Health Savings Act of 2018

S. 28, Health Savings Account Expansion Act (Flake) - HSA improvements S. 85, Restoring Access to Medications Act (Roberts) - paying for OTC products with HSA funds S. 403, Health Savings Act (Hatch) - HSA and FSA improvements S. 761, Health Care Options Act (Alexander) - using premiums for off-Exchange plans S. 1859, Healthcare Tax Relief Act (Gardner) - suspension of ACA health insurance tax S. 1978, Small Business and Family Health Tax Relief Act (Heitkamp) - suspension of ACA health insurance tax S. 2410, Chronic Disease Management Act (Thune) - flexibility for high-deductible health plans S. 3063, Health Insurance Tax Relief Act (Barrasso) - suspension of ACA health insurance tax H.R. 88, Retirement, Savings, and Other Tax Relief Act - relief from health insurance tax and Cadillac tax H.R. 246, Jobs and Premium Protection Act (Noem-Sinema) - repeal of ACA health insurance tax H.R. 247, Health Savings Account Expansion Act (Brat) - HSA improvements H.R. 394, Restoring Access to Medications Act (Jenkins) - paying for OTC products with HSA funds H.R. 1175, Health Savings Act (Paulsen) - HSA and FSA improvements H.R. 3798, Save American Workers Act (Walorski) - delay in Cadillac tax H.R. 4616 (Nunes) - delay in ACA excise tax on employer-provided health coverage H.R. 4618 (Jenkins) - use of HSA funds for OTC medications H.R. 4620, Protecting Families and Small Businesses Act (Noem) - relief from ACA health insurance tax H.R. 4894, Harmful Tax Prevention Act (Noem) - relief from ACA health insurance tax H.R. 4978, Chronic Disease Management Act (Black) - flexibility for high-deductible health plans H.R. 5138, Bipartisan HSA Improvement Act (Kelly) - HSA changes H.R. 5963, Health Insurance Premium Reduction Act (Noem) - suspension of ACA health insurance tax H.R. 6199, Restoring Access to Medication Act (Jenkins) - OTC medical products as qualified medical expense, HSA improvements H.R. 6301, Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act (Roskam) - flexibility on first dollar coverage for HSA plans H.R. 6305, Bipartisan HSA Improvement Act (Kelly) - HSA flexibility; treatment of certain employment-related services; FSA and HRA conversions H.R. 6306, Health Care Security Act (Paulsen) - HSA contribution limits, spousal catch-up contributions, grace period for medical expenses H.R. 6309, Allowing Working Seniors to Keep Their Health Savings Accounts Act (Paulsen) - HSA contributions by Medicare-eligible individuals H.R. 6311, Increasing Access to Lower Premium Plans and Expanding HSAs Act (Roskam) - suspension of health insurance tax, HSA improvements H.R. 6312, Personal Health Investment Today Act (Smith) - medical care tax deduction for qualified sports and fitness expenses H.R. 6313, RAISE Health Benefits Act (Stivers) - Health FSA rollovers H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6317, Primary Care Enhancement Act (Paulsen) - participation by HSA-eligible individuals in direct primary care (DPC) arrangements Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate; W-2 reporting requirements; health reimbursement accounts; deductibility limits for insurer compensation; health insurer and employer reporting of health coverage; issues related to implementation of health insurance tax; issues related to the refundable credit for coverage under a qualified health plan; issues related to coverage of chronic conditions in high deductible health plans; issues related to health savings accounts; issues related to the deductibility of employer-sponsored health coverage; issues related to enhancing tax treatment of long-term care insurance; issues related to qualified small employer health reimbursement accounts (QSEHRAs); issues related to implementation of the excise tax on high cost employer-sponsored health coverage; 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

Support for permanent business deduction for sole proprietors on insurance premiums. Support implementation and expansion of HRA availability. Continued addressing of ACA implementation and analysis of new health care bills. Support HRA's as a tool for micro-business. Advocacy against the classification of HRAs as health insurance. Support protection of Essential health Benefits. Support robust individual health insurance markets. Regulatory action regarding HSA's at Health and Human Services. Support small business and self-employed issues in American Health Care Act of 2017 (H.R. 1628). Support H.R. 2953 scoring amendments. Support favorable treatment of HRA and AHIP in Executive Orders affecting the ACA. Support H.R. 6314 The Health Savings Act of 2018.

Client expense: $80,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of

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

ACA; Medicare Part D Reform; ERISA; Health Reform; Transparency; Market Stabilization; Medication Adherence; Value-based Purchasing; HSAs; Drug Pricing; HR 6301 the "Promoting High-Value Health Care through Flexibility for High Deductible Plans Act of 2018"; HR 6199 the "Restoring Access to Medication Act of 2018"; HR 6314 the "Health Savings Act of 2018"; HR 6311 the "Increasing Access to Lower Premiums Act of 2018."

