House resisting Senate push for short-term Obamacare fix

Some Republican senators are considering the possibility of a narrow, standalone healthcare bill that would ensure funding for Obamacare’s insurer subsidies, but are getting resistance from House Republicans.

The Senate is wrestling with how to handle a larger, House-passed bill to partially repeal and replace Obamacare. But that process could take months, and insurers are nervous that these cost-sharing reduction payments could soon be reduced or eliminated by the Trump administration unless they are guaranteed by new legislation.

Insurers have said they need to know as soon as possible whether the payments will be made for 2018 since they are formulating rates for next year and have to publicize them in a matter of weeks. Without the payments, insurers have said, they could be forced to drastically raise premiums or leave Obamacare’s exchanges altogether.

Given this potential problem, Sen. Ron Johnson, R-Wis., told reporters Monday he wants to do “something very quickly short-term to stabilize the insurance markets for 2018.”

“This process has dragged on longer than I would have liked,” said Johnson. “They need some certainty as to what is going to happen in 2018.”

Sen. Bill Cassidy, R-La., agreed Congress needs to swiftly appropriate the CSR payments, which reimburse Obamacare insurers for lowering copays and deductibles for low-income customers.

“We need to stabilize premiums, or we are not gonna have a market,” he said.

But Johnson admitted that the idea of a standalone bill that just deals with CSR payments is falling flat in the House. He said he met with some House lawmakers on Monday afternoon, but came away empty.

“There is obviously resistance to it,” he said. “I am just saying on the record that is what we need to do to stabilize the markets I would be willing to swallow something I normally wouldn’t support.”

Other senators said they have heard of a similar pushback to the idea of a narrow bill that gives insurers a quick fix.

“It’s my understanding that the House has not been interested in appropriating the funds,” Collins said.

Some House members have said outright that they were opposed to a short-term fix for what they say is a long-term problem.

“Short-term Band-Aids are not the solution here,” said Rep. Tom MacArthur, R-N.J. “The system is imploding, and we need long-term answers.”

MacArthur negotiated with House Freedom Caucus members to amend the American Health Care Act, a bill that guts Obamacare, which helped get the bill passed in the House earlier this month.

He and other House members would rather see the Senate finish its own version of the AHCA quickly and then pass it to give insurers certainty. The House bill would keep the CSR payments going for two years and then transition away from them.

But that seems unlikely to happen, which is why senators are floating the idea of a standalone bill. Senate leaders have indicated they are going to start from scratch on their own healthcare bill, which is likely to take weeks and likely months.

Insurers, meanwhile, are facing a more immediate timetable. Several states have already asked for rates for 2018 for the individual market, which houses Obamacare’s exchanges and is used by people that don’t have insurance through work.

Rates for plans offered in 38 states and the District of Columbia are due on June 21, and insurers want to get some kind of signal on whether the CSRs will be around by then.

MacArthur said there “might be a sense of direction” in the Senate bill by then to help send a signal to insurers.

“I am optimistic they are not going to start from scratch, will work with the framework that we sent and make some adjustments maybe around the tax credits or Medicaid,” he said.

Rep. Mark Meadows, R-N.C., chairman of the conservative House Freedom Caucus, said he was in favor of continuing the CSRs but only if they were tied to full repeal and replacement of Obamacare.

The timetable for the Senate bill isn’t the only issue facing the CSRs, as it remains unclear how a federal lawsuit involving the payments will play out. The House sued the Obama administration in 2014 and argued that Congress should have appropriated the CSRs.

A federal judge sided with the House last year, but the Obama administration appealed. The lawsuit has essentially been in limbo since Trump’s win last November, and the Trump administration on Monday asked for another 90-day delay in the court proceedings.

The joint filing said that both the House and Trump administration are continuing to work on solutions that negate the need for the appeal, “including potential legislative action.”

This post originally appeared on Washington Examiner


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