A bipartisan Senate health panel is set to meet on Obamacare in September, but lawmakers disagree on funding for insurer payments that would otherwise lead to more exits from health insurance companies and higher premiums for people who don't receive subsidies.
Members of the Senate Health, Education, Labor, and Pensions Committee are holding hearings Sept. 6-7 to discuss how to keep premiums from rising much more than they are, particularly if the payments, called cost-sharing reduction subsidies, or CSRs, are not funded. If cut off, a Congressional Budget Office analysis found, premiums would rise by an average of 20 percent next year.
Areas of political disagreement between Democrats and Republicans became apparent at a Thursday breakfast with congressional aides hosted by the Alliance for Health Care Policy, including on whether and how long the insurer payments, called cost-sharing reduction payments, will be appropriated through Congress. Aides spoke to reporters on the condition of not being named, but were involved with committees on healthcare.
The CSRs are being funded monthly by the Trump administration, but the president has indicated he would consider cutting them off. Senate HELP Chairman Lamar Alexander, R-Tenn., has said Congress should fund the payments.
One House Republican aide said it was "great to see House and Senate Democrats appropriate cost-sharing reduction subsidies."
A Democratic House aide quickly jumped in to respond, saying, "In theory there is no need for Congress to do anything [on CSRs]. But if needed, we can provide a technical fix ... I think if we were in charge, we would say, ‘We're cool here.'"
The dispute over CSRs, which is both political and legal, is over whether the payments, begun under the Obama administration, need an appropriation through Congress. Democrats have said the administration can pay them but must offer certainty that they will be paid out longer-term. A federal judge sided with Republicans on the case, however, and it is now on appeal.
"Nothing is settled yet ... members on both sides have indicated CSR funding is something that is important," a Senate Democratic aide said.
Though most people who sign up for coverage through the Obamacare exchanges are protected from higher rates because the federal subsidies they receive also increase, as many as 9 million Americans make too much to qualify for such subsidies. For an individual, that amounts to making more than $48,240 a year.
It was not clear during the breakfast which policies would receive bipartisan agreement, but the Senate Democratic aide said that a goal of mid-September for a bipartisan plan was reasonable. Final contracts in most states between insurers and state insurance divisions need to be signed by Sept. 27. In many states insurers have filed two separate rates: one that assumes CSRs will be made and another assuming they will not.
"We are eager to turn the page and focus in a bipartisan way without the interference of a partisan fight … and do some of the tweaks that both sides agree are needed," the Democratic aide said.
Republicans also are hoping that discussions on Obamacare will include more flexibility for states, a proposal that the Senate Democrats appear open to having conversations about.
"We think we can have productive discussions about market stabilization and some of the state flexibility idea without getting into ideas that take a chunk out of coverage," the Democratic Senate aide said.