Client expense: Not reported · Firm income: $160,000

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

H.R.5 - Regulatory Accountability Act of 2017 To reform the process by which Federal agencies analyze and formulate new regulations and guidance documents, to clarify the nature of judicial review of agency interpretations, to ensure complete analysis of potential impacts on small entities of rules, and for other purposes. NSBA supports. H.R. 8 - Water Resources Development Act of 2018 H.R. 8 authorizes Army Corps of Engineers (Corps) civil works activities and builds on previous reform efforts to ensure improvements are made to the Nations ports, inland waterways, locks, dams, flood protection, ecosystem restoration, and other water resources infrastructure. NSBA supports. H.R. 10 - The Financial CHOICE Act of 2017 Bill repeals provisions of the Dodd-Frank Act, aims to eliminate red tape to increase access to capital and credit and create opportunities for investors, consumers and entrepreneurs. NSBA is monitoring. H.R. 25 - The Fair Tax Act To promote freedom, fairness, and economic opportunity by repealing the income tax and other taxes, abolishing the Internal Revenue Service, and enacting a national sales tax to be administered primarily by the states. NSBA supports H.R. 33 - Small Business Regulatory Flexibility Improvements Act This bill modifies the rulemaking requirements and procedures of federal agencies (excluding Congress, U.S. courts, U.S. territories and possessions, and the District of Columbia) under the Regulatory Flexibility Act of 1980 (RFA) and the Small Business Regulatory Enforcement Fairness Act of 1996 (SBREFA). NSBA supports. H.R.76 - Separation of Powers Restoration Act of 2017 This bill modifies the scope of judicial review of agency actions to authorize courts reviewing agency actions to decide de novo (without giving deference to the agency's interpretation) all relevant questions of law, including the interpretation of: (1) constitutional and statutory provisions, and (2) rules made by agencies. NSBA supports. H.R. 79 - Helping Angels Lead Our Startups (HALOS) Act The legislation will make it easier for businesses to notify potential investors of their offerings as well as provide a statutory definition for angel investor group. Additionally, it would require the Securities Exchange Commission (SEC) to revise the Regulation D rules regarding general solicitation. NSBA supports. H.R. 184 -- Protect Medical Innovation Act of 2017 This bill amends the Internal Revenue Code to repeal the excise tax on the sale of a medical device by the manufacturer, producer, or importer. NSBA supports. H.R. 198 -- Death Tax Repeal Act of 2017 This bill repeals the federal estate, gift, and generation-skipping transfer taxes. NSBA supports. H.R. 477 - Small Business Mergers, Acquisitions, Sales & Brokerage Simplification Act of 2017 The bill alleviates costs to small-business owners by simplifying the securities registration system for mergers and acquisition brokers who help transfer the ownership of small, privately held companies. It also disqualifies bad actors from utilizing the simplified process and does not allow transactions involving shell companies. NSBA supports. H.R. 561 - Small Business Job Protection Act of 2017 This bill amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act, to redefine "applicable large employer," for purposes of the mandate requiring employers to provide health insurance for their employees, to mean an employer with at least 100 full-time employees (currently, 50). NSBA supports. H.R. 631 - Death Tax Repeal Act of 2017 This bill amends the Internal Revenue Code to: (1) repeal the estate and generation-skipping transfer taxes, and (2) make permanent the maximum 35% gift tax rate and the lifetime gift tax exemption. The bill provides for an inflation adjustment to such exemption amount. NSBA supports. H.R. 1105 - Stop WOTUS Act To repeal the rule entitled "Clean Water Rule: Definition of 'Waters of the United States. NSBA supports H.R.1180 - Working Families Flexibility Act of 2017 This bill amends the Fair Labor Standards Act of 1938 to authorize employers to provide compensatory time off to private employees at a rate of not less than 1 1/2 hours for each hour of employment for which overtime compensation is required, but only if it is in accordance with an applicable collective bargaining agreement or, in the absence of such an agreement, an agreement between the employer and employee. NSBA supports. H.R. 1314 - Renewable Fuel Standard Repeal Act The bill would remove the renewable fuel standard. NSBA is monitoring. H.R. 1339 - Freedom from Government Competition Act Legislation that would require federal agencies to rely on the private sector when providing goods and services that are readily available. NSBA supports. H.R. 1585 - Fair Investment Opportunities for Professional Experts Act It modernizes the definition of accredited investor so those who do not have a high income or high net worth but do have the education and job experience to evaluate investment risks and merits can participate in the growth of promising companies. NSBA supports. H.R. 1680 - Womens Business Centers Improvements Act The bill revises the duties of the Office of Women's Business Ownership and declares it is the Office's mission to assist women entrepreneurs to start, grow, and compete in global markets by providing quality support with access to capital, access to markets, job creation, growth, and counseling. NSBA supports. H.R. 1702 - Small Business Development Centers Improvement Act This bill amends the Small Business Act with respect to the authority of the Small Business Administration (SBA) to use certain SBA programs, including the small business development center (SBDC) program, to provide grants, financial assistance, loans, export assistance, and subcontracting opportunities on federal contracts to specified small businesses, organizations, state governments, universities, companies, and other entities that assist smaller enterprises. NSBA supports. H.R. 1773 - The Clarity for Americas Small Contractors Act of 2017 Amends the Small Business Act to improve reporting on small business goals, achieve uniformity in procurement terminology, clarify the role of small business advocates, and for other purposes. NSBA supports. H.R. 1774 - The Developing the Next Generation of Small Business Act of 2017 Amends the Small Business Act to provide for improvements to small business development centers, the women's business center program, the SCORE program, and for other purposes. NSBA supports. H.R. 2364 - The Investing in Main Street Act H.R. 2364 increases the amount of capital and surplus that a financial institution and federal savings association can invest in a SBIC from 5 percent to 15 percent in order to assist small businesses in obtaining venture capital and private equity. NSBA supports. H.R. 3170 - Small Business Development Center Cyber Training Act This bill amends the Small Business Act to require the Small Business Administration to establish a program for certifying employees of small business development centers to provide cybersecurity planning assistance to small businesses. NSBA supports. H.R. 3717 - the Small Business Owners Tax Simplification Act H.R 3717 introduces a number of provisions to benefit small businesses, such as aligning estimated payment deadlines and tax filing thresholds, as well as tackling inconsistencies in reporting requirements. NSBA supports. H.R. 3972 - Family Office Technical Correction Act The bill clarifies that family offices and family clients, as defined in section 275.202(a)(11)(G)-1 of title 17, Code of Federal Regulations, are accredited investors under Regulation D of the Securities and Exchange Commission. NSBA supports. H.R. 3798 -- Save American Workers Act It delays the ACAs employer mandate, further postpones the so-called Cadillac tax on high-cost health plans and changes the definition of a full-time worker to someone employed 40 hours a week, up from 30 hours. In a win for the sun-tanning lobby, it would repeal ACAs 10 percent tax on indoor tanning salons. NSBA supports. H.R. 4111 - Spurring Business in Communities Act This bill amends the Small Business Investment Act of 1958 to: require the Small Business Administration (SBA), in reviewing and processing a small business investment company's (SBIC's) application, to give first priority to an SBIC applicant located in an underlicensed state (i.e., a state in which the number of licensees per capita is less than the median number of licensees per capita for all states) with below median financing; and exempt applicants in underlicensed states from certain SBA capital requirements. NSBA supports. H.R. 4616 - Employer Relief Act of 2018 It provide for a temporary moratorium on the employer mandate until Jan. 1, 2019 and delay for one year- until after Dec. 31, 2020-the implementation of the Cadillac Tax. NSBA supports. H.R. 4754 - Change Order Transparency for Federal Contractors Act Amend the Small Business Act to provide prospective construction contractors with information about an agency's policies on the administration of change orders to allow such contractors to make informed business decisions regarding the pricing of bids or proposals, and for other purposes. NSBA supports. H.R. 4886 - Permanent Tax Cuts for Americans Act This bill makes permanent the provisions of subtitle A (Individual Tax Reform) and subtitle B (Alternative Minimum Tax) of P.L. 115-97 (commonly known as the Tax Cuts and Jobs Act) that are currently scheduled to terminate on December 31, 2025. NSBA supports. H.R. 5236 - Main Street Employee Ownership Act Expands opportunities available to employee-owned business concerns through Small Business Administration loan programs, and for other purposes. NSBA supports. H.R. 5340 - Support Technology & Research for Our Nations Growth and Economic Resilience (STRONGER) Patents Act The STRONGER Patents Act would restore patents as property rights, make standards of protections in courts uniform, and protect start-ups from being out-resourced by technology incumbents. NSBA supports. H.R. 5515 -John S. McCain National Defense Authorization Act for Fiscal Year 2019 The bill authorizes FY2019 appropriations and sets forth policies for Department of Defense (DOD) programs and activities, including military personnel strengths. NSBA supports the small business contracting provisions. H.R. 5660 - The Small Business Credit Card Act The measure provides small-business owners the same consumer protections as individual credit card holders, by protecting small-business owners credit cards from unfair and deceptive practices of credit card companies. NSBA supports. H.R. 5728 - The Workplace Democracy Act The bill narrows who can lawfully be classified an independent contractor, nullify state right-to-work laws, and allow workers to vote in a union campaign through the informal method of card check instead of a secret-ballot vote. NSBA opposes. H.R. 6199 -- Restoring Access to Medication Act of 2018 This bill repeals provisions of the Internal Revenue Code, as added by the Patient Protection and Affordable Care Act, that limit payments for medications from health savings accounts, medical savings accounts, health flexible spending arrangements, and health reimbursement arrangements to only prescription drugs or insulin (thus allowing distributions from such accounts for over-the-counter drugs). The bill also allows the accounts to be used for menstrual care products. NSBA supports. H.R. 6264 - Restoring Americas Leadership in Innovation Act Bill offers various reforms and other improvements to the current U.S. patent system and helps to reverse prior bills discouraging innovation in the U.S. by weakening patents. NSBA supports. H.R. 6301 - Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act of 2018 It expands access and enhances the utility of HSAs by offering health plans a certain amount of flexibility in their plan design while still maintaining eligibility for HSA contributions. This flexibility will allow insurers to offer coverage for high-value, low-cost services like telehealth, chronic disease management (e.g. diabetic testing strips), or primary care visits below the deductible. NSBA supports. H.R. 6305 - Bipartisan HSA Improvement Act of 2018 The bill would allow eligible individuals to make HSA contributions if a spouse has a flexible spending account and permit flexible spending accounts and health reimbursement account terminations or conversions to fund HSAs. NSBA supports. H.R. 6306 - Health Care Security Act of 2018 It expands access and enhances the utility of HSAs by: (1) increasing the contributions limits for HSAs; (2) permitting spousal catch-up contributions into the same account; and (3) creating a grace period for medical expenses incurred before the establishment of an HSA. NSBA supports. H.R. 6311 - The Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act The bill expands access and use of Health Savings Accounts (HSAs) and lowers premiums on health care plans. NSBA supports. H.R. 6314 - Health Savings Act of 2018 H.R. 6314 expands eligibility and access to HSAs by allowing plans categorized as catastrophic and bronze in the individual and small group markets to qualify for HSA contributions. NSBA supports. H.R. 6316 - Small Business Advocacy Improvements Act of 2018 H.R. 6316 allows the SBA Office of Advocacy to examine the role of small business in international economies and to represent small business views before foreign governments and international entities. NSBA supports. H.R. 6321 - Investment Adviser Regulatory Flexibility Improvement Act The legislation directs the SEC to consider alternative methods for businesses or organizations to qualify as a small business or small organization for the purposes of assessing the regulatory impact on investment advisors. NSBA supports. H.R. 6330 - Small Business Runway Extension Act of 2018 H.R. 6330 modifies SBAs size calculation to provide small businesses with more time to be considered small for the purposes of SBAs small business programs. NSBA supports. H.R. 6347 - 7 (a) Real Estate Harmonization Act H.R. 6347 updates SBAs 7(a) Loan Programs commercial real estate appraisal threshold. NSBA supports. H.R. 6348 - Small Business Access to Capital and Efficiency (ACE) Act H.R. 6348 reduces burdens and conflicting regulations for small businesses by updating the Small Business Administrations 504/Certified Development Company Loan Programs commercial real estate appraisal threshold. NSBA supports. H.R. 6367 - Incentivizing Fairness in Subcontracting H.R. 6367 allows large prime contractors to take credit for subcontracting to small businesses at lower tiers, provided that prime contractors keep records substantiating subcontracting credit claimed at lower tiers, and creates a new dispute process for small subcontractors to bring nonpayment issues to the agencys small business advocate (Offices of Small and Disadvantaged Business Utilization). NSBA supports. H.R. 6368 - Encouraging Small Business Innovators Act H.R. 6368 makes a series of changes to the Small Business Innovation Research and Small Business Technology Transfer programs, making them easier for small firms to use. NSBA supports. H.R. 6369 - Expanding Contracting Opportunities for Small Businesses Act of 2018 H.R. 6369 increases the size of sole source contract awards for women owned, service-disabled veteran-owned, HUBZone, and socially and economically disadvantaged small businesses, and implements a new eligibility determination process to ensure sole source awards are made to eligible firms. NSBA supports. H.R. 6382 -Clarity on Small Business Participation in Category Management Act of 2018 H.R. 6382 requires the SBA to report federal spending made through designated best-in-class vehicles, and to report on the dollars spent through these vehicles awarded to small businesses. NSBA supports. H.R. 6446 - White House Conference on Small Business Act of 2018 It reauthorizes, and amends, the White House Conference on Small Business Authorization Act from the early 1990s, which is Public Law 101-409. The bill requires the state conferences, regional conferences and the National Conference to occur no earlier than December 31, 2018 and no later than December 1, 2019. NSBA supports. H.R. 6695 -The Trademark Licensing Protection Act of 2018 The bill clarifies that licensing trademarks, and controlling or exercising those trademarks, do not create an employment relationship. NSBA is monitoring. H.R. 6757 - The Family Savings Act of 2018 It includes a variety of provisions aimed at making it easier for smaller businesses to offer tax-qualified retirement savings plans to their employees, encouraging individuals to participate in retirement plans, and promoting savings for nonretirement expenses. NSBA is monitoring. H.R. 6756 - The American Innovation Act of 2018 It includes two provisions intended to boost innovation by allowing new businesses to write off larger amounts of their costs up front as well as allowing a corporation that buys a start-up to retain some of the acquired entitys net operating losses or other tax attributes, like research and development tax credits. NSBA supports. H.R. 6760 - the Protecting Family and Small Business Tax Cuts Act of 2018 Bill would make permanent provisions from the 2017 tax law such as the lower individual income tax rates, the higher standard deduction, the increased and modified child tax credit, the increased exemption and phase-out threshold for the individual alternative minimum tax, the increased estate and gift tax exemption, and the 20 percent deduction for certain passthrough income, all of which are currently set to expire after 2025. NSBA supports. S. 18 - the Fair Tax Act To promote freedom, fairness, and economic opportunity by repealing the income tax and other taxes, abolishing the Internal Revenue Service, and enacting a national sales tax to be administered primarily by the states. NSBA supports S. 21 - Regulations from the Executive in Need of Scrutiny (REINS) Act The REINS Act seeks to restore authority to Congress by allowing lawmakers to have final say on regulations with an estimated economic impact of more than $100 million. NSBA supports. S. 34 - Midnight Rule Relief Act The bill would prevent agencies from proposing or finalizing regulations from the day after elections to the day of the next presidential inauguration. NSBA supports S. 205 -- Death Tax Repeal Act of 2017 This bill amends the Internal Revenue Code to: (1) repeal the estate and generation-skipping transfer taxes, and (2) make permanent the maximum 35% gift tax rate and the lifetime gift tax exemption. The bill also provides for an inflation adjustment to such exemption amount. NSBA supports. S. 584 - The Small Business Regulatory Flexibility Improvements Act To require federal agencies to analyze the full impact of a proposed regulation on small businesses during the rulemaking process. NSBA supports. S.770 - NIST Small Business Cybersecurity Act To require the Director of the National Institute of Standards and Technology to disseminate resources to help reduce small business cybersecurity risks, and for other purposes. NSBA supports. S.791 - Small Business Innovation Protection Act of 2017 To amend the Small Business Act to expand intellectual property education and training for small businesses, and for other purposes. NSBA supports. S. 951 - the Regulatory Accountability Act (RAA) This bill codifies and revises notice-and-comment rulemaking procedures to require federal agencies to consider: (1) whether a rulemaking is required by statute or is within the discretion of the agency, (2) whether existing federal laws or rules could be amended or rescinded to address the problem, and (3) reasonable alternatives for a new rule. NSBA supports. S.1390 - STRONGER Patents Act of 2017 The STRONGER Patents Act takes critical steps to improve the patent system. It treats patents like any other property, permitting injunctions to protect patent owners against infringement during and after court cases. It ensures fairness in Patent Office administrative proceedings, limiting repetitive and harassing challenges against inventors and it ends the diversion of patent application fees to other government spending, ensuring the Patent Office has the funding needed to grant high-quality patents without harmful delay. NSBA supports. S.2108 - The Miscellaneous Tariff Bill Act of 2017 Trims the duties on more than 1,800 imports deemed to not pose a competitive threat to U.S. producers. NSBA supports. S.2283 - The Small Business 7(a) Lending Oversight Reform Act of 2018 Amends the Small Business Act to strengthen the Office of Credit Risk Management within the Small Business Administration, and for other purposes. NSBA supports. S.2708 - Choose Medicare Act Bill creates a Medicare health plan for all ages that would be offered in state and federal health exchanges, as well as the employer-sponsored market. NSBA is monitoring. S. 2800 - Americas Water Infrastructure Act of 2018 A bill to provide for the conservation and development of water and related resources, to authorize the Secretary of the Army to construct various projects for improvements to rivers and harbors of the United States, and for other purposes. NSBA supports. S. 2810 - The Workplace Democracy Act The bill narrows who can lawfully be classified an independent contractor, nullify state right-to-work laws, and allow workers to vote in a union campaign through the informal method of card check instead of a secret-ballot vote. NSBA opposes. S. 3345 - Economic Security for New Parents Act Bill allows those who choose to withdraw from their Social Security benefits early will be able to get at least two months of leave after the arrival of a child by birth or adoption. NSBA is monitoring.

