June 5, 2012
As posted on the Web site of the House Committee on Rules (Committee Print 112-23)
Enacting the bill would affect both direct spending and revenues; therefore, pay-as-you-go procedures apply. CBO and the staff of the Joint Committee on Taxation estimate that those effects would increase the deficit by $2.2 billion in 2013 and $3.2 billion over the 2013-2017 period, but decrease the deficit by $6.7 billion over the 2013-2022 period. That total reflects on-budget savings of about $9.2 billion and off-budget costs of about $2.5 billion. For pay-as-you-go purposes, only the on-budget effects are counted.
H.R. 436 would repeal an excise tax on medical devices scheduled to take effect in January 2013, allow up to $500 of unused balances in health flexible spending accounts to be distributed back to the account holder after the plan year ends, and allow contributions to certain tax-favored health savings accounts to be used to cover the cost of over-the-counter medications. The bill also would eliminate existing limits on the amounts to be repaid by taxpayers who purchase health insurance through exchanges and receive advance payments larger than the premium assistance credits to which they are entitled.
H.R. 436 combines four bills approved by the House Committee on Ways and Means. CBO has prepared the following cost estimates for those bills:
- H.R. 436, the Protect Medical Innovation Act of 2012, as ordered reported by the House Committee on Ways and Means on May 31, 2012;
- H.R. 1004, the Health Flexible Spending Arrangements Improvements Act of 2012, as ordered reported by the House Committee on Ways and Means on May 31, 2012;
- H.R. 5842, the Restoring Access to Medications Act of 2012, as ordered reported by the House Committee on Ways and Means on May 31, 2012; and
- The Reconciliation Recommendation Related to the Recapture of Overpayments Resulting from Certain Federally Subsidized Health Insurance, as approved by the House Committee on Ways and Means on April 18, 2012.