NTU Sends Memo to Senate HELP Committee on Priorities for the 118th Congress

To: Chair Bernie Sanders, Ranking Member Bill Cassidy, and Members of the Senate Health, Education, Labor, and Pensions Committee
From: Nicholas Johns, Policy and Government Affairs Manager, National Taxpayers Union 
Date: March 17, 2023
Subject: Key Taxpayer Considerations for the First Session of the 118th Congress

  1. Introduction and Key Taxpayer Considerations
On behalf of National Taxpayers Union (NTU), the nation’s oldest taxpayer advocacy organization, we write to inform you of a number of NTU’s top health and labor policy priorities in the 118th Congress.
Joint Employer
The current National Labor Relations Board (NLRB) expansion of the joint employer standard is the latest evolution of bad policy started under the Obama administration in 2015. As NTU has written, this new rule is even more nebulous than the standard promulgated by the Obama-era NLRB. It is clear that Congress should exercise oversight on the development of this rulemaking only two short years after an effective and brightline standard was implemented by the previous administration. Furthermore, to avoid the constant uncertainty the NLRB creates by lurching from one standard to the next, Congress should codify the longstanding joint employer standard created under the Reagan administration. NTU supports legislation like H.R. 3185, the Save Local Business Act.
Independent Contractor
Another significant and concerning rulemaking proposed by the Biden administration is the revised independent contractor definition. NTU urges the Department of Labor (DOL) to halt this new rulemaking, which is a poor use of taxpayer funds and reduces the legal certainty of their employment relationships for millions of freelancers and small businesses nationwide. Returning to the 2021 rule will retain a clear regulatory standard for independent contractors to rely on and guide their business decisions. If DOL does proceed with this rulemaking, then it should remain cognizant of the immense economic and legal risks associated with any potential implementation of California’s failed and controversial AB-5 model. NTU would support legislation to codify the 2021 standard. 
Higher Education Debt Cancellation
The $400+ billion cost of student debt cancellation would be over $400 billion previously borrowed by college students (and their parents) from the federal government and not returning to the Treasury. Policymakers will need to make up for that gap in the future with government spending cuts, tax increases, more borrowing, or some combination thereof. NTU believes that oversight should be exercised on the legal justification for this executive action, its implementation, and the administration’s budget estimates for student debt cancellation. If lawsuits against the administration’s actions do not succeed, Congress should consider enacting legislation to avoid this type of interpretation moving forward. 
Unleashing Workforce Potential
Barriers to well-paying employment are rampant in today’s economy. Patchwork occupational licensing laws, onerous regulatory burdens on educational pathways, and an imbalanced approach to technical education create or contribute to inefficiencies in the employment market. Streamlining these processes will unleash the technical expertise of the American workforce and enable us to compete with China on high-tech manufacturing and in other well-paying industries. NTU supports legislative efforts to right-size employment laws and create pathways to success for American workers through career and technical education that will not unduly burden the taxpayer. 
Reducing Regulatory Barriers to New Cures for Diseases
NTU believes that America’s world-leading biotechnology and pharmaceutical industries set the standard for balancing the pursuit of innovation with the need to ensure sufficient competition in the prescription drug marketplace. During the pandemic, we saw prudent exceptions made to the typically slow regulatory approval process for vaccines and other COVID-19 treatments, through initiatives like the Coronavirus Treatment Acceleration Program and Operation Warp Speed. As variants of current and future diseases evolve and emerge, new solutions must be found for treatment. Seeking federal approval for new therapies often entails onerous regulatory scrutiny that does not reflect or support the creative tempo needed to keep ahead of diseases’ progressions. This creates a huge barrier for new preventive or treatment products to come to market. NTU supports legislative efforts to carefully codify some of the important lessons from the recent pandemic and streamline the approval process for breakthrough cures and treatments for infectious diseases. 
Expand HSAs and Telehealth
Health Savings Account (HSA) expansion is a key element to improving health coverage in America. NTU supports legislation that would create a new safe harbor, allowing patients in a high-deductible plan (HDHP) who have a $0 deductible for primary care services to also open or continue contributing to an HSA. Given primary care use has the potential to lower health care costs in the long run and lead to better health outcomes for patients, this type of HSA expansion has considerable merit.
The Primary and Virtual Care Affordability Act is one example: it would expand HSA eligibility in a way that aligns with how health care is being delivered in the 21st century. NTU would also support legislation increasing HSA contribution limits, delinking HSAs and HDHPs, allowing Medicare beneficiaries to contribute to HSAs, and expanding qualifying medical expenses. 
Narrow Medicare Price-Fixing Requirements from IRA
The Inflation Reduction Act (IRA) has several measures that distort the market for key pharmaceutical innovations in our country. NTU has written extensively on this in the past, and there are several opportunities to make a meaningful difference in restoring more freedom to pharmaceutical innovators. NTU would support measures to delay implementation of IRA drug pricing measures, exempt additional categories of drugs, reduce the number of drugs subjected to Medicare price setting, increase the number of years of exclusivity required for a drug to be covered by price setting, increase the maximum allowable price in negotiations, reduce the excise tax for failure to accept the government’s price, expand the small business carve out, or expand the biosimilar carveout.
  1. Contact Information
We look forward to working with each of you in the new congress and welcome the opportunity to meet with you or your staff on these priorities as the 118th Congress gets underway. Should you have any questions about the recommendations in this memo, please do not hesitate to reach out to Nicholas Johns at NJohns@ntu.org.