Insurance market policies (Bipartisan Health Care Stabilization Act; Short-term, Limited Duration Health Insurance rule; Association Health Plans rule) Risk adjustment payments Cost sharing reduction payments Insurance navigator funding 340B Drug Pricing Program (H.R. 4392; H.R. 4710, 340B PAUSE Act; S. 2453, Ensuring the Value of the 340B Program Act; H.R. 6071, Stretching Entity Resources for Vulnerable Communities Act; H.R. 2889, Closing Loopholes for Orphan Drugs Act; H.R. 5598, 340B Optimization Act; H.R. 6240, Drug Discount Accountability Act; H.R. 6273, Creating Access to Rape Kit Exams (CARE) for Survivors Act) Opioid issues (S. 2680, the Opioid Crisis Response Act of 2018; H.R. 5176, Preventing Overdoses While in Emergency Rooms (POWER) Act; H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act; H.R. 5009, Jessies Law; H.R. 5818 / S. 2843, the Opioid Workforce Act; H.R. 5797, the IMD CARE Act; H.R. 6082/H.R. 5795, the Overdose Prevention and Patient Safety Act; S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act; S. 2460, Every Prescription Conveyed Securely Act; S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act; H.R. 5582, the Abuse Deterrent Access Act; H.R. 5685, the Medicare Opioid Safety Education Act; Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018; H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act; S. 2899, Caring Recovery for Infants and Babies Act; S. 2898, Medication-Assisted Treatment Improvement Act; S.2911, Enhancing Patient Access to Non-Opioid Treatment Options) IV and medication shortages Drug prices (American Patients First, Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs; S. 2554 / H.R. 6143, Patient Right to Know Drug Prices Act; S. 2553, Know the Lowest Price Act; H.R. 6733, Know the Cost Act) Draft Protecting Patients from Surprise Medical Bills Act HIPAA policy in mental and behavioral health information sharing 21st Century Cures Act implementation Pandemic and All Hazards Preparedness Reauthorization, including Hospital Preparedness Program (S. 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI) of 2018) S.781/ HR 1876. Good Samaritan Health Professional Act of 2017 Health workforce reauthorizations (H.R. 959, the Title VIII Nursing Workforce Reauthorization Act; H.R. 3728, the Educating Medical Professionals and Optimizing Workforce Efficiency Readiness (EMPOWER) Act; H.R. 1676, the Palliative Care and Hospice Education and Training Act Consumer Directed Health Plans Legislation (H.R. 6311 would modify the definition of a qualified health plan and allow individuals purchasing health insurance in the individual market to purchase a "copper" plan or use the premium tax credit to buy off-marketplace coverage; H.R. 6301 to allow CDHPs to provide coverage for services like telehealth, chronic disease management, or primary care visits below the minimum deductible; H.R. 6317 to allow coverage of direct primary care service arrangements; H.R. 6305 to permit use of CDHPs to receive certain employment-related health services like onsite clinics; H.R. 6309 to allow individuals only enrolled in Medicare Part A to contribute to health savings accounts; H.R. 6199 to include certain over-the-counter medical products as qualified medical expenses; H.R. 6306 to increase the current contribution limits for HSAs; H.R. 6312, Personal Health Investment Today (PHIT) Act to count sports equipment and exercise costs toward medical expenses; H.R. 6313 to allow carry-forward of flexible spending account balances each year; H.R. 6314 to allow bronze and catastrophic plans in connection with health savings accounts, allowing plans categorized as catastrophic and bronze in the individual and small group markets to qualify for HSA contributions) H.R. 4616 to delay the implementation of the excise tax on high cost employer-sponsored health coverage; and place a moratorium on the employer mandate Liver allocation policy

