Small Business Health Fairness Act of 2017

PL 111-148, health care reform; repeal of employer mandates; HR 246, repeal of health insurance tax; HR 1101, association health plans, Labor Department proposed Association Health Plan rule.

Client expense: $953,051 · Firm income: Not reported

Government targets: Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Aviation Administration (FAA), Federal Emergency Management Agency (FEMA), Federal Energy Regulatory Commission (FERC), Federal Highway Administration (FHA), Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

PL 111-148, health care reform; repeal of employer mandates; HR 246, repeal of health insurance tax; HR 1101, association health plans, Labor Department proposed Association Health Plan rule.

Client expense: $891,120 · Firm income: Not reported

Government targets: Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Aviation Administration (FAA), Federal Emergency Management Agency (FEMA), Federal Energy Regulatory Commission (FERC), Federal Highway Administration (FHA), Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

Legislation and federal issues related to Association Health Plans, Small Business Health Plans, Healthcare-related Tax Credits, Health Savings Accounts, Auto Enrollment and Flexible Spending Accounts. Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Proposed revisions to and repeal of the ACA, including employer mandate. H.R. 1101, Small Business Health Fairness Act of 2017. H.R. 3798, Save American Workers Act of 2017. H.R. 3919/S. 1908, Commonsense Reporting Act of 2017. H.R. 3956/S. 2670, STARS Act. S. 1782, Forty Hours Is Full Time Act of 2017. H.R. 6, SUPPORT for Patients and Communities Act.

Client expense: $600,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Small Business Administration (SBA)

Health Insurance reform HR247 - Health Savings Account Expansion Act HR708 - State Age Rate Flexibility Act HR1101 - Small Business Health Fairness Act HR1628 - American Health Care Act S28 - Health Savings Account Expansion Act S__ - Better Care Reconciliation Act Discussions with the Department of Labor (DOL) regarding association health plans (AHPs).

Client expense: $19,000,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Consumer Financial Protection Bureau (CFPB), Energy, Dept of, Environmental Protection Agency (EPA), Federal Bureau of Investigation (FBI), Federal Deposit Insurance Corporation (FDIC), Federal Emergency Management Agency (FEMA), Federal Housing Finance Agency (FHFA), Federal Reserve System, Federal Trade Commission (FTC), Financial Crimes Enforcement Network (FinCEN), Ginnie Mae, HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Credit Union Administration (NCUA), Natl Economic Council (NEC), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), SENATE, Small Business Administration (SBA), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Small Business Health Fairness Act (H.R.1101) Obamacare Replacement Act (H.R.1072/S.222) American Health Care Act of 2017/Better Care Reconciliation Act of 2017 (H.R.1628) Healthcare Tax Relief Act (S.1859) Middle Class Health Benefits Tax Repeal Act of 2017 (H.R.173, S.40, S.58) Providing for consideration of the bill (H.R. 1101) to amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees (H.Res.210) Tax Cuts and Jobs Act (H.R.1, also a TAX issue) Executive Order 13813, Promoting Healthcare Choice and Competition Across the United States RIN 1210-AB85; Definition of Employer under Section 3(5) of ERISA-Association Health Plans Continuing Appropriations Amendments Act, 2018 (H.R.1301) (Also TAX & BUD Issue)

Client expense: $50,000 · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), Education, Dept of, General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, Small Business Administration (SBA), White House Office

S.58/H.R. 173 - Middle Class Health Benefits Tax Repeal Act of 2017. This bill amends the Internal Revenue Code to repeal, beginning with taxable years beginning after December 31, 2017, the excise tax on employer-sponsored health care coverage for which there is an excess benefit (high-cost plans). H.R. 1101 - Small Business Health Fairness Act of 2017. This bill amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide for the establishment and governance of association health plans (AHPs), which are group health plans sponsored by business associations.

Client expense: $540,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1101, Small Business Health Fairness Act S. 1818, Small Business Health Plans Act of 2017 Department of Labor NPRM/Final Rule, Definition of Employer Under Section 3(5) of ERISA-Association Health Plans

Client expense: $240,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Transportation, Dept of (DOT)

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios S. 3388, Ensuring Coverage for Patients with Pre-Existing Conditions Act (Tillis) - protections for individuals with pre-existing conditions S. 3541, Reducing Costs for Out-of-Network Services Act (Shaheen) -cost-sharing for out-of-network services S. 3592, No More Surprise Medical Bills Act (Hassan) - surprise medical bills S. 3742, Cancer Drug Parity Act (Smith) - cost sharing for cancer drugs H.R. 2, Agriculture and Nutrition Act (Conaway) - agricultural association health plans H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1606, DOC Access Act (Carter) - reimbursement for dental and vision providers H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (Roskam) - access to catastrophic plans, definition of qualified health plans H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6496, Continuing Coverage for Preexisting Conditions Act (Joyce) - protections for individuals with pre-existing conditions H.R. 7003, Federal Invisible Risk Sharing Program (Schweikert) Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues related to expanding long-term care insurance coverage; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health reimbursement accounts; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $1,540,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

