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114th Congress, Vote 375; House of Representatives #160

Protect Medical Innovation Act of 2015

Official Title: To amend the Internal Revenue Code of 1986 to repeal the excise tax on medical devices.

HR 1190: Repealing the ACA's medical device tax
Passed by the House Jun 18, 2015, 280-140 (13 abstaining).

Synopsis: The ACA included a 2.3 percent excise tax on medical devices. The tax is levied on the manufacturer or importer of the devices, and applies to medical devices sold after December 31, 2012. It does not apply to devices that are generally sold directly to consumers (ie, it's for things like pacemakers, dentures, and artificial hips, not Band-Aids and eyeglasses), and it does not apply to medical devices manufactured in the US for export to other countries.

H.R. 160 would repeal the medical device tax, effective the first quarter that starts after the bill is enacted. But there is no provision in H.R. 160 to replace the revenue that would be lost if the medical device tax is repealed. That revenue is currently used to provide premium subsidies to millions of low and middle-income Americans who purchase coverage in the exchanges.

President Obama has promised to veto H.R. 160, but there is widespread support for repealing the medical device tax, even among some Congressional Democrats. The House voted to repeal the medical device tax in 2012 and again in 2014; in 2013 the Senate approved a non-binding resolution to repeal the tax.

In 2015, the Senate introduced their own version of legislation to repeal the medical device tax.S. 149 hasn't advanced out of committee, although it has bipartisan support - probably due in large part to successful industry lobbying.

Why supporters pushed for this bill

  • The medical device tax is seen as stifling innovation, encouraging manufacturers to send jobs overseas and/or reducing manufacturing.
  • The US Chamber of Commerce supports H.R. 160, noting that the medical device tax could increase the cost of health care in the US.
  • AdvaMed, the top lobbyist for the medical device industry, released a study stating that in its first year, the medical device tax resulted in the elimination of roughly 14,000 medical device industry jobs. They also found that another 19,000 jobs were not created, but would have been, absent the device tax.
  • Senator Elizabeth Warren (D, Massachusetts) supports repealing the medical device tax, despite being a strong supporter of the ACA. Warren's position is that the medical device tax will result in fewer manufacturing jobs in the US, and she's stated that our taxation policies should be geared towards increasing - rather than decreasing - manufacturing jobs (although Warren notes that we must find a way to replace the lost revenue if the device tax is repealed). Her position has been criticized by some progressives, but she's joined by other Congressional Democrats - including Senator Al Franken - who also support repeal of the medical device tax.
  • Although the medical device tax is a revenue generator for the ACA's premium subsidies, it's a relatively small amount of revenue compared with other ACA taxes.

Why opponents tried to stop the bill

  • It would be expensive. The Congressional Budget Office estimated that repealing the medical device tax would reduce revenue (and increase federal deficits) by $24.4 billion over the period from 2015 to 2025, assuming the measure is enacted starting with the fourth quarter of 2015.
  • Although opponents of the device tax have stated that its negative impact on the medical device industry is profound, the Congressional Research Service predicts that output and employment in the medical device industry would be reduced by "no more than two-tenths of one percent" as a result of the tax. Industry advocates may have greatly overstated the impact of the tax.
  • The ACA was written to be deficit neutral, with provisions to generate revenue that could be used to significantly expand access to health coverage for uninsured Americans. In addition to medical device manufacturers, new taxes are levied on health insurance carriers, hospitals, home health agencies, clinical laboratories, and pharmaceutical companies (in total, these taxes will generate $165 billion over the next decade). The Center for Budget and Policy Priorities warns that if the medical device tax is repealed, there would be ample motivation for those other industries to seek repeal of their taxes as well, possibly crippling the ACA's revenue stream.
  • Since the excise tax is levied equally on domestically-made and imported medical devices, the Center for Budget and Policy Priorities argues that the device tax will not result in jobs being shifted overseas.
  • Medical device manufacturers and importers stand to gain significant business as a result of health care reform, so it makes sense to ask them to contribute revenue to support health care reform.
06/18/2015 Status: House passed

More: select a member to see his or her other key health care votes.