S. 28, Health Savings Account Expansion Act (Flake) - HSA improvements S. 85, Restoring Access to Medications Act (Roberts) - paying for OTC products with HSA funds S. 403, Health Savings Act (Hatch) - HSA and FSA improvements S. 761, Health Care Options Act (Alexander) - using premiums for off-Exchange plans S. 1859, Healthcare Tax Relief Act (Gardner) - suspension of ACA health insurance tax S. 1978, Small Business and Family Health Tax Relief Act (Heitkamp) - suspension of ACA health insurance tax S. 2410, Chronic Disease Management Act (Thune) - flexibility for high-deductible health plans S. 3063, Health Insurance Tax Relief Act (Barrasso) - suspension of ACA health insurance tax H.R. 246, Jobs and Premium Protection Act (Noem-Sinema) - repeal of ACA health insurance tax H.R. 247, Health Savings Account Expansion Act (Brat) - HSA improvements H.R. 394, Restoring Access to Medications Act (Jenkins) - paying for OTC products with HSA funds H.R. 1175, Health Savings Act (Paulsen) - HSA and FSA improvements H.R. 3798, Save American Workers Act (Walorski) - delay in Cadillac tax H.R. 4616 (Nunes) - delay in ACA excise tax on employer-provided health coverage H.R. 4618 (Jenkins) - use of HSA funds for OTC medications H.R. 4620, Protecting Families and Small Businesses Act (Noem) - relief from ACA health insurance tax H.R. 4894, Harmful Tax Prevention Act (Noem) - relief from ACA health insurance tax H.R. 4978, Chronic Disease Management Act (Black) - flexibility for high-deductible health plans H.R. 5138, Bipartisan HSA Improvement Act (Kelly) - HSA changes H.R. 5963, Health Insurance Premium Reduction Act (Noem) - suspension of ACA health insurance tax H.R. 6199, Restoring Access to Medication Act (Jenkins) - OTC medical products as qualified medical expense, HSA improvements H.R. 6301, Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act (Roskam) - flexibility on first dollar coverage for HSA plans H.R. 6305, Bipartisan HSA Improvement Act (Kelly) - HSA flexibility; treatment of certain employment-related services; FSA and HRA conversions H.R. 6306, Health Care Security Act (Paulsen) - HSA contribution limits, spousal catch-up contributions, grace period for medical expenses H.R. 6309, Allowing Working Seniors to Keep Their Health Savings Accounts Act (Paulsen) - HSA contributions by Medicare-eligible individuals H.R. 6311, Increasing Access to Lower Premium Plans and Expanding HSAs Act (Roskam) - suspension of health insurance tax, HSA improvements H.R. 6312, Personal Health Investment Today Act (Smith) - medical care tax deduction for qualified sports and fitness expenses H.R. 6313, RAISE Health Benefits Act (Stivers) - Health FSA rollovers H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6317, Primary Care Enhancement Act (Paulsen) - participation by HSA-eligible individuals in direct primary care (DPC) arrangements Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate; W-2 reporting requirements; health reimbursement accounts; deductibility limits for insurer compensation; health insurer and employer reporting of health coverage; issues related to implementation of health insurance tax; issues related to the refundable credit for coverage under a qualified health plan; issues related to coverage of chronic conditions in high deductible health plans; issues related to health savings accounts; issues related to the deductibility of employer-sponsored health coverage; issues related to enhancing tax treatment of long-term care insurance; issues related to qualified small employer health reimbursement accounts (QSEHRAs); issues related to implementation of the excise tax on high cost employer-sponsored health coverage; and other issues relating to health care reform implementation.