Employer Mandate Repeal;Commonsense Reporting Act of 2017, H.R. 3919, S. 1908; HR 173/S. 58, Middle Class Health Benefits Tax Repeal Act; HR 1101, Small Business Healthcare Relief Act; HR 246, Health Insurance; HR 1628, American Health Care Act of 2017, Tax Exclusion; Better Care Reconciliation Act; S. 1859; Bipartisan HSA Improvement Act; HR 5138 Association Health Plans; STARS Act, H.R. 3956, S. 2670

Client expense: $171,955 · Firm income: Not reported

Government targets: Education, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act H.R. 35, Health Savings Act of 2017 H.R. 143, Health Insurance Industry Antitrust Enforcement Act of 2017 H.R. 173/S. 40/S. 58, Middle Class Health Benefits Tax Repeal Act of 2017 H.R. 184, Protect Medical Innovation Act of 2017 H.R. 195, Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes H.R. 246, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 394/S. 85, Restoring Access to Medication Act of 2017 H.R. 620, ADA Education and Reform Act of 2017 H.R. 849/S. 260, Protecting Seniors Access to Medicare Act H.R. 1101, Small Business Health Fairness Act of 2017 H.R. 1175/S. 403, Health Savings Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 1313, Preserving Employee Wellness Programs Act H.R. 1625, Consolidated Appropriations Act, 2018 H.R. 1892, Bipartisan Budget Act of 2018 H.R. 3331, To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology H.R. 3798, Save American Workers Act of 2017 H.R. 4284, Indexing Narcotics, Fentanyl, and Opioids (INFO) Act of 2018 H.R. 4616, To amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on the medical device excise tax H.R. 4618, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619, To amend the Patient Protection and Affordable Care Act to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620, Protecting Families and Small Businesses Act of 2017 H.R. 4978/S. 2410, Chronic Disease Management Act of 2018 H.R. 5009, Jessies Law H.R. 5041, Safe Disposal of Unused Medication Act H.R. 5138, Bipartisan HSA Improvement Act of 2018 H.R. 5272, To provide additional guidance to grantees seeking funding to treat or prevent mental health or substance use disorders H.R. 5582, Abuse Deterrent Access Act of 2018 H.R. 5788, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 H.R. 5892, To establish an Advisory Committee on Opioids and the Workplace to advise the Secretary of Labor on actions the Department of Labor can take to address the impact of opioid abuse on the workplace H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018 S. 108, Medical Device Access and Innovation Protection Act S. 191, Patient Freedom Act of 2017 S. 222, Obamacare Replacement Act S. 251, Protecting Medicare from Executive Action Act of 2017 S. 974, Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2017 S. 1835, Lower Premiums Through Reinsurance Act of 2017 S. 1850, Protecting Jessica Grubb's Legacy Act S. 1859, Healthcare Tax Relief Act S. 1978, Small Business and Family Health Tax Relief Act of 2017 S. 2004, Combating the Opioid Epidemic Act S. 2164, To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings S. 3057, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 Draft legislation to stabilize individual market premiums for the 2018 and 2019 plan years and provide meaningful State flexibility (Alexander-Murray) Proposed regulation on health reimbursement arrangements and other account-based group health plans (83 Fed. Reg. 54,420-54,477, October 29, 2018) Final Regulation, definition of employer under Section 3(5) of ERISA - association health plans (83 Fed. Reg. 28912-28964, June 21, 2018) Various issues relating to Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including the employer-sponsored health care system, implementation of regulatory process, provider network adequacy, delivery system reform, health savings account (HSAs), health reimbursement account (HRAs), and flexible spending account (FSAs) changes, IPAB, employer mandate, reporting requirements for issuers and applicable large employers, premium stabilization programs, medical loss ratio, medical malpractice reform, exchanges, the impact on small business, the Small Business Tax Credit, section 1332 waivers, section 1557 on nondiscrimination, caps on compensation deductibility required under section 9014, incompleteness or inaccuracy of cost impact analysis, lack of quantified benefit analysis, and need for empirical data sources on which to base costs and benefits, the Cost Sharing Reduction (CSR) program, the section 9010 Health Insurance Providers Fee or Health Insurance Tax (HIT), 40% excise tax on high-cost employer-sponsored health coverage (Cadillac tax); medical device tax; protect Medicare Part D's Non-Interference Clause from repeal Public Health Services Act (P.L.78-410), Internal Revenue Code and the Employee Retirement Income Security Act (ERISA) (P.L. 93-406), regarding regulatory process and legislative corrections to ERISA preemption, changes to Medicare Advantage and Parts B, C, and D, including rebates and non-interference with prescription drug prices, entitlement reform, health information technology, telemedicine services in Medicare, and coordination and disease management programs; House Republican Taskforce on Health Care report; A Better Way to Fix Health Care; association health plans; importation of foreign pharmaceuticals into the United States and preemptive authority of federal food and drug regulations; Executive Order 13813, Promoting Healthcare Choice and Competition; addressing the opioids crisis, including end-stage renal disease; balance or surprise billing; single-payer health care options; aligning 42 CFR Part 2 with the Health Insurance Portability and Accountability Act (P.L. 104-191) for the purposes of treatment, payment, and health car operation (TPO); inclusion of prescription drug pricing on 2019 congressional agenda; general advocacy for Congress to reach a working quorum for the board of the Export-Import Bank; section 301 of the Trade Act of 1974; U.N. Convention on the Assignment of Receivables in Int'l Trade

