Congress returns to ACA battles and a narrow reform tweak

Members of Congress were back in their districts on holiday break when President Barack Obama announced that enrollments in the insurance exchanges had reached 8 million and the Congressional Budget Office projected that exchange plan premiums would be 15% lower in 2016 than anticipated.

But don't expect Republicans to sing Obamacare's praises when Congress reconvenes this week. Indeed, the conservative group, Americans for Prosperity, announced it is launching big anti-Obamacare ad buys in Colorado, Louisiana, Michigan and New Hampshire mostly blasting Democratic senators running for re-election.

Any substantial changes to the law are highly unlikely before November's elections—and perhaps beyond. “It's going to be something that's going to be contested for at least the next two election cycles,” said James Capretta, a conservative healthcare analyst at the Ethics and Public Policy Center.

Still, Congress has shown some bipartisan willingness to tweak the law. The “doc fix” bill passed last month delayed the Patient Protection and Affordable Care Act's Medicare cuts to hospitals serving a disproportionate share of low-income patients. And this week could see House debate on the Expatriate Health Coverage Clarification Act of 2014, sponsored by Rep. John Carney Jr. (D-Del.), exempting plans purchased by Americans living abroad from ACA requirements.

Carney argued for exempting such plans by saying “expatriate” plans “offer high-end, robust coverage to executives and others working outside their home country, giving them access to a global network of healthcare providers.” The bill has nothing to do with low-income or uninsured people, and it has bipartisan support.

Follow Paul Demko on Twitter: @MHPDemko