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.

S. 28, Health Savings Account Expansion Act (Flake) - HSA improvements S. 85, Restoring Access to Medications Act (Roberts) - paying for OTC products with HSA funds S. 403, Health Savings Act (Hatch) - HSA and FSA improvements S. 761, Health Care Options Act (Alexander) - using premiums for off-Exchange plans S. 1859, Healthcare Tax Relief Act (Gardner) - suspension of ACA health insurance tax S. 1978, Small Business and Family Health Tax Relief Act (Heitkamp) - suspension of ACA health insurance tax S. 2410, Chronic Disease Management Act (Thune) - flexibility for high-deductible health plans S. 3063, Health Insurance Tax Relief Act (Barrasso) - suspension of ACA health insurance tax H.R. 195, Extension of Continuing Appropriations Act - one-year suspension of ACA health insurance tax, two-year delay in ACA excise tax on employer-sponsored health plans H.R. 246, Jobs and Premium Protection Act (Noem-Sinema) - repeal of ACA health insurance tax H.R. 247, Health Savings Account Expansion Act (Brat) - HSA improvements H.R. 394, Restoring Access to Medications Act (Jenkins) - paying for OTC products with HSA funds H.R. 1175, Health Savings Act (Paulsen) - HSA and FSA improvements H.R. 4616 (Nunes) - delay in ACA excise tax on employer-provided health coverage H.R. 4618 (Jenkins) - use of HSA funds for OTC medications H.R. 4620, Protecting Families and Small Businesses Act (Noem) - relief from ACA health insurance tax H.R. 4894, Harmful Tax Prevention Act (Noem) - relief from ACA health insurance tax H.R. 4978, Chronic Disease Management Act (Black) - flexibility for high-deductible health plans H.R. 5138, Bipartisan HSA Improvement Act (Kelly) - HSA changes H.R. 5963, Health Insurance Premium Reduction Act (Noem) - suspension of ACA health insurance tax H.R. 6199, Restoring Access to Medication Act (Jenkins) -- OTC medical products as qualified medical expense H.R. 6301, Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act (Roskam) - flexibility on first dollar coverage for HSA plans H.R. 6305, Bipartisan HSA Improvement Act (Kelly) - HSA flexibility H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate; W-2 reporting requirements; health reimbursement accounts; deductibility limits for insurer compensation; health insurer and employer reporting of health coverage; issues related to implementation of health insurance tax; issues related to the refundable credit for coverage under a qualified health plan; issues related to coverage of chronic conditions in high deductible health plans; issues related to health savings accounts; issues related to the deductibility of employer-sponsored health coverage; issues related to qualified small employer health reimbursement accounts (QSEHRAs); issues related to implementation of the excise tax on high cost employer-sponsored health coverage; and other issues relating to health care reform implementation.

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.

Support for permanent business deduction for sole proprietors on insurance premiums. Support implementation and expansion of HRA availability. Continued addressing of ACA implementation and analysis of new health care bills. Support HRA's as a tool for micro-business. Advocacy against the classification of HRAs as health insurance. Support protection of Essential health Benefits. Support robust individual health insurance markets. Regulatory action regarding HSA's at Health and Human Services. Support small business and self-employed issues in American Health Care Act of 2017 (H.R. 1628). Support H.R. 2953 scoring amendments. Support favorable treatment of HRA and AHIP in Executive Orders affecting the ACA. Support H.R. 6314 The Health Savings Act of 2018.

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

Government targets: Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of

H.R. 1267, Personal Health Investment Today (PHIT) Act, all provisions H.R. 4240, Public Safety and Second Amendment Rights Protection Act of 2017, all provisions H.R. 6142, Reducing Drug Waste Act of 2018, all provisions H.R. 6301, Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act of 2018, all provisions H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018, all provisions H.R. 6305, Bipartisan HSA Improvement Act of 2018, all provisions H.R. 6306, Health Care Security Act of 2018, all provisions H.R. 6313, Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2018, all provisions H.R. 6314, Health Savings Act of 2018, all provisions H.R. 6317, Primary Care Enhancement Act of 2018, all provisions H.R. 6082, Overdose Prevention and Patient Safety Act, all provisions H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, all provisions S. 2680, Opioid Crisis Response Act of 2018, all provisions S. 3120, Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018, provisions relating to human services H.R. 6733, Know the Cost Act of 2018, all provisions S. 2554, Patient Right to Know Drug Prices Act, all provisions S. 2020, Cyber Shield Act of 2017, all provisions H.R. 394, Restoring Access to Medication Act of 2017, all provisions S. 85, Restoring Access to Medication Act of 2017, all provisions H.R. 1375, Prescriber Support Act of 2017, all provisions S. 1016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017, provisions relating to telehealth S. 2456, CARA 2.0 Act of 2018, all provisions H.R. 4825, Marijuana Effective Drug Studies (MEDS) Act of 2018, all provisions S. 1112, Maternal Health Accountability Act of 2017, all provisions Diagnostic Accuracy and Innovation Prescription Drug Pricing Affordable Care Act (ACA) risk-adjustment program 42 CFR Part 2/Substance abuse confidentiality regulations Software as a Medical Device (SaMD) SaMD Transparency Certificate-of-Need Reform Physician-Owned Hospitals Augmented Intelligence (AI) Cybersecurity ACA Navigator program funding cuts Electronic Health Records (EHR) EHR Vendor Reporting Program EHR Interoperability In-Office Compounding Opioids Consent2Share demonstration Prescription drug costs and pricing Substance use disorder Medical price transparency Administrative burdens and simplification Telehealth Laboratory developed tests (LDTs) Health Savings Accounts - Prescription requirement for over-the-counter medications Electronic prescribing of controlled substances Prescription Drug Monitoring Program (PDMP) Federal prescription limits Sunshine Act Regulation - Journal reprints and textbooks Direct-to-consumer (DTC) advertising - prescription drug price disclosure Biosimilar Regulations Generic Drug Regulations Pharmacy Benefit Managers (PBMs) Surprise billing

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; 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: $1,892,000 · Firm income: Not reported

ACA; Medicare Part D Reform; ERISA; Health Reform; Transparency; Market Stabilization; Medication Adherence; Value-based Purchasing; HSAs; HR 6301 the "Promoting High-Value Health Care through Flexibility for High Deductible Plans Act of 2018"; HR 6199 the "Restoring Access to Medication Act of 2018"; HR 6314 the "Health Savings Act of 2018"; HR 6311 the "Increasing Access to Lower Premiums Act of 2018."