Client expense: $15,950,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Consumer Financial Protection Bureau (CFPB), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Energy Regulatory Commission (FERC), Federal Reserve System, Federal Trade Commission (FTC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Natl Telecommunications & Information Administration (NTIA), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), Office of the Vice President of the United States, Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Social Security Administration (SSA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office

OSHA Fall Protection, Davis-Bacon, Employee Misclassification, NLRB and DOL proposed rules on union elections, micro-unions and persuader activity, proposals related to DOL overtime rules, proposals related to NLRB joint employer liability, proposals related to association health plans, policies related to the implementation of the Affordable Care Act, including the employer mandate, Shared Responsibility Rules and the implementation of the small business exchanges, OSHA Crystalline Silica Rulemaking, proposals related to EE0-1 form. H.R. 1101, Small Business Health Fairness Act of 2017. H.J. Res. 83/S.J Res. 27, Disapproving the rule submitted by the Department of Labor relating to "Clarification of Employer's Continuing Obligation to Make and Maintain an Accurate Record of Each Recordable Injury and Illness".

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

EDA supports the passage of H.R. 1101, the Small Business Health Fairness Act of 2017. This bill would allow small businesses to be exempt from certain healthcare obligations under the Affordable Care Act. EDA supports the passage of H.R. 33 and S. 584, The Small Business Regulatory Flexibility Improvements Act of 2017. These bills would modify the rulemaking requirements to include initial and final regulatory analysis. This would increase small business participation in the regulatory process and would require agencies to consider the economic impact of proposed rules. EDA supports the passage of H.R. 76, the Separation of Powers Restoration Act of 2017. This bill would modify the legal standard applied by judges to rules implemented by administrative agencies. EDA supports the including the Tillis-Harris Amendment to the House Appropriations Bill. If adopted, this amendment would increase the number of H-2B visas from 66,000 to 132,000 and implement various accountability requirements including the use of E-Verify.

Client expense: $183,119 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

EDA supports the passage of H.R. 1101. the Small Business Health Fairness Act of 2017. This bill would allow small businesses to be exempt from certain health care obligations under the Affordable Care Act. EDA supports the passage of H.R. 33 and S. 584, The Small Business Regulatory Flexibility Improvements Act of 2017. These bills would modify the rulemaking requirements to include initial and final regulatory analysis. This would increase small business participation in the regulatory process and would require agencies to consider the economic impact of proposed rules. EDA supports the passage of H.R. 76, the Separation of Powers Restoration Act of 2017. This bill would modify the legal standard applied by judges to rules implemented by administrative agencies. EDA supported the Tillis-Harris Amendment to the 2018 Appropriations Bill related to H-2B visas. If it had been adopted, the amendment would provide a permanent increase in the cap from 66,000 to 132,000.

Client expense: Not reported · Firm income: $10,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Issues Related to Professional Employer Organizations related to health benefit sponsorship, Association Health Plans H.R. 1101, the Small Business Health Fairness Act, Discussion Draft, the Self-Insurance Protection Act and Discussion Draft, Preserving Employee Wellness Programs Act. H. R. 1628,

Client expense: Not reported · Firm income: $40,000

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Personnel Management (OPM), SENATE, White House Office

Support H.R. 246, the Jobs and Premium Protection Act Support H.R. 1101, the Small Business Health Fairness Act Support H.R. 1628, the American Health Care Act Support S. 1859/ H.R. 4831, the Healthcare Tax Relief Act Support S. 222, the Obamacare Replacement Act Support H.R. 4894, the Harmful Tax Prevention Act Support S. 3063, the Health Insurance Tax Relief Act of 2018 Support H.R. 5963, To Delay the Reimposition of the Annual Fee on Health Insurance Providers Until After 2020 Support S. 1978, the Small Business and Family Health Tax Relief Act of 2017 Support H.R. 6311, the Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018

Client expense: $150,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), SENATE, Treasury, Dept of

Executive Order on Association Health Care Plans S. 1818 Small business Health Fairness Act H.R. 1101 Bipartisan HSA Improvement Act

Client expense: $60,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE, Securities & Exchange Commission (SEC), U.S. Trade Representative (USTR)

PL III-148, Patient Protection and Affordable Healthcare Act, regulations regarding employer reporting and implementation of Act; H.R. 1101,Small Business Health Fairness Act of 2017; H.R.246, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act; H.R. 1101, Small Business Health Fairness Act of 2017; S. 1818, Small Business Health Plans Act of 2017; S.1908 and H.R. 3919, Commonsense Reporting Act of 2017.

