Small Business and Family Health Tax Relief Act of 2017

Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148); Legislation Amending and Repealing P.L. 111-148; Essential Health Benefits; State/Federal Health Exchanges; Individual Mandate; Subsidies; Risk Corridors; Risk Adjustment; Cost Sharing Reduction; Jobs and Premium Protection Act (HR 246); Healthcare Tax Relief Act (S. 1859); Small Business and Family Health Tax Relief Act (S. 1978); and Health Insurance Tax Relief Act of 2018 (S. 3063).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148); Legislation Amending and Repealing P.L. 111-148; Essential Health Benefits; State/Federal Health Exchanges; Individual Mandate; Subsidies; Risk Corridors; Risk Adjustment; Cost Sharing Reduction; Jobs and Premium Protection Act (HR 246); Healthcare Tax Relief Act (S. 1859); Small Business and Family Health Tax Relief Act (S. 1978); and Health Insurance Tax Relief Act of 2018 (S. 3063).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 246, the Jobs and Premium Protection Act; S. 1859, Healthcare Tax Relief Act; S. 1978, Small Business and Family Health Tax Relief Act; Health Insurance Tax Relief Act of 2018 (S. 3063) and issues impacting small business as result of the enactment and implementation of P.L. 111- 148.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 195 - Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes. HR 4894 - Harmful Tax Prevention Act. Noem (R-SD) S 1859 - To provide a moratorium on the ACA health insurance tax. S 1978 - To suspend the ACA health insurance tax for 2018 and 2019. HR 246 - To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. Noem (R-SD).

Client expense: $210,000 · Firm income: Not reported

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

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: $1,550,000 · 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

HR 88 - Regarding Health insurer tax HR 3798 - Regarding the tax on high cost insurance (Cadillac tax) HR 195 - Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes. HR 4894 - Harmful Tax Prevention Act. Noem (R-SD) S 1859 - To provide a moratorium on the ACA health insurance tax. S 1978 - To suspend the ACA health insurance tax for 2018 and 2019. HR 246 - To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. Noem (R-SD).

Client expense: $1,190,000 · Firm income: Not reported

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

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

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

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

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

S. 1978, "Small Business and Family Health Tax Relief Act of 2017", regarding all provisions. H.R. 6082, "Overdose Prevention and Patient Safety Act", regarding all provisions. S. 3254, "Eliminating Kickbacks in Recovery Act of 2018", regarding all provisions. Issues relating to CMS Exchange Market Stability Rulemakings.

Client expense: $450,000 · Firm income: Not reported

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

H.R. 246 - Jobs and Premium Protection Act. ACA Implementation, Medicare Advantage, Prescription Drugs. S. 1859 - Healthcare Tax Relief Act. S. 1978 - Small Business and Family Health Tax Relief Act of 2017. H.R. 4620 - Protecting Families and Small Businesses Act of 2017. Request for Information 0991-ZA49, HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. H.R. 6 - SUPPORT for Patients and Communities Act. S. 3120 - HEAL Act of 2018. S. 2554 - Patient Right to Know Drug Prices Act. H.R. 878; H.R. 2368/S. 204 - Right-to-Try Legislation.

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

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

Support H.R. 631/S. 205, the Death Tax Repeal Act Support H.R. 1696/S. 711, the S Corps Modernization Act Monitor tax reform implementation Support S. 1144, INVEST Act Support S. 1859/H.R. 4831, the Healthcare Tax Relief Act Support H.R. 4894, the Harmful Tax Prevention Act Support S. 3063, the Health Insurance Tax Relief Act of 2018 Support H.R. 5963, To Delay the Reimposition of the Annual Fee on Health Insurance Providers until after 2020 Support H.R. 246, the Jobs and Premium Protection Act Support S. 1978, the Small Business and Family Health Tax Relief Act of 2017 Support H.R. 6277, the Main Street Tax Certainty Act Support H.R. 6760, the Protecting Family and Small Business Tax Cuts Act of 2018