Client expense: Not reported · Firm income: $160,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

ACA; Medicare Reform; ERISA; Health Reform; Transparency; Market Stabilization; Omnibus; Medication adherence; Value-based Purchasing; HSAs; HR 6301 "The Promoting High-Value Health Care through Flexibility for High Deductible Plans Act of 2018"-- Allows up to $250 in first-dollar coverage flexibility for HSA-eligible high deductible health plans; HR 6305 the "Bi Partisan HSA Improvement Act of 2018" -- Makes various tweaks to HSA policy, including allowing patients to make HSA contributions if a spouse has an FSA, and letting FSA or Health Reimbursement arrangement funds be converted to HSAs; HR 6199 the "Restoring Access to medication Act of 2018" -- would reverse a provision in the ACA barring HSA reimbursement of over-the-counter medications obtained without a prescription, also expands HSA reimbursement for menstrual care products; HR 6314 the "Health Savings Act of 2018" -- Makes catastrophic and bronze-level plans HSA-eligible; HR 6311 the "Increasing Access to Lower Premiums Act of 2018" -- would allow consumers on ACA exchanges to purchase a qualifies off-exchange plan without forfeiting their premium tax credits. Also allows the use of premium tax credits for purchases of catastrophic plans.

Client expense: Not reported · Firm income: $160,000

Affordable Care Act, all provisions; HR1628 - 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; S.1818 - Small Business Health Plans Act; HR 4616 - Cadillac Tax; Employer Mandate Delay; H.R.4620 - Protecting Families and Small Businesses Act; HR4200/S.2052 - H.R. 4200: Healthcare Market Certainty and Mandate Relief Act; S. 1996/HR 2919 Commonsense Reporting Act; Cadillac Tax; ERISA; Alexander - Murray - Individual Market Stabilization; Opioids Legislation - mental health parity enforcement. HR 5138, Bipartisan HSA Improvement Act, all provisions. DOL proposed rule on Association Health Plans; H.R.6 - Support for Patients and Communities Act, Mental health parity 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