Client expense: $720,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Federal Communications Commission (FCC), Federal Trade Commission (FTC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, State, Dept of (DOS), White House Office

H.R. 246 - Health Insurance Tax H.R. 1101 - Small Business Health Care Fairness Act H.R. 1628 - American Health Care Act H.R. 1857 - Healthcare Tax Relief Act H.R. 6 - SUPPORT for Patients and Communities Act S. 3120 - HEAL Substance Use Disorders Act S. 2680 - Opioid Crisis Response Act no specific bills - health care reform, health savings accounts, reinsurance, cost sharing reductions (CSRs), special needs plans, third party payment, Risk ratios, individual market reform, market stability, Grace periods, Special Enrollment Period

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 1628 - American Health Care Act of 2017 H.R. 246 - health insurance tax repeal H.R. 1101 - Small Business Health Care Fairness Act H.R. 372 - Competitive Health Insurance Reform Act H.R. 1121 - Pre-existing Conditions Protection Act of 2017 H.R. 708- State Age Rating Flexibility Act H.R. 6 - SUPPORT for Patients and Communities Act S. 3120 - HEAL Substance Use Disorders Act S. 2680 - Opioid Crisis Response Act ***, no specific bill(s), Health Savings Accounts/Medical Savings Accounts, Transparency, Interoperability, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Uninsured, Employer Based Health System, Exchanges, Risk Corridors and Reinsurance, Federal employees and regional PPOs, Cybersecurity, telehealth, Co-ops, special enrollment periods, Risk Mitigation, mental health, opioid abuse, market stabilization, out of network billing, risk adjustment, value based purchasing, NBPP

Client expense: Not reported · Firm income: $90,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

H.R.1101 - Small Business Health Fairness Act Affordable Care Act

Client expense: $182,508 · Firm income: Not reported

Government targets: Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Federal Motor Carrier Safety Administration, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE

Employer Mandate Repeal;Commonsense Reporting Act of 2017, H.R. 3919, S. 1908; HR 173/S. 58, Middle Class Health Benefits Tax Repeal Act; HR 1101, Small Business Healthcare Relief Act; HR 246, Health Insurance; HR 1628, American Health Care Act of 2017, Tax Exclusion; Better Care Reconciliation Act; S. 1859; Bipartisan HSA Improvement Act; HR 5138 Association Health Plans; STARS Act, H.R. 3956, S. 2670

Client expense: $171,955 · Firm income: Not reported

Government targets: Education, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Affordable Care Act, all provisions; HR1101 - Small Business Health Fairness Act, all provisions; HR173/S58 - Middle Class Health Benefits Tax Repeal Act, all provisions; H.R. 246 Jobs and Premium Protection Act; S.1859 - Healthcare Tax Relief Act; S.1978 - Small Business and Family Health Tax Relief Act; HR 4616 - Cadillac Tax; Employer Mandate Delay; H.R.4620 - Protecting Families and Small Businesses Act; HR4200/S.2052 - Healthcare Market Certainty and Mandate Relief Act; S. 1996/HR 2919 Commonsense Reporting Act; Cadillac Tax; ERISA; Opioids Legislation - mental health parity enforcement. HR 5138, Bipartisan HSA Improvement Act, all provisions. DOL rule on Association Health Plans; surprise billing. H.R.6 - Support for Patients and Communities Act, Mental health parity; ESRD HR 6301 - All Provisions HR 6317 - All Provisions HR 6305 - All Provisions, Bipartisan HSA Improvement Act HR 6312 - All Provisions, PHIT Act HR 6309 - All Provisions HR 6199 - All Provisions HR 6306 - All Provisions HR 6313 - All Provisions, Responsible Additions And Increases To Sustain Employee Health Benefits HR 6314 - All Provisions, Health Savings Act HR 6311 - All Provisions HR 3919 - All Provisions, Commonsense Reporting Act S.1908 - Commonsense Reporting Act H.R. 3798-Save American Workers Act - all provisions

Client expense: $2,540,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Consumer Product Safety Commission (CPSC), Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Federal Maritime Commission, Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), Natl Telecommunications & Information Administration (NTIA), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, White House Office

S 3702/HR 7223 - Tax legislation, provisions regarding generic drugs S 3738/HR 7251 - Patent legislation regarding inter partes review HR 302 - FAA Re-authorization (provisions related to air ambulance services HR 7217 - IMPROVE Act Blueprint on Drug Pricing State Reinsurance Program H.R. 6 - The Support for Patients and Communities Act S 1835 - Lower Premiums through Reinsurance Act of 2017. Collins (R-ME) HR 3545 - Overdose Prevention and Patient Safety Act. Murphy (R-PA) S 1850 - Protecting Jessica Grubbs Legacy Act. Manchin (D-WV) HR 4200 & S 2052 - To provide for temporary funding for health insurance cost-sharing reduction payments and provide targeted tax relief, and for other purposes. HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). S. 974 and H.R. 2212 - Creates Act of 2017: To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: To amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State law. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR) HR - 6082 Overdose Prevention and Patient Safety Act S 2554 Patient Right to Know Drug Prices Act

Client expense: $150,000 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Energy, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Issues related to agent compensation. Issues related to the implementation of the Patient Protection and Affordable Care Act: H.R. 246, H.R. 394 and S. 761. Issues related to HSA/FSA reform including S. 28 and H.R. 247. Issues related to the McCarran Ferguson antitrust exemption including H.R. 372. Issues with respect to the small employer health care insurance taxes including S. 58 and H.R. 173. Issues relating to the establishment and governance of association health plans (AHPs) including H.R. 1101. Issues related to the American Health Care Act H.R. 1628. Issues related to short-term limited duration insurance.