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

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

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

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

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

Affordable Care Act (Public Law 111-148). Healthcare Reform, generally. Health Savings Accounts, generally. Affordable Care Act taxes and penalties, generally. Small Business Health Plans/Association Health Plans. Executive Order 13813: Promoting Healthcare Choice and Competition Across the United States - October 12, 2017. H.R. 246: the Jobs and Premium Protection Act. S. 1859: the Healthcare Tax Relief Act. S. 1978: the Small Business and Family Health Tax Relief Act. H.R. 3919/S. 1908: Commonsense Reporting Act of 2017. H.R. 5138: Bipartisan HSA Improvement Act of 2018. H.R. 3798: Save American Workers Act. Tax exclusion for employer-sponsored health insurance, generally. DOL-EBSA (Reg) Title: Definition of "Employer" under section 3(5) of ERISA - Association Health Plans (RIN 1210-AB85). H.R. 3956/S.2670: Simplifying Technical Aspects Regarding Seasonality (STARS) Act of 2018 Act. Affordable Care Act: Sections 6055 and 6056 of the Internal Revenue Code - Information Reporting Requirements. Employer Sponsored Health Care, generally. H.R. 5963/ S.3063: Health Insurance Tax Relief Act of 2018. Affordable Care Act: employer shared responsibility provisions under section 4980H of the Internal Revenue Code. Assessment of tax penalties under the employer shared responsibility provisions of Affordable Care Act. S. 1782: Forty Hours Is Full Time. H.R.6311: Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018. H.R.6199: Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018. H.R.3798: Save American Workers Act. HHS (RFI) Title: HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs (RIN 0991-ZA49). Implementation of the health insurance tax (HIT) for 2018, generally. Health Insurance Tax (HIT). H.R. 88: the Shiloh National Military Park Boundary Adjustment and Parker's Crossroads Battlefield Designation Act, the Legislative vehicle for the Retirement, Savings, and Other Tax Relief Act of 2018 and Taxpayer First Act of 2018. Section 1411 of the Affordable Care Act: Exchange Notices to Employers. Treasury/DOL/HHS (REG) Title: Health Reimbursement Arrangements and other Account-Based Group Health Plans (REG - 136724-17). Treasury-IRS (REG) Title: Request for Information; Shared Responsibility for Employers Regarding Health Coverage; Amounts Received Under Accident and Health Plans (Notice 2018-88). Section 1332 of the Affordable Care Act: State Innovation Waivers.

Client expense: $670,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Highway Administration (FHA), Federal Transit Administration (FTA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Occupational Safety & Health Administration (OSHA), Office of Policy Development, President of the U.S., SENATE, Small Business Administration (SBA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

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

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

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

HR 88 - Regarding Health insurer tax HR 3798 - Regarding the tax on high cost insurance (Cadillac tax) HR 195 - Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes. HR 4894 - Harmful Tax Prevention Act. Noem (R-SD) S 1859 - To provide a moratorium on the ACA health insurance tax. S 1978 - To suspend the ACA health insurance tax for 2018 and 2019. HR 246 - To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. Noem (R-SD).