Yes (280)
R Don Young AK
R Robert Aderholt AL
R Mo Brooks AL
R Gary Palmer AL
R Martha Roby AL
R Mike Rogers AL
D Terri Sewell AL
R Eric Crawford AR
R French Hill AR
R Bruce Westerman AR
R Steve Womack AR
R Trent Franks AZ
D Ann Kirkpatrick AZ
R Martha McSally AZ
R Matt Salmon AZ
R David Schweikert AZ
D Kyrsten Sinema AZ
D Pete Aguilar CA
D Ami Bera CA
D Julia Brownley CA
R Ken Calvert CA
D Tony Cárdenas CA
R Paul Cook CA
D Susan Davis CA
R Jeff Denham CA
R Duncan Hunter CA
R Darrell Issa CA
R Steve Knight CA
D Ted Lieu CA
R Kevin McCarthy CA
R Tom McClintock CA
D Jerry McNerney CA
R Devin Nunes CA
D Scott Peters CA
R Dana Rohrabacher CA
R Edward Royce CA
D Raul Ruiz CA
D Loretta Sanchez CA
D Jackie Speier CA
D Eric Swalwell CA
D Norma Torres CA
R David Valadao CA
D Juan Vargas CA
R Mimi Walters CA
R Ken Buck CO
R Mike Coffman CO
R Doug Lamborn CO
R Scott Tipton CO
R Gus Bilirakis FL
R Vern Buchanan FL
R Curtis Clawson FL
R Ander Crenshaw FL
R Carlos Curbelo FL
R Ron DeSantis FL
R Mario Diaz-Balart FL
D Gwen Graham FL
R John Mica FL
R Jeff Miller FL
D Patrick Murphy FL
R Richard Nugent FL
R Bill Posey FL
R Thomas Rooney FL
R Ileana Ros-Lehtinen FL
R Dennis Ross FL
R Daniel Webster FL
R Ted Yoho FL
R Rick Allen GA
D Sanford Bishop GA
R Buddy Carter GA
R Doug Collins GA
R Tom Graves GA
R Jody Hice GA
R Barry Loudermilk GA
R Tom Price GA
R Austin Scott GA
D David Scott GA
R Lynn Westmoreland GA
R Rob Woodall GA
D Tulsi Gabbard HI
R Rod Blum IA
D David Loebsack IA
R David Young IA
R Raúl Labrador ID
R Michael Simpson ID
R Mike Bost IL
D Cheri Bustos IL
R Bob Dold IL
D Tammy Duckworth IL
R Randy Hultgren IL
R Adam Kinzinger IL
D Daniel Lipinski IL
R Peter Roskam IL
R John Shimkus IL
R Susan Brooks IN
R Larry Bucshon IN
R Todd Rokita IN
R Marlin Stutzman IN
R Jackie Walorski IN
R Todd Young IN
R Tim Huelskamp KS
R Lynn Jenkins KS
R Mike Pompeo KS
R Kevin Yoder KS
R Garland Barr KY
R Brett Guthrie KY
R Thomas Massie KY
R Ed Whitfield KY
R Ralph Abraham LA
R Charles Boustany LA
R John Fleming LA
R Garret Graves LA
R Steve Scalise LA
D Katherine Clark MA
D William Keating MA
D Stephen Lynch MA
D Seth Moulton MA
R Andy Harris MD
R Bruce Poliquin ME
R Justin Amash MI
R Dan Benishek MI
R Mike Bishop MI
R Bill Huizenga MI
R Candice Miller MI
R John Moolenaar MI
R Dave Trott MI
R Fred Upton MI
R Tim Walberg MI
R Tom Emmer MN
R John Kline MN
D Richard Nolan MN
R Erik Paulsen MN
D Collin Peterson MN
D Timothy Walz MN
R Sam Graves MO
R Vicky Hartzler MO
R Billy Long MO
R Blaine Luetkemeyer MO
R Jason Smith MO
R Ann Wagner MO
R Gregg Harper MS
R Steven Palazzo MS
R Ryan Zinke MT
R Renee Ellmers NC
R Virginia Foxx NC
R George Holding NC
R Richard Hudson NC