Client expense: $1,467,000 · Firm income: Not reported

H.R. 1 - Tax Cuts and Jobs Act Bill makes widespread changes to the Internal Revenue Code. NSBA supports. H.R.5 - Regulatory Accountability Act of 2017 To reform the process by which Federal agencies analyze and formulate new regulations and guidance documents, to clarify the nature of judicial review of agency interpretations, to ensure complete analysis of potential impacts on small entities of rules, and for other purposes. NSBA supports. H.R. 8 - Water Resources Development Act of 2018 H.R. 8 authorizes Army Corps of Engineers (Corps) civil works activities and builds on previous reform efforts to ensure improvements are made to the Nations ports, inland waterways, locks, dams, flood protection, ecosystem restoration, and other water resources infrastructure. NSBA supports. H.R. 10 - The Financial CHOICE Act of 2017 Bill repeals provisions of the Dodd-Frank Act, aims to eliminate red tape to increase access to capital and credit and create opportunities for investors, consumers and entrepreneurs. NSBA is monitoring. H.R. 25 - The Fair Tax Act To promote freedom, fairness, and economic opportunity by repealing the income tax and other taxes, abolishing the Internal Revenue Service, and enacting a national sales tax to be administered primarily by the states. NSBA supports H.R. 33 - Small Business Regulatory Flexibility Improvements Act This bill modifies the rulemaking requirements and procedures of federal agencies (excluding Congress, U.S. courts, U.S. territories and possessions, and the District of Columbia) under the Regulatory Flexibility Act of 1980 (RFA) and the Small Business Regulatory Enforcement Fairness Act of 1996 (SBREFA). NSBA supports. H.R.76 - Separation of Powers Restoration Act of 2017 This bill modifies the scope of judicial review of agency actions to authorize courts reviewing agency actions to decide de novo (without giving deference to the agency's interpretation) all relevant questions of law, including the interpretation of: (1) constitutional and statutory provisions, and (2) rules made by agencies. NSBA supports. H.R. 79 - Helping Angels Lead Our Startups (HALOS) Act The legislation will make it easier for businesses to notify potential investors of their offerings as well as provide a statutory definition for angel investor group. Additionally, it would require the Securities Exchange Commission (SEC) to revise the Regulation D rules regarding general solicitation. NSBA supports. H.R. 184 -- Protect Medical Innovation Act of 2017 This bill amends the Internal Revenue Code to repeal the excise tax on the sale of a medical device by the manufacturer, producer, or importer. NSBA supports. H.R. 198 -- Death Tax Repeal Act of 2017 This bill repeals the federal estate, gift, and generation-skipping transfer taxes. NSBA supports. H.R. 477 - Small Business Mergers, Acquisitions, Sales & Brokerage Simplification Act of 2017 The bill alleviates costs to small-business owners by simplifying the securities registration system for mergers and acquisition brokers who help transfer the ownership of small, privately held companies. It also disqualifies bad actors from utilizing the simplified process and does not allow transactions involving shell companies. NSBA supports. H.R. 561 - Small Business Job Protection Act of 2017 This bill amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act, to redefine "applicable large employer," for purposes of the mandate requiring employers to provide health insurance for their employees, to mean an employer with at least 100 full-time employees (currently, 50). NSBA supports. H.R. 631 - Death Tax Repeal Act of 2017 This bill amends the Internal Revenue Code to: (1) repeal the estate and generation-skipping transfer taxes, and (2) make permanent the maximum 35% gift tax rate and the lifetime gift tax exemption. The bill provides for an inflation adjustment to such exemption amount. NSBA supports. H.R. 1105 - Stop WOTUS Act To repeal the rule entitled "Clean Water Rule: Definition of 'Waters of the United States. NSBA supports H.R.1180 - Working Families Flexibility Act of 2017 This bill amends the Fair Labor Standards Act of 1938 to authorize employers to provide compensatory time off to private employees at a rate of not less than 1 1/2 hours for each hour of employment for which overtime compensation is required, but only if it is in accordance with an applicable collective bargaining agreement or, in the absence of such an agreement, an agreement between the employer and employee. NSBA supports. H.R. 1314 - Renewable Fuel Standard Repeal Act The bill would remove the renewable fuel standard. NSBA is monitoring. H.R. 1339 - Freedom from Government Competition Act Legislation that would require federal agencies to rely on the private sector when providing goods and services that are readily available. NSBA supports. H.R. 1585 - Fair Investment Opportunities for Professional Experts Act It modernizes the definition of accredited investor so those who do not have a high income or high net worth but do have the education and job experience to evaluate investment risks and merits can participate in the growth of promising companies. NSBA supports. H.R. 1680 - Womens Business Centers Improvements Act The bill revises the duties of the Office of Women's Business Ownership and declares it is the Office's mission to assist women entrepreneurs to start, grow, and compete in global markets by providing quality support with access to capital, access to markets, job creation, growth, and counseling. NSBA supports. H.R. 1702 - Small Business Development Centers Improvement Act This bill amends the Small Business Act with respect to the authority of the Small Business Administration (SBA) to use certain SBA programs, including the small business development center (SBDC) program, to provide grants, financial assistance, loans, export assistance, and subcontracting opportunities on federal contracts to specified small businesses, organizations, state governments, universities, companies, and other entities that assist smaller enterprises. NSBA supports. H.R. 1773 - The Clarity for Americas Small Contractors Act of 2017 Amends the Small Business Act to improve reporting on small business goals, achieve uniformity in procurement terminology, clarify the role of small business advocates, and for other purposes. NSBA supports. H.R. 1774 - The Developing the Next Generation of Small Business Act of 2017 Amends the Small Business Act to provide for improvements to small business development centers, the women's business center program, the SCORE program, and for other purposes. NSBA supports. H.R. 2333 - The Small Business Investment Opportunity Act Bill will increase the individual leverage limit within the Small Business Investment Company (SBIC) program. NSBA supports. H.R. 2364 - The Investing in Main Street Act H.R. 2364 increases the amount of capital and surplus that a financial institution and federal savings association can invest in a SBIC from 5 percent to 15 percent in order to assist small businesses in obtaining venture capital and private equity. NSBA supports. H.R. 3170 - Small Business Development Center Cyber Training Act This bill amends the Small Business Act to require the Small Business Administration to establish a program for certifying employees of small business development centers to provide cybersecurity planning assistance to small businesses. NSBA supports. H.R. 3717 - the Small Business Owners Tax Simplification Act H.R 3717 introduces a number of provisions to benefit small businesses, such as aligning estimated payment deadlines and tax filing thresholds, as well as tackling inconsistencies in reporting requirements. NSBA supports. H.R. 3972 - Family Office Technical Correction Act The bill clarifies that family offices and family clients, as defined in section 275.202(a)(11)(G)-1 of title 17, Code of Federal Regulations, are accredited investors under Regulation D of the Securities and Exchange Commission. NSBA supports. H.R. 4111 - Spurring Business in Communities Act This bill amends the Small Business Investment Act of 1958 to: require the Small Business Administration (SBA), in reviewing and processing a small business investment company's (SBIC's) application, to give first priority to an SBIC applicant located in an underlicensed state (i.e., a state in which the number of licensees per capita is less than the median number of licensees per capita for all states) with below median financing; and exempt applicants in underlicensed states from certain SBA capital requirements. NSBA supports. 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 It provide for a temporary moratorium on the employer mandate until Jan. 1, 2019 and delay for one year- until after Dec. 31, 2020-the implementation of the Cadillac Tax. NSBA supports. H.R. 4743 - Small Business 7(a) Lending Oversight and Reform Act of 2018 Amends the Small Business Act to strengthen the Office of Credit Risk Management within the Small Business Administration, and for other purposes. NSBA supports. H.R. 4754 - Change Order Transparency for Federal Contractors Act Amend the Small Business Act to provide prospective construction contractors with information about an agency's policies on the administration of change orders to allow such contractors to make informed business decisions regarding the pricing of bids or proposals, and for other purposes. NSBA supports. H.R. 4886 - Permanent Tax Cuts for Americans Act This bill makes permanent the provisions of subtitle A (Individual Tax Reform) and subtitle B (Alternative Minimum Tax) of P.L. 115-97 (commonly known as the Tax Cuts and Jobs Act) that are currently scheduled to terminate on December 31, 2025. NSBA supports. H.R. 5236 - Main Street Employee Ownership Act Expands opportunities available to employee-owned business concerns through Small Business Administration loan programs, and for other purposes. NSBA supports. H.R. 5340 - Support Technology & Research for Our Nations Growth and Economic Resilience (STRONGER) Patents Act The STRONGER Patents Act would restore patents as property rights, make standards of protections in courts uniform, and protect start-ups from being out-resourced by technology incumbents. NSBA supports. H.R. 5515 -John S. McCain National Defense Authorization Act for Fiscal Year 2019 The bill authorizes FY2019 appropriations and sets forth policies for Department of Defense (DOD) programs and activities, including military personnel strengths. NSBA supports the small business contracting provisions. H.R. 5660 - The Small Business Credit Card Act The measure provides small-business owners the same consumer protections as individual credit card holders, by protecting small-business owners credit cards from unfair and deceptive practices of credit card companies. NSBA supports. H.R. 5728 - The Workplace Democracy Act The bill narrows who can lawfully be classified an independent contractor, nullify state right-to-work laws, and allow workers to vote in a union campaign through the informal method of card check instead of a secret-ballot vote. NSBA opposes. H.R. 6199 -- Restoring Access to Medication Act of 2018 This bill repeals provisions of the Internal Revenue Code, as added by the Patient Protection and Affordable Care Act, that limit payments for medications from health savings accounts, medical savings accounts, health flexible spending arrangements, and health reimbursement arrangements to only prescription drugs or insulin (thus allowing distributions from such accounts for over-the-counter drugs). The bill also allows the accounts to be used for menstrual care products. NSBA supports. H.R. 6264 - Restoring Americas Leadership in Innovation Act Bill offers various reforms and other improvements to the current U.S. patent system and helps to reverse prior bills discouraging innovation in the U.S. by weakening patents. NSBA supports. H.R. 6301 - Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act of 2018 It expands access and enhances the utility of HSAs by offering health plans a certain amount of flexibility in their plan design while still maintaining eligibility for HSA contributions. This flexibility will allow insurers to offer coverage for high-value, low-cost services like telehealth, chronic disease management (e.g. diabetic testing strips), or primary care visits below the deductible. NSBA supports. H.R. 6305 - Bipartisan HSA Improvement Act of 2018 The bill would allow eligible individuals to make HSA contributions if a spouse has a flexible spending account and permit flexible spending accounts and health reimbursement account terminations or conversions to fund HSAs. NSBA supports. H.R. 6306 - Health Care Security Act of 2018 It expands access and enhances the utility of HSAs by: (1) increasing the contributions limits for HSAs; (2) permitting spousal catch-up contributions into the same account; and (3) creating a grace period for medical expenses incurred before the establishment of an HSA. NSBA supports. H.R. 6311 - The Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act The bill expands access and use of Health Savings Accounts (HSAs) and lowers premiums on health care plans. NSBA supports. H.R. 6314 - Health Savings Act of 2018 H.R. 6314 expands eligibility and access to HSAs by allowing plans categorized as catastrophic and bronze in the individual and small group markets to qualify for HSA contributions. NSBA supports. H.R. 6321 - Investment Adviser Regulatory Flexibility Improvement Act The legislation directs the SEC to consider alternative methods for businesses or organizations to qualify as a small business or small organization for the purposes of assessing the regulatory impact on investment advisors. NSBA supports. H.R. 6446 - White House Conference on Small Business Act of 2018 It reauthorizes, and amends, the White House Conference on Small Business Authorization Act from the early 1990s, which is Public Law 101-409. The bill requires the state conferences, regional conferences and the National Conference to occur no earlier than December 31, 2018 and no later than December 1, 2019. NSBA supports. S. 18 - the Fair Tax Act To promote freedom, fairness, and economic opportunity by repealing the income tax and other taxes, abolishing the Internal Revenue Service, and enacting a national sales tax to be administered primarily by the states. NSBA supports S. 21 - Regulations from the Executive in Need of Scrutiny (REINS) Act The REINS Act seeks to restore authority to Congress by allowing lawmakers to have final say on regulations with an estimated economic impact of more than $100 million. NSBA supports. S. 34 - Midnight Rule Relief Act The bill would prevent agencies from proposing or finalizing regulations from the day after elections to the day of the next presidential inauguration. NSBA supports S. 205 -- Death Tax Repeal Act of 2017 This bill amends the Internal Revenue Code to: (1) repeal the estate and generation-skipping transfer taxes, and (2) make permanent the maximum 35% gift tax rate and the lifetime gift tax exemption. The bill also provides for an inflation adjustment to such exemption amount. NSBA supports. S. 584 - The Small Business Regulatory Flexibility Improvements Act To require federal agencies to analyze the full impact of a proposed regulation on small businesses during the rulemaking process. NSBA supports. S.770 - MAIN STREET Cybersecurity Act of 2017 To require the Director of the National Institute of Standards and Technology to disseminate resources to help reduce small business cybersecurity risks, and for other purposes. NSBA supports. S.791 - Small Business Innovation Protection Act of 2017 To amend the Small Business Act to expand intellectual property education and training for small businesses, and for other purposes. NSBA supports. S. 951 - the Regulatory Accountability Act (RAA) This bill codifies and revises notice-and-comment rulemaking procedures to require federal agencies to consider: (1) whether a rulemaking is required by statute or is within the discretion of the agency, (2) whether existing federal laws or rules could be amended or rescinded to address the problem, and (3) reasonable alternatives for a new rule. NSBA supports. S.1390 - STRONGER Patents Act of 2017 The STRONGER Patents Act takes critical steps to improve the patent system. It treats patents like any other property, permitting injunctions to protect patent owners against infringement during and after court cases. It ensures fairness in Patent Office administrative proceedings, limiting repetitive and harassing challenges against inventors and it ends the diversion of patent application fees to other government spending, ensuring the Patent Office has the funding needed to grant high-quality patents without harmful delay. NSBA supports. S.2108 - The Miscellaneous Tariff Bill Act of 2017 Trims the duties on more than 1,800 imports deemed to not pose a competitive threat to U.S. producers. NSBA supports. S. 2155 - Economic Growth, Regulatory Relief, and Consumer Protection Act Bill would scale back key rules from the 2010 Dodd-Frank law to the benefit of the nation's lenders. NSBA is monitoring. S.2283 - The Small Business 7(a) Lending Oversight Reform Act of 2018 Amends the Small Business Act to strengthen the Office of Credit Risk Management within the Small Business Administration, and for other purposes. NSBA supports. S.2708 - Choose Medicare Act Bill creates a Medicare health plan for all ages that would be offered in state and federal health exchanges, as well as the employer-sponsored market. NSBA is monitoring. S. 2800 - Americas Water Infrastructure Act of 2018 A bill to provide for the conservation and development of water and related resources, to authorize the Secretary of the Army to construct various projects for improvements to rivers and harbors of the United States, and for other purposes. NSBA supports. S. 2810 - The Workplace Democracy Act The bill narrows who can lawfully be classified an independent contractor, nullify state right-to-work laws, and allow workers to vote in a union campaign through the informal method of card check instead of a secret-ballot vote. NSBA opposes.