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

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

H.R. 246, the Jobs and Premium Protection Act; S. 1859, Healthcare Tax Relief Act; S. 1978, Small Business and Family Health Tax Relief Act; Health Insurance Tax Relief Act of 2018 (S. 3063) and issues impacting small business as result of the enactment and implementation of P.L. 111-148.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148); Legislation Amending and Repealing P.L. 111-148; Essential Health Benefits; State/Federal Health Exchanges; Individual Mandate; Subsidies; Risk Corridors; Risk Adjustment; Cost Sharing Reduction; Jobs and Premium Protection Act (HR 246); Healthcare Tax Relief Act (S. 1859); Small Business and Family Health Tax Relief Act (S. 1978); and Health Insurance Tax Relief Act of 2018 (S. 3063).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act (Public Law 111-148). Healthcare Reform, generally. Health Savings Accounts, generally. Implementation of the health insurance tax (HIT) for 2018, generally. Affordable Care Act taxes and penalties, generally. Small Business Health Plans/Association Health Plans. Executive Order 13813: Promoting Healthcare Choice and Competition Across the United States - October 12, 2017. H.R. 246: the Jobs and Premium Protection Act. S. 1859: the Healthcare Tax Relief Act. S. 1978: the Small Business and Family Health Tax Relief Act. H.R. 3919/S. 1908: Commonsense Reporting Act of 2017. H.R. 5138: Bipartisan HSA Improvement Act of 2018. H.R. 3798: Save American Workers Act. Tax exclusion for employer-sponsored health insurance, generally. DOL-EBSA (Reg) Title: Definition of "Employer" under section 3(5) of ERISA - Association Health Plans (RIN 1210-AB85). H.R. 3956/S.2670: Simplifying Technical Aspects Regarding Seasonality (STARS) Act of 2018 Act. Affordable Care Act: Sections 6055 and 6056 of the Internal Revenue Code - Information Reporting Requirements. Employer Sponsored Health Care, generally. H.R. 5963/ S.3063: Health Insurance Tax Relief Act of 2018. Affordable Care Act: employer shared responsibility provisions under section 4980H of the Internal Revenue Code. Assessment of tax penalties under the employer shared responsibility provisions of Affordable Care Act. S. 1782: Forty Hours Is Full Time. H.R.6311: Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018. H.R.6199: Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018. H.R.3798: Save American Workers Act. HHS (RFI) Title: HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs (RIN 0991-ZA49).

Client expense: $670,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Highway Administration (FHA), Federal Transit Administration (FTA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Office of Policy Development, President of the U.S., SENATE, Small Business Administration (SBA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

H.R. 246, the Jobs and Premium Protection Act; S. 1859, Healthcare Tax Relief Act; S. 1978, Small Business and Family Health Tax Relief Act; Health Insurance Tax Relief Act of 2018 (S. 3063) and issues impacting small business as result of the enactment and implementation of P.L. 111-148.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148); Legislation Amending and Repealing P.L. 111-148; Essential Health Benefits; State/Federal Health Exchanges; Individual Mandate; Subsidies; Risk Corridors; Risk Adjustment; Cost Sharing Reduction; Jobs and Premium Protection Act (HR 246); Healthcare Tax Relief Act (S. 1859); Small Business and Family Health Tax Relief Act (S. 1978); and Health Insurance Tax Relief Act of 2018 (S. 3063).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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.

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

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

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.

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

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

H.R. 5176, "Preventing Overdoses While in Emergency Rooms Act of 2018", regarding all provisions. S. 1978, "Small Business and Family Health Tax Relief Act of 2017", regarding all provisions. H.R. 6082, "Overdose Prevention and Patient Safety Act", regarding all provisions. S. 3254, "Eliminating Kickbacks in Recovery Act of 2018", regarding all provisions. S. 2905, "Strengthening Partnerships to Prevent Opioid Abuse Act of 2018", regarding all provisions. Issues relating to CMS Exchange Market Stability Rulemakings.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

HR 195 - Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes. HR 4894 - Harmful Tax Prevention Act. Noem (R-SD) S 1859 - To provide a moratorium on the ACA health insurance tax. S 1978 - To suspend the ACA health insurance tax for 2018 and 2019. HR 246 - To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. Noem (R-SD).