R Walter Jones NC
R Patrick McHenry NC
R Mark Meadows NC
R Robert Pittenger NC
R David Rouzer NC
R Mark Walker NC
R Kevin Cramer ND
D Brad Ashford NE
R Jeff Fortenberry NE
R Adrian Smith NE
R Frank Guinta NH
D Ann Kuster NH
R Rodney Frelinghuysen NJ
R Scott Garrett NJ
R Leonard Lance NJ
R Frank LoBiondo NJ
R Tom MacArthur NJ
D Donald Norcross NJ
R Christopher Smith NJ
R Stevan Pearce NM
R Mark Amodei NV
R Cresent Hardy NV
R Joseph Heck NV
D Dina Titus NV
R Chris Collins NY
R Daniel Donovan NY
R Christopher Gibson NY
R Richard Hanna NY
D Brian Higgins NY
R John Katko NY
R Peter King NY
D Sean Maloney NY
R Tom Reed NY
R Elise Stefanik NY
D Paul Tonko NY
R Lee Zeldin NY
R Steve Chabot OH
R Bob Gibbs OH
R Bill Johnson OH
R Jim Jordan OH
R David Joyce OH
R Robert Latta OH
R James Renacci OH
R Steve Stivers OH
R Patrick Tiberi OH
R Michael Turner OH
R Brad Wenstrup OH
R Jim Bridenstine OK
R Tom Cole OK
R Frank Lucas OK
R Markwayne Mullin OK
R Steve Russell OK
R Greg Walden OR
R Lou Barletta PA
D Brendan Boyle PA
R Ryan Costello PA
R Charles Dent PA
D Chaka Fattah PA
R Michael Fitzpatrick PA
R Mike Kelly PA
R Tom Marino PA
R Patrick Meehan PA
R Tim Murphy PA
R Scott Perry PA
R Joseph Pitts PA
R Keith Rothfus PA
R Bill Shuster PA
R Glenn Thompson PA
R Jeff Duncan SC
R Trey Gowdy SC
R Mick Mulvaney SC
R Tom Rice SC
R Marshall Sanford SC
R Joe Wilson SC
R Kristi Noem SD
R Diane Black TN
R Marsha Blackburn TN
R Scott DesJarlais TN
R John Duncan TN
R Charles Fleischmann TN
R David Roe TN
R Brian Babin TX
R Joe Barton TX
R Kevin Brady TX
R Michael Burgess TX
R John Carter TX
R K. Conaway TX
D Henry Cuellar TX
R John Culberson TX
R Blake Farenthold TX
R Bill Flores TX
R Louie Gohmert TX
R Kay Granger TX
D Gene Green TX
R Jeb Hensarling TX
R Will Hurd TX
R Sam Johnson TX
R Kenny Marchant TX
R Michael McCaul TX
R Randy Neugebauer TX
R Pete Olson TX
R John Ratcliffe TX
R Pete Sessions TX
R Lamar Smith TX
R Mac Thornberry TX
R Randy Weber TX
R Roger Williams TX
R Rob Bishop UT
R Jason Chaffetz UT
R Mia Love UT
R Chris Stewart UT
R David Brat VA
R Barbara Comstock VA
R J. Forbes VA
R Bob Goodlatte VA
R H. Griffith VA
R Robert Hurt VA
R Edward Rigell VA
R Robert Wittman VA
D Suzan DelBene WA
R J. Herrera Beutler WA
D Derek Kilmer WA
R C. McMorris Rodgers WA
R Dan Newhouse WA
R David Reichert WA
R Sean Duffy WI
R Glenn Grothman WI
R Reid Ribble WI
R Paul Ryan WI
R F. Sensenbrenner WI
R Evan Jenkins WV
R David McKinley WV
R Alex Mooney WV
R Cynthia Lummis WY
No (140)
Our pick
D Ruben Gallego AZ
D Raúl Grijalva AZ
D Karen Bass CA
D Xavier Becerra CA
D Lois Capps CA
D Judy Chu CA
D Jim Costa CA
D Mark DeSaulnier CA
D Anna Eshoo CA
D Sam Farr CA