Client expense: $624,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of

HR.3798, Save American Workers Act HR.246, Jobs & Premium Protection Act HR.173, Middle Class Health Benefits Tax Repeal Act HR.1628, American Healthcare Act HR.1101, Small Business Fairness Act S.1859, Healthcare Tax Relief Act S.1979, Small Business & Family Health Tax Relief Act S.1908 and HR.3919, Commonsense Reporting Act to streamline IRG reporting process HR.5138, Bipartisan HSA Improvement Act Repeal Cadillac Tax Authorize small business health plans; preserve employee exclusion Preserve ERISA preemption American Health Care Act of 2017 Health Insurance Tax (HIT) Cost-sharing reduction payments under ACA

Client expense: $135,736 · Firm income: Not reported

Government targets: Federal Aviation Administration (FAA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Transportation, Dept of (DOT), Treasury, Dept of

H.R.1101 - Small Business Health Fairness Act of 2017 - This bill amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide for the establishment and governance of association health plans (AHPs), which are group health plans sponsored by business associations. Commenting/Following proposed regulations concerning the expansion of Small Business Health Plans (Association Health Plans). Following how the expansion will be done, who will be covered, and if 501(c)(6) will be allowed to participate.

Client expense: Not reported · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), SENATE, Small Business Administration (SBA), U.S. International Trade Commission (ITC)

Small Business Health Fairness Act (H.R.1101) Obamacare Replacement Act (H.R.1072/S.222) American Health Care Act of 2017/Better Care Reconciliation Act of 2017 (H.R.1628) Healthcare Tax Relief Act (S.1859) Middle Class Health Benefits Tax Repeal Act of 2017 (H.R.173, S.40, S.58) Providing for consideration of the bill (H.R. 1101) to amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees (H.Res.210) Tax Cuts and Jobs Act (H.R.1, also a TAX issue) Executive Order 13813, Promoting Healthcare Choice and Competition Across the United States RIN 1210-AB85; Definition of Employer under Section 3(5) of ERISA-Association Health Plans Continuing Appropriations Amendments Act, 2018 (H.R.1301) (Also TAX & BUD Issue)

Client expense: $50,000 · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), Education, Dept of, General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, Small Business Administration (SBA), White House Office

S. 2680, "The Opioid Crisis Response Act of 2018", regarding all provisions. S. 2902, "Better Data Sharing to Combat the Opioid Crisis Act" regarding all provisions. S. 3042, "Agriculture Improvement Act of 2018", regarding federal funding for AHPs. S. 974, "CREATES Act", regarding all provisions. S.3063, "Health Insurance Tax Relief Act of 2018", regarding all provisions. HR 246, "To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act", regarding all provisions. HR 1101, "Small Business Health Fairness Act of 2017", regarding all provisions. HR 314, "Health Care Choice Act of 2017", regarding all provisions. HR 1628, "American Health Care Act of 2017", regarding all provisions. HR 2051, "FAST Generics Act of 2017", regarding all provisions. HR 2400, "To amend title 5, United States Code, to allow individuals who are not Federal employees to enroll in the Federal Employees Health Benefits Program, and for other purposes", regarding all provisions. HR 2212, "CREATES Act of 2017", regarding all provisions. HR 3976, "Access to Marketplace Insurance Act", regarding all provisions. S 1835, "Lower Premiums Through Reinsurance Act of 2017", regarding all provisions. Issues relating to the Health Insurance Tax. Issues relating to the Alexander/Murray legislation to stabilize the health insurance market. HR 195, "Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes", regarding all provisions. Affordable Care Act; Reinsurance; Cost Sharing Reductions (CSRs); Special Needs Plans (SNPs); Third Party Payment Premiums (TPPs); Drug Pricing; Individual Market, Health insurance Tax, Short Term Limited Duration Plans. FAA Reauthorization Act of 2018. Issues regarding Opioids.

