Changing course after a failed healthcare vote last week, senators plan to hold bipartisan hearings in September to evaluate how to stabilize the Obamacare exchanges where 11 million Americans buy health insurance.
The exchanges are deeply damaged heading into the next open enrollment season, which begins in November and allows people who do not have coverage through a job or through the government to buy tax-subsidized coverage. Insurers already have exited some states or are planning double-digit rate increases, and are facing uncertainty over what to charge as they wait to hear about whether the Trump administration will continue to allocate billions of dollars in funding for them.
In a Health, Labor, Education, and Pensions Committee hearing Tuesday, committee Chairman Lamar Alexander said he has urged President Trump to make the payments through September as Congress works on a solution.
"Without payment of these cost-sharing subsidies, Americans will be hurt," the Tennessee Republican said, adding that Congress should work not only to allocate the funds but also toward provisions that include greater flexibility for states in approving health insurance policies.
Senators will aim to begin hearings during the first week in September and to come up with a solution by mid-month, he said.
He noted that the deadline was tight because insurers needed to have final contracts signed with states by Sept. 27, and he warned that if they did not come to a decision, then "millions of Americans with government subsidies in up to half our states may find themselves with zero options for buying health insurance on the exchanges in 2018."
Without action from Congress, people who don't receive subsidies under Obamacare, estimated at between 6 to 9 million Americans, the majority of whom often buy coverage through a broker or directly from an insurer rather than through the exchanges, may be facing premiums so high that they are unable to afford it, Alexander said.
The hearings will bring in insurers, patients, healthcare providers, and governors.
"There are a number of issues with the American healthcare system, but if your house is on fire, you want to put out the fire," Alexander said. "The fire, in this case, is the individual health insurance market. Both Republicans and Democrats agree on this."
Republicans were planning to advance a bill that would repeal and replace portions of Obamacare, but they were unable to come to an agreement about what the legislation should do, particularly when it came to changes proposed for Medicaid and on ways to reduce the costs of premiums. The meetings on these measures were held behind closed doors and crafted by Senate leadership rather than through committees, a process that several senators said they were worried about.
Insurers have said that one of the reasons they are raising rates or leaving the exchanges is because of the uncertainty they faced during this time and from the administration, which they worry may not enforce Obamacare's mandate that penalizes people for going uninsured. Some insurers also have pointed to massive losses they incurred while selling coverage in the exchanges in past years.
The Trump administration has urged senators to continue to work on efforts to repeal portions of Obamacare, but Senate leaders have indicated they are prepared to move on to other issues, such as tax reform. Trump is expected to make a decision about the subsidies this week.