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

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

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

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

H.R. 246 - Jobs and Premium Protection Act. ACA Implementation, Medicare Advantage, Prescription Drugs. S. 1859 - Healthcare Tax Relief Act. S. 1978 - Small Business and Family Health Tax Relief Act of 2017. H.R. 4620 - Protecting Families and Small Businesses Act of 2017. Request for Information 0991-ZA49, HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. H.R. 6 - SUPPORT for Patients and Communities Act. S. 3120 - HEAL Act of 2018. S. 2554 - Patient Right to Know Drug Prices Act. H.R. 878; H.R. 2368/S. 204 - Right-to-Try Legislation.

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

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

Support H.R. 631/S. 205, the Death Tax Repeal Act Support H.R. 1696/S. 711, the S Corps Modernization Act Monitor tax reform implementation Support S. 1144, INVEST Act Support S. 1859/H.R. 4831, the Healthcare Tax Relief Act Support H.R. 4894, the Harmful Tax Prevention Act Support S. 3063, the Health Insurance Tax Relief Act of 2018 Support H.R. 5963, To Delay the Reimposition of the Annual Fee on Health Insurance Providers until after 2020 Support H.R. 246, the Jobs and Premium Protection Act Support S. 1978, the Small Business and Family Health Tax Relief Act of 2017 Support H.R. 6277, the Main Street Tax Certainty Act

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

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

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

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

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

S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072/S. 222 Obamacare Replacement Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1628 American Health Care Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 2824 Increasing Opportunity and Success for Children and Parents Through Evidence-Based Home Visiting Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953/S. 2164 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3358/S. 1771 Fiscal Year 2018 Labor-Health and Human Services-Education Appropriations Bill H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 3922 Continuing Community Health and Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4541 Continuing Community Health and Medical Professional Programs to Improve Our Nation and Keep Insurance Delivery Stable H.R. 4613 Ensuring Patient Access to Healthcare Records Act H.R. 4619 to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620 Protecting Families and Small Businesses Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 4520 to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017 H.R. 4552/S. 1291 Advancing Medical Training in Community Hospitals Act H.R. 4105 to extend the health professions workforce demonstration project H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes H.R. 4206/S. 2051 Medicare Care Coordination Improvement Act Introduction of the Healthcare Cybersecurity Improvement Act Introduction of the Stark Law Modernization Act of 2017 Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub L. 115-31 Fiscal Year 2017 Consolidated Appropriations Act Pub L. 115-80 National Clinical Care Commission Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255, 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub L. 115-63 Disaster Relief and Airway Extension Act Pub. L. 115-96 2018 Continuing Resolution Reintroduction of TELE-MED Act of 2015 S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 1967 Mandate Relief Act S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. 1978 Small Business and Family Health Tax Relief Act

Client expense: $190,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H. Res. 142/S. Res. 63 National Obesity Care Week Resolution S. Res. 325 National Obesity Care Week Resolution S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1004 Regulatory Integrity Act H.R. 1009/S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072/S. 222 Obamacare Replacement Act H.R. 1101 Small Business Health Fairness Act H.R. 1121 Pre-Existing Conditions Protection Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1267/S. 482 Personal Health Investment Today Act H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1628 American Health Care Act H.R. 1703 Medical Product Communications Act H.R. 184 Protect Medical Innovation Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 246/S. 183 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 2824 Increasing Opportunity and Success for Children and Parents Through Evidence-Based Home Visiting Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953/S. 2164 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 3120 to reduce the volume of future electronic health record-related significant hardship requests H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3358/S. 1771 Fiscal Year 2018 Labor-Health and Human Services-Education Appropriations Bill H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3545 Overdoes Prevention and Patient Safety Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 3922 Continuing Community Health and Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4541 Continuing Community Health and Medical Professional Programs to Improve Our Nation and Keep Insurance Delivery Stable H.R. 4613 Ensuring Patient Access to Healthcare Records Act H.R. 4616 to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617 to provide for a temporary moratorium on the medical device excise tax H.R. 4618 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619 to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620 Protecting Families and Small Businesses Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 4200/S. 2052 Healthcare Market Certainty and Mandate Relief Act H.R. 4520 to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017 H.R. 4552/S. 1291 Advancing Medical Training in Community Hospitals Act H.R. 4105 to extend the health professions workforce demonstration project H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 706 Plan Verification and Fairness Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 749 Lower Drug Costs Through Competition Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R.3545 Overdose Prevention and Patient Safety Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes H.R. 4206/S. 2051 Medicare Care Coordination Improvement Act Introduction of the Healthcare Cybersecurity Improvement Act Introduction of the Stark Law Modernization Act of 2017 Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub L. 115-31 Fiscal Year 2017 Consolidated Appropriations Act Pub L. 115-80 National Clinical Care Commission Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255, 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub. L. 114-328 National Defense Authorization Act for Fiscal Year Pub. L. 114-329 American Innovation and Competitiveness Act Pub L. 115-63 Disaster Relief and Airway Extension Act Pub. L. 115-96 2018 Continuing Resolution Pub. L. 115-97 Tax Cuts and Jobs Act Reintroduction of TELE-MED Act of 2015 S. 108 Medical Device Access and Innovation Protection Act S. 297 Increasing Competition in Pharmaceuticals Act S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1850 Protecting Jessica Grubbs Legacy Act (The Legacy Act) S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 1967 Mandate Relief Act S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act H .R. 1933/S. 761 Health Care Options Act of 2017 S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. 1978 Small Business and Family Health Tax Relief Act S. Con. Res. 3 Budget Resolution

