Mixed signals from President Trump and opposition from House Republicans will make it difficult to pass a stand-alone bill to fund ObamaCare subsidies before December, Senate Republican sources say.
But Republican leaders are looking at attaching a bipartisan health care deal to a major bill, likely a package funding the federal government beyond Dec. 8 or an end-of year spending deal.
That move would likely reduce insurance rates beginning in October of 2018 — just one month before the midterm elections, when Republicans will be defending their House and Senate majorities.
“It’s not going to be a standalone vote. Now we’re going to be in a wait-and-see mode until CHIP or the CR,” a senior Republican aide said, referring to a bill to reauthorize the Children’s Health Insurance Program and a continuing resolution (CR) to fund the government beyond Dec. 8.
Pushing action until the end of the year means that Congress will not be able to reduce individual insurance premiums immediately; ObamaCare’s open enrollment period for next year begins on Nov. 1 and is scheduled to end Dec. 15.
But if a deal crafted by Senate Health Committee Chairman Lamar Alexander (R-Tenn.) and Sen. Patty Murray (Wash.), the ranking Democrat on the committee, passes by the end of the year or early next year, insurance rates could drop significantly ahead of the enrollment period for 2019.
“We won’t be able to lower premiums for 2018,” said the senior GOP aide. “The good news is that premiums in 2019 will lower dramatically. The new insurance rates will be released by Oct. 8, just before the midterms. From our perspective, that’s great.”
Senate Democratic Leader Charles Schumer (D-N.Y.) on Wednesday floated the possibility of delaying ObamaCare’s open enrollment period for a month, so that insurance rates would not jump by as much as 20 to 25 percent in some areas.
Trump last week announced he was going to halt the payment of cost-sharing reduction subsidies, which the federal government has been making to insurance companies to make up for losses they incur for covering older and sicker patients.
Without a guarantee that the government will help offset costs, insurance companies might set higher rates for the upcoming enrollment period.
Once those rates are set, it will be difficult to reduce costs for consumers in 2018, even if Congress passes the Alexander-Murray agreement. The bill would fund the cost-sharing subsidies through the end of 2019 and grant states more flexibility to waive ObamaCare’s regulatory requirements.
Still, there are ways for insurance companies to lower premiums in 2018 if Congress doesn’t pass a deal until December. Insurers could offer policy holders rebates or holidays — months during which they wouldn’t be charged premiums — or re-file insurance rates midway through next year.
But passage of a deal in December would almost certainly be felt in October of 2018.
Senate Republicans are hoping to get a political boost when consumers see insurance rates shortly before next year’s election.
“As long as we pass a bill before March or April, next year becomes much more simple,” the senior aide said.
Senate Republicans say the prospects of passing a stand-alone bill before December are slim.
White House director of legislative affairs Marc Short said on CNN Thursday evening that the bill needed to be moved substantially to the right to win Trump’s support.
“We need a lot more than what’s in the bill right now,” he said.
Short called for relief from ObamaCare’s mandates for people to have coverage and for employers to provide it.
“If we really want to reduce prices, then we need to begin repealing the mandates and repealing the taxes and then we could have a deal,” Short said.
But changing the mandate for people to have coverage would upset the balance struck with Democrats, likely driving them away from the deal.
Trump himself, though, has not made those same requests, instead tacking back and forth on the agreement.
On Tuesday, Trump seemed to endorse the deal, then later blasted it as “bailing out” insurance companies, before saying on Thursday that he is “open to it.”
That has given political cover to House conservatives to oppose the deal.
Rep. Mark Walker (R-N.C.), the chairman of the conservative Republican Study Committee, a caucus that includes more than 150 House Republicans, said on MSNBC’s “Morning Joe” that he was “strongly against it at this point.”
Walker also tweeted “this bailout is unacceptable” after Alexander and Murray announced their deal.
On Thursday, Trump seemingly reversed course and said he was “open to it,” arguing the agreement would protect people from premiums increases while Congress works on transforming ObamaCare’s subsidy programs and Medicaid expansion into block grants for states.
But Senate GOP sources say Trump’s inconsistent statements have made it tougher to pass the healthcare bill through the House, closing the door on a stand-alone vote.
“The House is the higher hurdle,” said Sen. Ron Johnson (R-Wis.), who has proposed several changes to make the Alexander-Murray package more palatable to House Republicans.
Johnson, who has been in contact with House lawmakers, wants to expand the use of “consumer-directed” accounts — such as flexible spending arrangements and health savings accounts — to purchase expanded insurance options and delay the enforcement of the employer mandate to shield an estimated 90,000 businesses from federal fines.
Alexander has been trying to assure Trump that the bill is not a bailout for insurance companies, given that there is a provision requiring that insurers pass on the payments they are receiving to consumers in the form of a rebate or another mechanism. Alexander has said that provision could also be strengthened.
Alexander has noted that Trump has encouraged him to make a bipartisan deal in phone calls.
(First reported by The Hill) http://thehill.com/policy/healthcare/356482-gop-eyes-move-to-lower-premiums-right-before-2018-elections (October 20, 2017)
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