Client expense: $1,130,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

HR 246, "To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act", regarding all provisions. HR 1101, "Small Business Health Fairness Act of 2017", regarding all provisions. HR 314, "Health Care Choice Act of 2017", regarding all provisions. HR 1628, "American Health Care Act of 2017", regarding all provisions. HR 2051, "FAST Generics Act of 2017", regarding all provisions. HR 2400, "To amend title 5, United States Code, to allow individuals who are not Federal employees to enroll in the Federal Employees Health Benefits Program, and for other purposes", regarding all provisions. HR 2212, "CREATES Act of 2017", regarding all provisions. HR 3976, "Access to Marketplace Insurance Act", regarding all provisions. S 1835, "Lower Premiums Through Reinsurance Act of 2017", regarding all provisions. Issues relating to the Health Insurance Tax. Issues relating to the Alexander/Murray legislation to stabilize the health insurance market. The January 22 & February 8 CR and CHIP re-authorization. HR 195, "Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes", regarding all provisions. HR 1625, "Consolidated Appropriations Act, 2018", regarding all provisions. HR 1892, "Bipartisan Budget Act of 2018", regarding all provisions. Affordable Care Act; Reinsurance; Cost Sharing Reductions (CSRs); Special Needs Plans (SNPs); Third Party Payment Premiums (TPPs); Drug Pricing; Individual Market, Health insurance Tax, Short Term Limited Duration Plans.

Client expense: $1,620,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

H.R. 1101, Small Business Health Fairness Act S. 1818, Small Business Health Plans Act of 2017 Department of Labor NPRM/Final Rule, Definition of Employer Under Section 3(5) of ERISA-Association Health Plans

Client expense: $220,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Transportation, Dept of (DOT)

PL 111-148, health care reform; repeal of employer mandates; HR 246, repeal of health insurance tax; HR 1101, association health plans, Labor Department proposed Association Health Plan rule.

Client expense: $776,776 · Firm income: Not reported

Government targets: Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Aviation Administration (FAA), Federal Emergency Management Agency (FEMA), Federal Energy Regulatory Commission (FERC), Federal Highway Administration (FHA), Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

Legislation and federal issues related to Association Health Plans, Small Business Health Plans, Healthcare-related Tax Credits, Health Savings Accounts, Auto Enrollment and Flexible Spending Accounts. Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Proposed revisions to and repeal of the ACA, including employer mandate. H.R. 1101, Small Business Health Fairness Act of 2017. H.R. 1628, American Health Care Act of 2017. H.R. 3798, Save American Workers Act of 2017. H.R. 3919/S. 1908, Commonsense Reporting Act of 2017. H.R. 3956/S. 2670, STARS Act. S. 1782, Forty Hours Is Full Time Act of 2017. H.R. 6, SUPPORT for Patients and Communities Act.

Client expense: $620,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE

PL III-148, Patient Protection and Affordable Healthcare Act, regulations regarding employer reporting and implementation of Act; H.R. 1101,Small Business Health Fairness Act of 2017; H.R.246, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act; H.R. 1101, Small Business Health Fairness Act of 2017; S. 1818, Small Business Health Plans Act of 2017; S.1908 and H.R. 3919, Commonsense Reporting Act of 2017.

Client expense: $770,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Federal Communications Commission (FCC), Federal Trade Commission (FTC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, White House Office

Health Insurance reform HR247 - Health Savings Account Expansion Act HR708 - State Age Rate Flexibility Act HR1101 - Small Business Health Fairness Act HR1628 - American Health Care Act S28 - Health Savings Account Expansion Act S__ - Better Care Reconciliation Act Discussions with House and Senate offices regarding Association Health Plans (AHPs). Discussions with the Department of Labor (DOL) regarding Association Health Plans (AHPs).

Client expense: $26,400,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Consumer Financial Protection Bureau (CFPB), Environmental Protection Agency (EPA), Federal Emergency Management Agency (FEMA), Federal Housing Finance Agency (FHFA), Federal Trade Commission (FTC), Financial Crimes Enforcement Network (FinCEN), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, U.S. Copyright Office, U.S. Geological Survey (USGS), Veterans Affairs, Dept of (VA), White House Office

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios S. 3388, Ensuring Coverage for Patients with Pre-Existing Conditions Act (Tillis) - protections for individuals with pre-existing conditions H.R. 2, Agriculture and Nutrition Act (Conaway) - agricultural association health plans H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1606, DOC Access Act (Carter) - reimbursement for dental and vision providers H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (Roskam) - access to catastrophic plans, definition of qualified health plans H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6496, Continuing Coverage for Preexisting Conditions Act (Joyce) - protections for individuals with pre-existing conditions H.R. 7003, Federal Invisible Risk Sharing Program (Schweikert) Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues related to expanding long-term care insurance coverage; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $1,500,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1405, FAA Reauthorization Act (Thune) - air ambulance issues S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios H.R. 2, Agriculture and Nutrition Act (Conaway) - agricultural association health plans H.R. 4, FAA Reauthorization Act (Shuster) - air ambulance issues H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3922, CHAMPION Act (Walden) - extension of federal CHIP funding, ACA grace periods, community health center funding H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $1,410,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

EDA supports the passage of H.R. 1101, the Small Business Health Fairness Act of 2017. This bill would allow small businesses to be exempt from certain healthcare obligations under the Affordable Care Act. EDA supports the passage of H.R. 33 and S. 584, The Small Business Regulatory Flexibility Improvements Act of 2017. These bills would modify the rulemaking requirements to include initial and final regulatory analysis. This would increase small business participation in the regulatory process and would require agencies to consider the economic impact of proposed rules. EDA supports the passage of H.R. 76, the Separation of Powers Restoration Act of 2017. This bill would modify the legal standard applied by judges to rules implemented by administrative agencies.

