Senators on a key healthcare committee have reached a deal to stabilize Obamacare, but some of the details are still being negotiated as lawmakers work to win support from both Republicans and Democrats.
A document circulating among Republicans showed that the bipartisan plan by Republican Sen. Lamar Alexander of Tennessee and Democratic Sen. Patty Murray of Washington, the top two members of the Health Education, Labor and Pensions Committee, would allow for two years of insurer funds known as cost-sharing reduction subsidies, plus the subsidy payments for the remainder of this year. President Trump abruptly cut off the funding in an announcement last week.
The plan would allow people 30 years and older to buy "copper plans," which cover a lower share of medical costs and have higher deductibles, with the aim of bringing healthier people into the Obamacare exchanges. It would allow states to implement waivers so they could adjust Obamacare's rules, and do so faster.
Here are four questions about the legislation's path to passage.
Will the bill pass the House?
The Republican Study Committee, a group of 170 House GOP lawmakers, made waves when it tweeted shortly after the deal's announcement that it was a "bailout" and the Senate needs to focus instead on repealing and replacing Obamacare.
The criticism was expected as Republicans in both the House and the Senate have derided the cost-sharing payments as a "bailout" to prop up Obamacare's insurers.
House Freedom Caucus Chairman Mark Meadows, R-N.C., was more guarded. He called the deal a "good start" but wanted more flexibility for consumers and states.
House Speaker Paul Ryan has not said if he would bring up the deal for a vote if it passes the Senate. He told Senate Majority Leader Mitch McConnell last month that a deal isn't viable for the House GOP, according to a source familiar with the conversation.
However, that conversation took place in the run-up to an effort to pass a last-minute bill to repeal Obamacare. That bill collapsed, and Trump decided late Thursday to cut off the cost-sharing reduction payments.
Alexander now is working to line up as many co-sponsors as he can for his deal, and he shrugged off the impact of the study committee's criticisms in the House. He also referred to encouragement from Trump, which brings us to question two.
Will Trump support the deal?
Trump endorsed the deal Tuesday at a press conference in the Rose Garden with Greek President Alex Tspiras. He said it would be only a short-term deal and pledged to return to repealing Obamacare after Republicans pass tax reform legislation.
But reports have already arisen of dissent and skepticism in the White House. CNN's Dana Bash reported that a White House official called the deal a "bailout" for insurers.
Then Trump made a cryptic tweet Tuesday evening about high premiums, a reference to attacks from Democrats that his decision to cut off the CSR payments will prompt insurers to raise premiums.
"Any increase in ObamaCare premiums is the fault of the Democrats for giving us a ‘product' that never had a chance of working," he tweeted.
Even if President Trump's support holds, another key question is how fervently he would support it. Trump may be called upon to get wary Republicans on board.
Will states benefit?
States vary in terms of what deals they struck with health insurance companies.
Some allowed insurers to file two separate rates, one that assumed that the cost-sharing payments would be made and one that assumed they would not. In North Dakota, for instance, insurers asked whether they could file new rates, but after they were told no, the insurer decided to remain in the market.
If the funds are appropriated by Congress, some states would see a slight decrease in health insurance rates for silver-tiered plans. Some states, however, are still expecting large increases. In Maryland, for example, rates are expected to increase by an average of 33 percent, and in Virginia, by 43 percent, according to independent analyst Charles Gaba, who supports Obamacare. A member of the health insurance industry recently told the Washington Examiner that "our assumption is everyone will work to be flexible if we can all agree on a good solution for the American people."
On the waiver side of the agreement, the question will be whether the waivers currently under consideration, such as one for Iowa, will be ready in time for open enrollment.
Will the Trump administration delay open enrollment?
Open enrollment has been cut in half this year and will run from Nov. 1 to Dec. 15, for coverage that will begin on Jan. 1.
Many of the changes being discussed in the proposal have little time to go into effect since lawmakers have to drum up support for the bill and then work on passing it. The deal under negotiation includes $106 million for states to use to help enroll people in coverage, but there might not be enough time for the legislation's elements, such as the new copper plan, to become available for 2018.
A senior administration official told the Washington Examiner that no discussions have been held about delaying open enrollment.