman Jackie Walorski (IN-02) issued statements supporting the decision:

“I am pleased that President Trump plans to declare the opioid epidemic a national emergency. We know that it will take all of us working together to effectively turn the tide against this public health crisis that has harmed so many families in Indiana and across the country,” Donnelly said. “I hope this declaration will lead to necessary, additional resources for states and local communities to ensure those battling substance use disorders can access treatment.”

Walorski stated: “Opioid abuse is having a devastating impact on our communities, and President Trump’s declaration of a national emergency treats this epidemic with the urgency it requires. I will continue working with my colleagues and the administration to make sure first responders, law enforcement, medical professionals, treatment providers and families in our communities have the tools and resources needed to solve this crisis.”

Congress last year passed into law the Comprehensive Addiction and Recovery Act (CARA), bipartisan legislation to address the nationwide opioid epidemic.

Congresswoman Walorski served on the conference committee that negotiated the final bill, which included two provisions she authored. One requires the Department of Veterans Affairs (VA) to participate in state prescription drug monitoring programs, and the other allows the VA to use FDA-approved medical devices and other non-opioid therapies to treat chronic pain. Donnelly also helped enact CARA, which included several of his provisions. Additionally, Donnelly helped pass the 21st Century Cures Act into law, which includes a $10.9 million federal grant that will support prevention, treatment and recovery services in Indiana.

More recently, in late July, Donnelly introduced a bipartisan package of legislation “aimed at providing the facilities and access to telemedicine needed “to prevent and treat substance use disorder in rural communities.”

Federal Health Care – Republicans Can’t Do It Alone

Progress on health care reform by Senate Republicans came to a halt very early this morning as the so-called “skinny repeal” of the Affordable Care Act (ACA) narrowly failed 49-51. All Democrats were joined in their opposition by Republican senators Susan Collins (Maine), John McCain (Arizona) and Lisa Murkowski (Alaska).

While Collins and Murkowski’s votes came as no real surprise, the GOP hope was for McCain to allow the bill to proceed to an expected conference committee for further work. But in McCain’s statement explaining his decision, he mentions the lack of complete certainty provided by House Speaker Paul Ryan that the bill wouldn’t be voted on as-is and passed by the House instead – as well as his opposition to voting on what he considered to be a “shell of a bill.”

Essentially, this outcome means the only path to reform now would appear to be a bipartisan approach, as Senate Majority Leader Mitch McConnell (Kentucky) alluded to in his remarks following the defeat.

Indiana’s Democratic senator, Joe Donnelly, has been pushing for this path all along and reiterated those thoughts after today’s vote:

“I still believe that by working together we can improve our health care system and, at a minimum, Congress and the administration should do no harm to the millions of Americans’ whose health and economic well-being are at stake. I share the frustration of Hoosiers and Americans who are tired of partisan proposals that fail to address issues with our existing health care system and the continued legislative uncertainty that is undermining the insurance markets.

“We should do the hard and necessary work to gather the input of doctors, nurses, hospitals and patients, and work in a bipartisan manner to make coverage more affordable and accessible for Hoosier and American families.”

Of note: Donnelly attended a dinner Wednesday evening with a bipartisan group of senators to discuss ways to work together on health care. In May, Donnelly also had a similar meeting.

Our junior senator, Todd Young, voted for the “skinny repeal” bill as “another step towards relieving Hoosiers and millions of Americans from the burdens of Obamacare. Too many Hoosiers have been left with too few options and rising costs. It is more important than ever that we keep our promise to them and fundamentally reform our health care system.”

Like Donnelly, Young is eager to strengthen the ACA and work in a bipartisan fashion to get that done.

“Going forward, I will participate in hearings in the HELP (Health, Education, Labor and Pensions) Committee and continue to work with my colleagues, on both sides of the aisle, to come up with a solution that provides long-term stability to our health care system and gives each and every Hoosier the opportunity to access quality and affordable insurance.”

Additionally, Young has previously looked for ways to find common ground. In the spring, he sent a letter to all Democratic senators urging them to share their views on what’s working and what’s not with the ACA.

Indeed, there are aspects of the ACA that both Democrats and Republicans have acknowledged as problematic; the medical device tax, which needs to be permanently repealed, is among them. So hopefully these areas can serve as a starting point for crafting a bipartisan solution.