Client expense: $183,119 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

EDA supports the passage of H.R. 1101. the Small Business Health Fairness Act of 2017. This bill would allow small businesses to be exempt from certain health care obligations under the Affordable Care Act. EDA supports the passage of H.R. 33 and S. 584, The Small Business Regulatory Flexibility Improvements Act of 2017. These bills would modify the rulemaking requirements to include initial and final regulatory analysis. This would increase small business participation in the regulatory process and would require agencies to consider the economic impact of proposed rules. EDA supports the passage of H.R. 76, the Separation of Powers Restoration Act of 2017. This bill would modify the legal standard applied by judges to rules implemented by administrative agencies.

Client expense: Not reported · Firm income: $10,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

OSHA Fall Protection, Davis-Bacon, Employee Misclassification, NLRB and DOL proposed rules on union elections, micro-unions and persuader activity, proposals related to DOL overtime rules, proposals related to NLRB joint employer liability, proposals related to association health plans, policies related to the implementation of the Affordable Care Act, including the employer mandate, Shared Responsibility Rules and the implementation of the small business exchanges, OSHA Crystalline Silica Rulemaking, proposals related to EE0-1 form. H.R. 1101, Small Business Health Fairness Act of 2017. H.J. Res. 83/S.J Res. 27, Disapproving the rule submitted by the Department of Labor relating to "Clarification of Employer's Continuing Obligation to Make and Maintain an Accurate Record of Each Recordable Injury and Illness".

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act H.R. 35, Health Savings Act of 2017 H.R. 143, Health Insurance Industry Antitrust Enforcement Act of 2017 H.R. 173/S. 40/S. 58, Middle Class Health Benefits Tax Repeal Act of 2017 H.R. 184, Protect Medical Innovation Act of 2017 H.R. 195, Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes H.R. 246, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 394/S. 85, Restoring Access to Medication Act of 2017 H.R. 620, ADA Education and Reform Act of 2017 H.R. 849/S. 260, Protecting Seniors Access to Medicare Act H.R. 1101, Small Business Health Fairness Act of 2017 H.R. 1175/S. 403, Health Savings Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 1313, Preserving Employee Wellness Programs Act H.R. 1625, Consolidated Appropriations Act, 2018 H.R. 1892, Bipartisan Budget Act of 2018 H.R. 3331, To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology H.R. 3798, Save American Workers Act of 2017 H.R. 4284, Indexing Narcotics, Fentanyl, and Opioids (INFO) Act of 2018 H.R. 4616, To amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on the medical device excise tax H.R. 4618, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619, To amend the Patient Protection and Affordable Care Act to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620, Protecting Families and Small Businesses Act of 2017 H.R. 4978/S. 2410, Chronic Disease Management Act of 2018 H.R. 5009, Jessies Law H.R. 5041, Safe Disposal of Unused Medication Act H.R. 5138, Bipartisan HSA Improvement Act of 2018 H.R. 5272, To provide additional guidance to grantees seeking funding to treat or prevent mental health or substance use disorders H.R. 5582, Abuse Deterrent Access Act of 2018 H.R. 5788, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 H.R. 5892, To establish an Advisory Committee on Opioids and the Workplace to advise the Secretary of Labor on actions the Department of Labor can take to address the impact of opioid abuse on the workplace H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018 S. 108, Medical Device Access and Innovation Protection Act S. 191, Patient Freedom Act of 2017 S. 222, Obamacare Replacement Act S. 251, Protecting Medicare from Executive Action Act of 2017 S. 974, Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2017 S. 1835, Lower Premiums Through Reinsurance Act of 2017 S. 1850, Protecting Jessica Grubb's Legacy Act S. 1859, Healthcare Tax Relief Act S. 1978, Small Business and Family Health Tax Relief Act of 2017 S. 2004, Combating the Opioid Epidemic Act S. 2164, To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings S. 3057, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 Draft legislation to stabilize individual market premiums for the 2018 and 2019 plan years and provide meaningful State flexibility (Alexander-Murray) Proposed regulations on definition of employer under section 3(5) of ERISA-association health plans (83 Fed. Reg. 614-636, January 5, 2018) Various issues relating to Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including the employer-sponsored health care system, implementation of regulatory process, provider network adequacy, delivery system reform, health savings account (HSAs), health reimbursement account (HRAs), and flexible spending account (FSAs) changes, IPAB, employer mandate, reporting requirements for issuers and applicable large employers, premium stabilization programs, medical loss ratio, medical malpractice reform, exchanges, the impact on small business, the Small Business Tax Credit, section 1332 waivers, section 1557 on nondiscrimination, caps on compensation deductibility required under section 9014, incompleteness or inaccuracy of cost impact analysis, lack of quantified benefit analysis, and need for empirical data sources on which to base costs and benefits, the Cost Sharing Reduction (CSR) program, the section 9010 Health Insurance Providers Fee or Health Insurance Tax (HIT), 40% excise tax on high-cost employer-sponsored health coverage (Cadillac tax); Public Health Services Act (P.L.78-410), Internal Revenue Code and the Employee Retirement Income Security Act (ERISA) (P.L. 93-406), regarding regulatory process and legislative corrections to ERISA preemption, changes to Medicare Advantage and Parts B, C, and D, including rebates and non-interference with prescription drug prices, entitlement reform, health information technology, telemedicine services in Medicare, and coordination and disease management programs; House Republican Taskforce on Health Care report, A Better Way to Fix Health Care; association health plans; importation of foreign pharmaceuticals into the United States and preemptive authority of federal food and drug regulations; Executive Order 13813, Promoting Healthcare Choice and Competition; addressing the opioids crisis, including end-stage renal disease; balance or surprise billing; single-payer health care options

