Sen. Lamar Alexander, chairman of a key committee that has been working on a bipartisan deal to stabilize Obamacare, said Tuesday that he has arrived at an agreement with Sen. Patty Murray, the committee's top Democrat.
The deal would fund Obamacare's insurer funds, known as cost-sharing reduction payments, for two years, and includes what Alexander refers to as "meaningful flexibility" for states. Trump abruptly cut off the subsidies last week, and the bipartisan deal would reinstate them for the end of this year.
It would allow insurers to sell "copper plans," to people who are older than 30, which tend to have higher deductibles and offer fewer benefits than more expensive options, but could be one way to attract individuals into the market who have fewer medical needs. States also would receive grants for outreach, paid for by user fees, to help people enroll in the plans.
Under the plan, states would be able to apply for waivers faster and the timeline would be shortened for them to be approved by federal officials, a process that currently takes months. The waivers allow states to change the details of Obamacare in ways that allow them to offer lower prices for coverage as well as more options.A provision in Obamacare that allows insurance companies to sell coverage across state lines, known as health compacts, also would be encouraged under the plan, Alexander said.
"This is a small step, I'd like to undersell it, not oversell it," said the chairman of the Senate Health, Education, Labor and Pensions Committee, adding that he hoped to release legislation this week.
Alexander said he is trying to line up Republican co-sponsors, while Murray is trying to get enough co-sponsors on the Democratic side as well. Murray said during remarks to reporters that more details were being ironed out, but that she was optimistic they would be able to make an announcement soon.
Senate Minority Leader Chuck Schumer said the bill received "broad support" during a lunch with Democrats."We think it's a good solution," he said. "I think there is growing consensus that in the short term we need stability in the markets." The bill, he added, would include "significant anti-sabotage provisions."
The Tennessee Republican cautioned that the changes wouldn't affect requirements that insurance plans cover people with pre-existing conditions and cover essential health benefits such as mental health and maternity care.
Alexander said that the deal would give "significant flexibility" to states, but it is not clear how much more flexibility they would receive from the federal government. He hinted the deal would make it easier for the federal government to approve waivers, a key problem as it currently takes about six months to get an initial approval from the Department of Health and Human Services.
Alexander was bullish on the prospects for a deal.
"The president likes this idea," he said. "There is emerging encouraging consensus and we will see how far it goes."
Trump has framed the deal as a short-term fix before Republicans take up an effort to repeal and replace Obamacare again in 2018. On Tuesday, ahead of the deal, he said that Obamacare was "on its final legs" and "virtually dead." He has also said publicly that he made the decision to end the payments to force Congress to come to a deal on healthcare.
But a critical question mark lingers on House support. Speaker Paul Ryan told Senate Majority Leader Mitch McConnell in September that a bipartisan deal isn't viable in the House. Democrats charged that Ryan tried to scuttle the Alexander-Murray talks to pave the way for a last-minute attempt to overhaul Obamacare, which eventually failed. The plan also has been slammed by the Republican Study Committee chairman, Rep. Mark Walker, R-N.C., who oversees the 170-member caucus.
Alexander said he spoke to Ryan a few weeks ago to give him an update on the new talks.