From the Indiana Chamber’s perspective, the reality is that the ACA has not made life easier or costs cheaper for businesses (or many Hoosiers).

Separately, the ACA’s pending collapse – with insurers pulling out – isn’t surprising based on its inherently flawed assumptions. Unfortunately, very little of the congressional debate so far has focused on shoring up the ACA at its core, or how to put forth a replacement program that is stronger foundationally. Hopefully, that will occur in future discussions.

Indiana Delegation Talks Affordable Care Act Repeal

The vote to repeal and replace the Affordable Care Act (ACA) couldn’t get off the ground in the U.S. Senate. But President Trump, Vice President Pence and many members of Congress instead have called for a simple repeal of the ACA – with a replacement coming at a later date.

Congressman Luke Messer (IN-06) is on board with that process. “Hoosiers are sick and tired of endless debate on the Obamacare repeal bill, and the failure of Congress to act. This is D.C. politics as usual, and exactly why Americans sent the President to Washington to shake things up and get something done.

“We’ve had more than enough time to deliver on this promise to Americans, who have sent us here for three election cycles to repeal this failed law. I agree with President Trump that we must repeal Obamacare NOW and then work together on a plan to ensure Hoosiers get the health care they want and deserve.”

Meanwhile, Sen. Joe Donnelly urged bipartisanship in finding common ground. “The proposed Senate health care bill would have been disastrous for Hoosiers. The latest plan to repeal without any replacement is downright reckless, playing politics with the health and economic well-being of millions of American families.

“It is time to do the hard work of forging a bipartisan bill to strengthen our current health care system, so that we can reduce costs for Hoosier families, continue to protect people with pre-existing conditions, and preserve the good work states like Indiana have done to expand affordable health care. The American people are counting on us to take a thoughtful approach together, and I urge the Senate to take this path in the coming days.”

Congressman Larry Bucshon (IN-08) had a different take. “Obamacare is collapsing and as a result patients across the country are at risk as premiums skyrocket and insurers flee the exchanges. In Indiana, premiums have increased an average of 74% and two of our state’s four insurers recently announced their departure from the Obamacare exchanges. Hoosiers are being priced out of the insurance market, if they can find insurance at all. This is not the health care Americans were promised by President Obama and congressional Democrats when they passed Obamacare, and certainly not what they deserve.

“To me, this is personal. I spent more than a decade as a surgeon before coming to Congress. This is about the well-being of my constituents who are struggling to access quality, affordable health care under Obamacare. That’s why I made a promise to repeal and replace this failed law to help drive down costs, expand access, and get the federal government out of decisions that should be left up to patients and their doctors. The House did its job to fulfill our promise. I’m extremely disappointed that, thus far, the Senate has failed to live up to its commitment to the American people. It’s time for the Senate to act.”

Health Care: Donnelly Co-Authors Bipartisan Bill to Speed Up FDA Approvals for Devices; Young Reaches Across the Aisle on ACA

Senators Joe Donnelly (D-IN) and Cory Gardner (R-CO) have re-introduced the bipartisan FDA Regulatory Efficiency Act, which would allow the Food and Drug Administration (FDA) to bring innovative medical devices to market more quickly.

Donnelly stated, “As scientists and innovators across Indiana and our country work to find new cures and therapies, we should be making it easier for them to bring these products safely to those who need them. I’m proud to work with Sen. Gardner on this bipartisan legislation to cut through the red tape at the FDA and safely speed up the approval process.”

The FDA Regulatory Efficiency Act would help the FDA concentrate on high-priority activities by authorizing third parties to approve quality systems of device companies. Authorized third parties could only approve changes that do not involve major technology changes or changes in the use of the product. The legislation would still hold companies accountable for their quality systems, while also helping to alleviate the overwhelmed FDA. Donnelly and Gardner first introduced the legislation in October 2015.

Health Care Reform Notes
Freshman Sen. Todd Young has reached across the aisle in an attempt to find common ground on health care. He recently sent a letter to all Democratic senators urging them to share their views on what’s working and what’s not with the Affordable Care Act. Young is a member of the Senate Health, Education, Labor and Pensions Committee, which will have a key role in shaping the Senate’s version of health care reform.

Congresswoman Jackie Walorski (IN-02) is touting the American Health Care Act (AHCA), as passed in the U.S. House of Representatives, and how it “brings us closer to a better health care system that puts patients first.” Her editorial appeared Sunday in the South Bend Tribune.

