Obama signs 14th bill making changes to Obamacare

WASHINGTON — President Obama signed a bill Wednesday night making an important change to Obamacare that will prevent health insurance premiums for 3 million people from going up next year.

The Protecting Affordable Coverage for Employees Act seems like an unlikely Washington success story: A bipartisan health care bill passed by both chambers without a single no vote and signed by the president with no controversy or fanfare.

Except it's actually not that unusual. For all the raucous debate over repealing Obamacare, such technical fixes can happen. Since the Affordable Care Act was first passed along party lines in 2010, President Obama has signed at least 14 bills making substantive changes in his signature legislation of his presidency, according to an analysis by the Congressional Research Service. Eight of those have been Republican bills.

"Unbeknownst to the public, there is actually some governing going on," said Larry Levitt, a senior vice president at the Kaiser Family Foundation who worked on health care legislation in the Clinton administration.

But don't get too excited. "I'm not sure this relatively modest measure will pave the way for a raft of bipartisan consensus around the health law," Levitt said. "None of the changes strike at the heart of the law or change it in any substantial way. So maybe it's a little overstated to say it’s actual governing."

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Among the most significant changes made to Obamacare thus far: The 2011 repeal of a provision requiring businesses to report to the IRS any time they made a purchase of more than $600 to a single vendor, and the 2013 repeal of a voluntary long-term care insurance plan that the Obama administration found unworkable.

The law signed by Obama Wednesday makes a minor fix in the definition of a small business that could result in thousands of dollars of savings for 150,000 businesses. Under the original law, small businesses of less than 50 employees have their own special rules requiring specific types of coverage with a higher cost to employers. Beginning in 2016, those special rules were scheduled to apply to small businesses of 51 to 100 employees.

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The new law gives states the ability to decide how to classify businesses of 51 to 100 employees, potentially saving premiums for small business employees from going up 18 percent or more, according to an estimate from the consulting firm Oliver Wyman. And there's a bonus: Reducing workers' insurance premiums means increasing their taxable income, resulting in a $280 million in additional revenues to the federal government over 10 years. That money will go to bolster Medicaid.

"There are a lot of things in the bill that need fixing. I'm for repeal and replace," said Brett Guthrie, R-Ky., the sponsor of the bill. "But here’s the situation: You have people being negatively affected, and so can we find a way to work together to fix it. Sometimes it’s not about who has the biggest lobbying firm. It’s when you have grassroots people who say they’re being negatively affected. ... And this affects businesses every congressional district in the country."

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Grace-Marie Turner of the Galen Institute, a prominent Obamacare critic, said the congressional action comes just under the wire, as insurance companies finish pricing contracts for 2016 coverage. And the quick, businesslike way in which the bill was passed just shows that neither side saw any benefit in politicizing the issue, she said.

"I think here the White House certainly doesn’t want to announce with big fanfare that the Republican Congress has led on making changes on the president's health law," she said. "And the Republicans don't want to say that they’re fixing it, because they want to repeal it entirely."

Still on the agenda for congressional Republicans: a repeal of the 2.3% medical device tax and the "Cadillac" tax on high-cost employer health care plans.