Democrats and Republicans tasked with forging a bipartisan bill to stabilize Obamacare are at odds over how much flexibility to give to states to avoid some of the law’s regulations.
The Senate Health, Education, Labor and Pensions Committee held another hearing Tuesday in a series on stabilizing the individual market, which includes Obamacare’s marketplaces. The hearing focused on how much flexibility to give to states on insurance coverage and plans for Obamacare.
Democrats opened the hearing worried that the push for more flexibility from Republicans is a workaround to eroding Obamacare’s protections.
“Democrats will reject any effort to use this discussion as a way to erode the guardrails and protections that so many patients and families rely on,” said Sen. Patty Murray of Washington, the panel’s top Democrat, in her opening statement.
HELP Chairman Lamar Alexander, R-Tenn., said there needs to be improvements to the state innovation waiver, called the 1332. He said the application process for the waivers, which allow states to waive key requirements that insurers must abide by in their state, are too cumbersome and inflexible.
He added that he doesn’t support changing the patient protection guardrails, which include protections for people with pre-existing illnesses.
The waivers are used by states to make changes to matters such as the requirements for essential health benefits and the types of plans offered on the marketplace. However, the Affordable Care Act includes guardrails that say coverage must still be as comprehensive in the plans.
Alexander called for easing the waiver process, which can takes six months to review the waiver.
He pointed to Alaska, which created a reinsurance program that pays Obamacare insurers with the sickest claims.
“Let’s ease the process of applying so that more states can do what Alaska has done, but faster, and let’s give states actual flexibility in their approaches, like Massachusetts requested,” he said, referring to Massachusetts’ waiver for a premium stabilization fund.
Alexander has said he hopes to put a bipartisan stabilization package together by the end of the week. However, there are still lingering doubts about what will be in the package, with Democrats wanting to include the creation of a federal reinsurance program and funding for Obamacare ads that were cut by the Trump administration.
Alexander wants a short-term deal that includes more waiver flexibility and funding for insurer subsidies for 2018.