D John Garamendi CA
D Janice Hahn CA
D Michael Honda CA
D Jared Huffman CA
D Barbara Lee CA
D Zoe Lofgren CA
D Alan Lowenthal CA
D Doris Matsui CA
D Grace Napolitano CA
D Nancy Pelosi CA
D L. Roybal-Allard CA
D Linda Sánchez CA
D Adam Schiff CA
D Brad Sherman CA
D Mark Takano CA
D Mike Thompson CA
D Maxine Waters CA
D Diana DeGette CO
D Ed Perlmutter CO
D Jared Polis CO
D Joe Courtney CT
D Rosa DeLauro CT
D Elizabeth Esty CT
D James Himes CT
D John Larson CT
D John Carney DE
D Corrine Brown FL
D Kathy Castor FL
D Theodore Deutch FL
D Lois Frankel FL
D Alan Grayson FL
D Alcee Hastings FL
D D. Wasserman Schultz FL
D Frederica Wilson FL
D Henry Johnson GA
D John Lewis GA
D Mark Takai HI
D Danny Davis IL
D Bill Foster IL
D Luis Gutiérrez IL
D Robin Kelly IL
D Mike Quigley IL
D Bobby Rush IL
D Janice Schakowsky IL
D André Carson IN
D Peter Visclosky IN
D John Yarmuth KY
D Cedric Richmond LA
D Michael Capuano MA
D Joseph Kennedy MA
D James McGovern MA
D Richard Neal MA
D Niki Tsongas MA
D Elijah Cummings MD
D Donna Edwards MD
D Steny Hoyer MD
D C. Ruppersberger MD
D John Sarbanes MD
D Chris Van Hollen MD
D Chellie Pingree ME
D John Conyers MI
D Debbie Dingell MI
D Daniel Kildee MI
D Brenda Lawrence MI
D Sander Levin MI
D Keith Ellison MN
D Betty McCollum MN
D Wm. Clay MO
D Emanuel Cleaver MO
D Bennie Thompson MS
D Alma Adams NC
D George Butterfield NC
D David Price NC
D Frank Pallone NJ
D Bill Pascrell NJ
D Donald Payne NJ
D Albio Sires NJ
D B. Watson Coleman NJ
D Ben Luján NM
D M. Lujan Grisham NM
D Yvette Clarke NY
D Joseph Crowley NY
D Eliot Engel NY
D Steve Israel NY
D Hakeem Jeffries NY
D Nita Lowey NY
D Carolyn Maloney NY
D Gregory Meeks NY
D Grace Meng NY
D Jerrold Nadler NY
D Charles Rangel NY
D Kathleen Rice NY
D José Serrano NY
D Louise Slaughter NY
D Nydia Velázquez NY
D Joyce Beatty OH
D Marcia Fudge OH
D Marcy Kaptur OH
D Tim Ryan OH
D Earl Blumenauer OR
D Suzanne Bonamici OR
D Peter DeFazio OR
D Kurt Schrader OR
D Robert Brady PA
D Matthew Cartwright PA
D Michael Doyle PA
D David Cicilline RI
D James Langevin RI
D Steve Cohen TN
D Jim Cooper TN
D Joaquin Castro TX
D Lloyd Doggett TX
D Al Green TX
D Rubén Hinojosa TX
D Sheila Jackson Lee TX
D Eddie Johnson TX
D Beto O’Rourke TX
D Marc Veasey TX
D Filemon Vela TX
D Donald Beyer VA
D Gerald Connolly VA
D Robert Scott VA
D Peter Welch VT
D Denny Heck WA
D Rick Larsen WA
D Jim McDermott WA
D Adam Smith WA
D Ron Kind WI
D Gwen Moore WI
D Mark Pocan WI
Not Voting (13)
R Bradley Byrne AL
R Paul Gosar AZ
R Doug LaMalfa CA
R David Jolly FL
R Steve King IA
R Rodney Davis IL
R Luke Messer IN
R Harold Rogers KY
D John Delaney MD
R Trent Kelly MS
D James Clyburn SC
R Stephen Fincher TN
R Ted Poe TX