Congressman Larry Bucshon, M.D. (IN-08), who sits on the House Committee on Energy and Commerce where he is a member of the Subcommittees on Health, is using his web site to promote the Washington Post’s fact-checking of several recent claims about the AHCA. One is on coverage for those with pre-existing conditions and the other on classification of assault as a pre-existing condition; both claims were deemed untrue.

Recent Happenings in Federal Affairs: Gorsuch Sworn in with Donnelly’s Support

Senator Joe Donnelly joined a select few Democrats last week to announce support for President Trump’s pick to the U.S. Supreme Court: federal appellate judge Neil Gorsuch.

Donnelly stated, “I have said consistently that part of my job is to carefully review, debate and vote on judicial nominations, including nominees to the Supreme Court. It is my obligation as senator to consider the qualifications of each nominee that comes to the Senate floor to determine if he or she can faithfully serve on our nation’s highest court. I take this responsibility very seriously.

“After meeting with Judge Gorsuch, conducting a thorough review of his record and closely following his hearing before the Senate Judiciary Committee, I believe that he is a qualified jurist who will base his decisions on his understanding of the law and is well-respected among his peers.

“I was deeply disappointed by the way the most recent Supreme Court nominee, judge Merrick Garland, was treated by the Senate, but as senator, I can only vote on the nominee that comes to the Senate floor. However, I believe that we should keep the current 60-vote threshold for Supreme Court nominees.”

Gorsuch was sworn in on Monday.

In other news:

  • Responding to the requests from a bipartisan cohort of Indiana elected officials, newly appointed Environmental Protection Agency Administrator Scott Pruitt has announced he will visit the U.S. Smelter and Lead Superfund site in East Chicago on April 19. Senators Donnelly and Todd Young, congressman Pete Visclosky (IN-01) and Gov. Eric Holcomb each had invited Pruitt to visit after his appointment to the position. The area has been the focus of concern for local, state and federal officials since the magnitude of the environmental (water) lead contamination became clear.
  • Representative Luke Messer (IN-06) last week called on Congress to come back, instead of breaking early for Easter, to repeal and replace Obamacare. In a floor speech addressing his colleagues in the House, Messer said, “Congress is leaving for Easter break with work undone. For seven years, we’ve told the American people we would repeal Obamacare and replace it with something better, and we have legislation that provides that opportunity. … We need to do what we said we would do.” Earlier, Messer joined members of the House Republican leadership – led by Speaker Paul Ryan – to announce an amendment to the American Health Care Act that safeguards patients with pre-existing conditions in a way that will also lower premiums. This amendment creates the $15 billion new federal risk-sharing program that will help states reduce premiums by reimbursing health insurance issuers for high-cost individuals beginning in 2018. The proposal by congressmen Gary Palmer of Alabama and David Schweikert of Arizona is modeled after a program in Maine.
  • Congressman Jim Banks (IN-03) has introduced the Head Start Improvement Act, a bill to reform the Head Start early childhood education program. The legislation would give states increased flexibility in spending the Head Start dollars they receive from the federal government to better meet the specific needs of low-income children. The bill would provide Head Start block grants directly to eligible grantees, which include states, territories and federally-recognized Indian tribes. He got the idea from state Sen. Luke Kenley (R-Noblesville), who has suggested this as part of the larger pre-K pilot program at the state level. “As a father of three young girls, I understand the importance of making sure our kids receive the best education possible,” said Banks. “Unfortunately, Head Start is failing to make a significant contribution to student development, and it is clear that Head Start needs a new start. Giving states, local officials and parents greater control over the Head Start program will result in better tailored pre-K programs for Hoosier students.”

Around the Horn With What Happened in D.C. Last Week

As expected, President Trump signed many executive orders this past week aligning with campaign promises for sweeping change. Some of these include:

  • Encouraging federal agencies to dismantle large parts of the Affordable Care Act, including the very controversial individual mandate requiring people to purchase insurance
  • The official withdrawal of the U.S. from the Trans-Pacific Partnership – a move the Indiana Chamber opposes
  • Freezing federal hiring
  • Advancement of the Keystone XL and Dakota Access oil pipelines
  • Illegal immigration activities – directing dollars to begin construction of a wall on the southern border and the boosting of federal agency efforts to stop illegal immigration
    On a related note, the President’s chief of staff, Reince Priebus, issued a memo telling federal agencies to put a freeze on any new regulations and a 60-day hold on regulations that have not yet taken effect.