Client expense: $190,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 3956, the STARS Act of 2017 - Legislation provides much needed clarity around the Patient Protection Affordable Care Acts (ACAs) definition and treatment of seasonal workers. Seasonal small businesses continue to struggle with determining their employer size and employer shared responsibility requirements due to the laws varying definitions of seasonal. When complying with the ACA, it is possible for the same worker to be a seasonal worker for the purpose of determining employer size, but not be considered a seasonal employee under an employers shared responsibility obligations. These various definitions create confusion for seasonal small businesses that struggle to comply with the law. The STARS Act adopts the Treasury Departments definition of seasonal employment while simplifying and aligning the seasonal provisions of the ACA to better enable employer compliance. This targeted approach provides seasonal employers with the clarity needed to assess their obligations under the ACA. Specifically, the STARS Act: â--� Aligns the separate definitions of seasonal found in statute and in the final regulation to the Treasury Departments preferred definition from the final regulation on IRC 4980H (six months or less, customary, annual, recurring) â--� Simplifies the determination of Applicable Large Employer size and the determination of a seasonal employees full-time status for the purposes of the ACAs Employer Shared Responsibility provisions. Supports legislation, S. 1978, the Small Business and Family Health Tax Relief Act of 2017, to delay the annual fee on health insurance providers that was enacted as part of the Patient Protection and Affordable Care Act (PPACA). The bill addresses one of the major concerns that farmers and ranchers have related to health insurance - cost. The health insurance tax (HIT) has increased health insurance costs for farmers, ranchers and other small businesses by imposing a levy on the net premiums of health insurance companies, which is passed on to consumers. Providing an additional two years of relief from the HIT is a welcome and critical step toward the certainty of a full repeal.

Client expense: $10,497 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

H.R. 246, the Jobs and Premium Protection Act; S. 1859, Healthcare Tax Relief Act; S. 1978, Small Business and Family Health Tax Relief Act; Health Insurance Tax Relief Act of 2018 (S. 3063) and issues impacting small business as result of the enactment and implementation of P.L. 111-148.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148); Legislation Amending and Repealing P.L. 111-148; Essential Health Benefits; State/Federal Health Exchanges; Individual Mandate; Subsidies; Risk Corridors; Risk Adjustment; Cost Sharing Reduction; Jobs and Premium Protection Act (HR 246); Healthcare Tax Relief Act (S. 1859); Small Business and Family Health Tax Relief Act (S. 1978); and Health Insurance Tax Relief Act of 2018 (S. 3063).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

HR 195 - Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes. HR 4894 - Harmful Tax Prevention Act. Noem (R-SD) S 1859 - To provide a moratorium on the ACA health insurance tax. S 1978 - To suspend the ACA health insurance tax for 2018 and 2019. HR 246 - To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. Noem (R-SD).