Affordable Care Act, all provisions; HR1628 - 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; S.1818 - Small Business Health Plans Act; HR 4616 - Cadillac Tax; Employer Mandate Delay; H.R.4620 - Protecting Families and Small Businesses Act; HR4200/S.2052 - H.R. 4200: Healthcare Market Certainty and Mandate Relief Act; S. 1996/HR 2919 Commonsense Reporting Act; Cadillac Tax; ERISA; Alexander - Murray - Individual Market Stabilization; Opioids Legislation - mental health parity enforcement. HR 5138, Bipartisan HSA Improvement Act, all provisions. DOL proposed rule on Association Health Plans; H.R.6 - Support for Patients and Communities Act, Mental health parity 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

Client expense: $1,467,000 · Firm income: Not reported

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.

S. 28, Health Savings Account Expansion Act (Flake) - HSA improvements S. 85, Restoring Access to Medications Act (Roberts) - paying for OTC products with HSA funds S. 403, Health Savings Act (Hatch) - HSA and FSA improvements S. 761, Health Care Options Act (Alexander) - using premiums for off-Exchange plans S. 1859, Healthcare Tax Relief Act (Gardner) - suspension of ACA health insurance tax S. 1978, Small Business and Family Health Tax Relief Act (Heitkamp) - suspension of ACA health insurance tax S. 2410, Chronic Disease Management Act (Thune) - flexibility for high-deductible health plans S. 3063, Health Insurance Tax Relief Act (Barrasso) - suspension of ACA health insurance tax H.R. 195, Extension of Continuing Appropriations Act - one-year suspension of ACA health insurance tax, two-year delay in ACA excise tax on employer-sponsored health plans H.R. 246, Jobs and Premium Protection Act (Noem-Sinema) - repeal of ACA health insurance tax H.R. 247, Health Savings Account Expansion Act (Brat) - HSA improvements H.R. 394, Restoring Access to Medications Act (Jenkins) - paying for OTC products with HSA funds H.R. 1175, Health Savings Act (Paulsen) - HSA and FSA improvements H.R. 4616 (Nunes) - delay in ACA excise tax on employer-provided health coverage H.R. 4618 (Jenkins) - use of HSA funds for OTC medications H.R. 4620, Protecting Families and Small Businesses Act (Noem) - relief from ACA health insurance tax H.R. 4894, Harmful Tax Prevention Act (Noem) - relief from ACA health insurance tax H.R. 4978, Chronic Disease Management Act (Black) - flexibility for high-deductible health plans H.R. 5138, Bipartisan HSA Improvement Act (Kelly) - HSA changes H.R. 5963, Health Insurance Premium Reduction Act (Noem) - suspension of ACA health insurance tax H.R. 6199, Restoring Access to Medication Act (Jenkins) -- OTC medical products as qualified medical expense H.R. 6301, Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act (Roskam) - flexibility on first dollar coverage for HSA plans H.R. 6305, Bipartisan HSA Improvement Act (Kelly) - HSA flexibility H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate; W-2 reporting requirements; health reimbursement accounts; deductibility limits for insurer compensation; health insurer and employer reporting of health coverage; issues related to implementation of health insurance tax; issues related to the refundable credit for coverage under a qualified health plan; issues related to coverage of chronic conditions in high deductible health plans; issues related to health savings accounts; issues related to the deductibility of employer-sponsored health coverage; issues related to qualified small employer health reimbursement accounts (QSEHRAs); issues related to implementation of the excise tax on high cost employer-sponsored health coverage; and other issues relating to health care reform implementation.

Support for permanent business deduction for sole proprietors on insurance premiums. Support implementation and expansion of HRA availability. Continued addressing of ACA implementation and analysis of new health care bills. Support HRA's as a tool for micro-business. Advocacy against the classification of HRAs as health insurance. Support protection of Essential health Benefits. Support robust individual health insurance markets. Regulatory action regarding HSA's at Health and Human Services. Support small business and self-employed issues in American Health Care Act of 2017 (H.R. 1628). Support H.R. 2953 scoring amendments. Support favorable treatment of HRA and AHIP in Executive Orders affecting the ACA. Support H.R. 6314 The Health Savings Act of 2018.

Client expense: $80,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of

ACA; Medicare Reform; ERISA; Health Reform; Transparency; Market Stabilization; Omnibus; Medication adherence; Value-based Purchasing; HSAs; HR 6301 "The Promoting High-Value Health Care through Flexibility for High Deductible Plans Act of 2018"-- Allows up to $250 in first-dollar coverage flexibility for HSA-eligible high deductible health plans; HR 6305 the "Bi Partisan HSA Improvement Act of 2018" -- Makes various tweaks to HSA policy, including allowing patients to make HSA contributions if a spouse has an FSA, and letting FSA or Health Reimbursement arrangement funds be converted to HSAs; HR 6199 the "Restoring Access to medication Act of 2018" -- would reverse a provision in the ACA barring HSA reimbursement of over-the-counter medications obtained without a prescription, also expands HSA reimbursement for menstrual care products; HR 6314 the "Health Savings Act of 2018" -- Makes catastrophic and bronze-level plans HSA-eligible; HR 6311 the "Increasing Access to Lower Premiums Act of 2018" -- would allow consumers on ACA exchanges to purchase a qualifies off-exchange plan without forfeiting their premium tax credits. Also allows the use of premium tax credits for purchases of catastrophic plans.

Client expense: Not reported · Firm income: $160,000