Client expense: $17,560,000 · Firm income: Not reported

Government targets: Agency for Toxic Substances & Disease Registry, Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Consumer Financial Protection Bureau (CFPB), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Energy Regulatory Commission (FERC), Federal Reserve System, Federal Trade Commission (FTC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Natl Telecommunications & Information Administration (NTIA), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), Office of the Vice President of the United States, Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Social Security Administration (SSA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Fish & Wildlife Service (USFWS), U.S. Trade Representative (USTR), White House Office

Blueprint on Drug Pricing State Reinsurance Program H.R. 6 - The Support for Patients and Communities Act HR 4666 - Relief Act of 2017. Costello (R-PA) S 1835 - Lower Premiums through Reinsurance Act of 2017. Collins (R-ME) HR 3545 - Overdose Prevention and Patient Safety Act. Murphy (R-PA) S 1850 - Protecting Jessica Grubbs Legacy Act. Manchin (D-WV) HR 4200 & S 2052 - To provide for temporary funding for health insurance cost-sharing reduction payments and provide targeted tax relief, and for other purposes. HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) HR 3922 - Community Health And Medical Professionals Improve Our Nation Act of 2017: To extend funding for certain public health programs, and for other purposes. Walden (R-OR) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). S. 974 and H.R. 2212 - Creates Act of 2017: To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: To amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State law. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR) HR - 6082 Overdose Prevention and Patient Safety Act S 2554 Patient Right to Know Drug Prices Act

Client expense: $150,000 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Energy, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 246 - Health Insurance Tax H.R. 1101 - Small Business Health Care Fairness Act H.R. 1628 - American Health Care Act H.R. 1857 - Healthcare Tax Relief Act H.R. 6 - SUPPORT for Patients and Communities Act S. 3120 - HEAL Substance Use Disorders Act S. 2680 - Opioid Crisis Response Act no specific bills - health care reform, health savings accounts, reinsurance, cost sharing reductions (CSRs), special needs plans, third party payment, Risk ratios, individual market reform, market stability, Grace periods, Special Enrollment Period

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 1628 - American Health Care Act of 2017 H.R. 246 - health insurance tax repeal H.R. 1101 - Small Business Health Care Fairness Act H.R. 372 - Competitive Health Insurance Reform Act H.R. 1121 - Pre-existing Conditions Protection Act of 2017 H.R. 708- State Age Rating Flexibility Act H.R. 6 - SUPPORT for Patients and Communities Act S. 3120 - HEAL Substance Use Disorders Act S. 2680 - Opioid Crisis Response Act ***, no specific bill(s), Health Savings Accounts/Medical Savings Accounts, Transparency, Interoperability, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Uninsured, Employer Based Health System, Exchanges, Risk Corridors and Reinsurance, Federal employees and regional PPOs, Cybersecurity, telehealth, Co-ops, special enrollment periods, Risk Mitigation, mental health, opioid abuse, market stabilization, out of network billing, risk adjustment, value based purchasing

Client expense: Not reported · Firm income: $90,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

H.R. 1101, Small Business Health Fairness Act S. 1818, Small Business Health Plans Act of 2017 Department of Labor NPRM/Final Rule, Definition of Employer Under Section 3(5) of ERISA-Association Health Plans

Client expense: $220,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Transportation, Dept of (DOT)

Employer Mandate Repeal;Commonsense Reporting Act of 2017, H.R. 3919, S. 1908; HR 173/S. 58, Middle Class Health Benefits Tax Repeal Act; HR 1101, Small Business Healthcare Relief Act; HR 246, Health Insurance; HR 1628, American Health Care Act of 2017, Tax Exclusion; Better Care Reconciliation Act; S. 1859; Bipartisan HSA Improvement Act; HR 5138 Association Health Plans; STARS Act, H.R. 3956, S. 2670

Client expense: $171,956 · Firm income: Not reported

Government targets: Education, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office