Client expense: $200,000 · Firm income: Not reported

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

H.R. 246 - Jobs and Premium Protection Act. ACA Implementation, Medicare Advantage, Prescription Drugs. S. 1859 - Healthcare Tax Relief Act. S. 1978 - Small Business and Family Health Tax Relief Act of 2017. H.R. 4620 - Protecting Families and Small Businesses Act of 2017. Request for Information 0991-ZA49, HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs.

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

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

H.R. 4666, "Premium Relief Act of 2017", regarding all provisions. H.R. 5176, "Preventing Overdoses While in Emergency Rooms Act of 2018", regarding all provisions. S. 1978, "Small Business and Family Health Tax Relief Act of 2017", regarding all provisions. H.R. 6082, "Overdose Prevention and Patient Safety Act", regarding all provisions. Issues relating to CMS Exchange Market Stability Rulemakings.

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

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

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

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

Affordable Care Act (Public Law 111-148). Healthcare Reform, generally. Health Savings Accounts, generally. Implementation of the health insurance tax (HIT) for 2018, generally. Affordable Care Act taxes and penalties, generally. Small Business Health Plans/Association Health Plans. Executive Order 13813: Promoting Healthcare Choice and Competition Across the United States - October 12, 2017. H.R. 246: the Jobs and Premium Protection Act. S. 1859: the Healthcare Tax Relief Act. S. 1978: the Small Business and Family Health Tax Relief Act. H.R. 3919/S. 1908: Commonsense Reporting Act of 2017. H.R. 5138: Bipartisan HSA Improvement Act of 2018. H.R. 3798: Save American Workers Act. Tax exclusion for employer-sponsored health insurance, generally. DOL-EBSA (Reg) Title: Definition of "Employer" under section 3(5) of ERISA - Association Health Plans (RIN 1210-AB85). H.R. 3956/S.2670: Simplifying Technical Aspects Regarding Seasonality (STARS) Act of 2018 Act. Affordable Care Act: Sections 6055 and 6056 of the Internal Revenue Code - Information Reporting Requirements. Employer Sponsored Health Care, generally. H.R. 5963/ S.3063: Health Insurance Tax Relief Act of 2018. Affordable Care Act: employer shared responsibility provisions under section 4980H of the Internal Revenue Code. Assessment of tax penalties under the employer shared responsibility provisions of Affordable Care Act. S. 1782: Forty Hours Is Full Time.

Client expense: $670,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Highway Administration (FHA), Federal Transit Administration (FTA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Office of Policy Development, President of the U.S., SENATE, Small Business Administration (SBA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

H.R. 246, Jobs and Premium Protection Act H.R. 4620, Protecting Families and Small Business Act S. 1859, Healthcare Tax Relief Act S. 1978, Small Business and Family Health Tax Relief Act H.R. 5963, Health Insurance Premium Reduction Act S. 3063, Health Insurance Tax Relief Act of 2018 HSA Tax Treatment Tax Reform Implementation (P.L. 115-97)