The members of the President’s cabinet that have been sworn in to date by Vice President Mike Pence: retired Marine General James Mattis as Defense Secretary, retired Marine General John Kelly as Secretary of Homeland Security, Rep. Mike Pompeo (R-Kansas) as Director of the CIA and Governor Nikki Haley (R-SC) as UN Ambassador.

Rex Tillerson’s nomination for Secretary of State made it out of the Senate Foreign Relations Committee and is awaiting consideration by the full Senate. Meanwhile, Betsy DeVos, nominee for Education Secretary, had her committee vote postponed until January 31. Indiana’s senior senator, Joe Donnelly, has announced that he will not support her nomination; watch his announcement of that decision.

Around the Horn on Federal Legislative Issues

As part of the Indiana Chamber’s robust federal advocacy program, Caryl Auslander will be working with the Indiana delegation (both in Washington, D.C. and here in Indiana) throughout the year. Look for additional stories and coverage of our federal efforts on your behalf in these reports and through other communications.

Below are some of the top recent Indiana news items:

  • Congressman Trey Hollingsworth spoke on the House floor in support of the REINS Act during his first week on the job; the measure to curb unnecessary government regulation passed the House on Wednesday. Hollingsworth has also been placed on the House Financial Services Committee.
  • A Hoosier connection remains on the House Ways and Means Committee with Rep. Jackie Walorski (IN 2) receiving a nod; Sen. Todd Young was most recently on this important committee.
  • Chairman alert: Rep. Susan Brooks (IN 5) has officially taken the helm of the House Ethics Committee.
  • This week, freshman Rep. Jim Banks (IN 3) presided over the House floor debate of a statement of opposition to the recent U.N. Resolution on Israel; the measure passed the House easily.
  • Newly sworn-in Sen. Young was assigned to four important Senate committees: Foreign Relations; Health, Education, Labor and Pensions; Commerce, Science and Transportation; and Small Business and Entrepreneurship.
  • Retirement is on hold for former Sen. Dan Coats, who was announced as President-elect Donald Trump’s pick for Director of National Intelligence.
  • Indiana’s now senior Sen. Joe Donnelly was awarded the Department of Defense Medal for Distinguished Public Service; Donnelly is a member of the Senate Armed Services Committee.
  • Senators Donnelly and Young were successful in getting the Government Publishing Office to formally designate Indiana residents as “Hoosiers” (bye-bye “Indianans”) and celebrated with this video announcement.
  • South Bend Mayor Pete Buttigieg threw his hat into the ring for chairman of the Democratic National Committee.

Sen. Donnelly’s Visit Highlights an Active Month for Our Congressional Affairs Committee

donnellyWhile the presidential election may be the talk of D.C. and the media, this is also a busy time of the year for federal policy conversations for the Indiana Chamber.

In mid-August alone, Sen. Joe Donnelly, Senate candidate Evan Bayh and state Sen. Jim Banks, the Republican candidate for congressional District 3, met with our congressional affairs committee members to discuss issues important to Indiana. And Congresswoman Susan Brooks (District 5) was the keynote speaker for our Indiana Conference on Energy Management, advocating for the need for both sustainable and affordable energy.

While we may never agree on all matters with our congressional members, their overall willingness to engage, listen and act – by and large – in the best interest of the Hoosier business community and residents is a longstanding hallmark of Indiana’s delegation. And we are very appreciative for that.

Donnelly, who is not up for re-election, shared his thoughts on a variety of issues during his nearly hour-long visit. For one, he contends the gridlock in Congress is overblown: “What you see on TV bears no reflection to what is reality.” He stressed that 80% of the time the group works together, but the 20% – which often features high profile issues – is what drives the media reports. And “time after time, the Indiana delegation works together.”

Whether that’s Brooks with Donnelly on the law to combat opioid abuse, signed by the President last month, or Indiana’s senior senator, Dan Coats, and Donnelly – joined by District 9 Congressman and Senate candidate Todd Young – leading the charge to suspend the medical device tax for two years. And these are just two of the many examples.

Incidentally, these are among the efforts that led to Donnelly being presented with the U.S. Chamber’s “Spirit of Enterprise” award at our office last week; the honor is for his continued commitment to job creation and economic growth.