Client expense: $310,000 · Firm income: Not reported

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

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act H.R. 35, Health Savings Act of 2017 H.R. 143, Health Insurance Industry Antitrust Enforcement Act of 2017 H.R. 173/S. 40/S. 58, Middle Class Health Benefits Tax Repeal Act of 2017 H.R. 184, Protect Medical Innovation Act of 2017 H.R. 195, Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes H.R. 246, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 394/S. 85, Restoring Access to Medication Act of 2017 H.R. 849/S. 260, Protecting Seniors Access to Medicare Act H.R. 1101, Small Business Health Fairness Act of 2017 H.R. 1175/S. 403, Health Savings Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 1313, Preserving Employee Wellness Programs Act H.R. 1625, Consolidated Appropriations Act, 2018 H.R. 1628, American Health Care Act of 2017 H.R. 1892, Bipartisan Budget Act of 2018 H.R. 3331, To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology H.R. 4284, Indexing Narcotics, Fentanyl, and Opioids (INFO) Act of 2018 H.R. 4616, To amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on the medical device excise tax H.R. 4618, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619, To amend the Patient Protection and Affordable Care Act to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620, Protecting Families and Small Businesses Act of 2017 H.R. 4978/S. 2410, Chronic Disease Management Act of 2018 H.R. 5009, Jessies Law H.R. 5041, Safe Disposal of Unused Medication Act H.R. 5138, Bipartisan HSA Improvement Act of 2018 H.R. 5272, To provide additional guidance to grantees seeking funding to treat or prevent mental health or substance use disorders H.R. 5582, Abuse Deterrent Access Act of 2018 H.R. 5788, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 S. 108, Medical Device Access and Innovation Protection Act S. 191, Patient Freedom Act of 2017 S. 222, Obamacare Replacement Act S. 251, Protecting Medicare from Executive Action Act of 2017 S. 974, Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2017 S. 1835, Lower Premiums Through Reinsurance Act of 2017 S. 1850, Protecting Jessica Grubb's Legacy Act S. 1859, Healthcare Tax Relief Act S. 1978, Small Business and Family Health Tax Relief Act of 2017 S. 2164, To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings Draft legislation titled To stabilize individual market premiums for the 2018 and 2019 plan years and provide meaningful State flexibility (Alexander-Murray) Proposed regulations on definition of employer under section 3(5) of ERISA-association health plans (83 Fed. Reg. 614-636, January 5, 2018) Various issues relating to Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including the employer-sponsored health care system, implementation of regulatory process, provider network adequacy, delivery system reform, health savings account (HSAs), health reimbursement account (HRAs), and flexible spending account (FSAs) changes, IPAB, employer mandate, reporting requirements for issuers and applicable large employers, premium stabilization programs, medical loss ratio, medical malpractice reform, exchanges, the impact on small business, the Small Business Tax Credit, section 1332 waivers, section 1557 on nondiscrimination, caps on compensation deductibility required under section 9014, incompleteness or inaccuracy of cost impact analysis, lack of quantified benefit analysis, and need for empirical data sources on which to base costs and benefits, the Cost Sharing Reduction (CSR) program, the section 9010 Health Insurance Providers Fee or Health Insurance Tax (HIT), 40% excise tax on high-cost employer-sponsored health coverage (Cadillac tax); Public Health Services Act (P.L.78-410), Internal Revenue Code and the Employee Retirement Income Security Act (ERISA) (P.L. 93-406), regarding regulatory process and legislative corrections to ERISA preemption, changes to Medicare Advantage and Parts B, C, and D, including rebates and non-interference with prescription drug prices, entitlement reform, health information technology, telemedicine services in Medicare, and coordination and disease management programs; House Republican Taskforce on Health Care report, A Better Way to Fix Health Care; association health plans; importation of foreign pharmaceuticals into the United States and preemptive authority of federal food and drug regulations; Executive Order 13813, Promoting Healthcare Choice and Competition; addressing the opioid crisis

Client expense: $15,190,000 · Firm income: Not reported

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

Issues affecting small business as a result of the implementation of the Patient Protection and Affordable Care Act (P.L.111-148); H.R.1628, American Health Care Act of 2017/Better Care Reconciliation Act of 2017; H.R.246, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act; H.R.4620, Protecting Families and Small Businesses Act of 2017; S.1859, Healthcare Tax Relief Act; S.1978, Small Business and Family Health Tax Relief Act of 2017; H.R.195, Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes (P.L.115-120).

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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