Members of the Senate health committee are hoping to ease rising premiums and insurer exits from Obamacare in the face of a tight deadline, though they aren’t certain if Senate leaders will up take the proposal in time or if it would receive a warm welcome in the House or from President Trump.
They also are divided in their goals: Democrats want to inject more funding into the exchanges so that premiums will drop, while Republicans seek to give states more flexibility over their healthcare systems. Sen. Lamar Alexander, chairman of the Health, Education, Labor, and Pensions Committee, said he hopes that committee members can agree to the trade-off as a compromise.
“Obviously when both sides have to give we have some discussions to make,” the Tennessee Republican told reporters.
Alexander will be working this weekend with Washington Sen. Patty Murray, the committee’s top Democrat, to come up with an agreement that they will present early next week, which Alexander said he hopes the executive and legislative branches will agree to. The deadline for a bipartisan deal is set for before Sept. 27, when insurers have to sign contracts in most states to sell coverage on the Obamacare exchanges. It’s possible the administration could push back the deadline, however.
Alexander said he has not received assurances from Senate Majority Leader Mitch McConnell, R-Ky., that the deal on Obamacare would be taken up before the end of the month. “He knows what we’re doing, and I’ve kept him and [Senate Minority Leader Chuck] Schumer up to date with what we are doing,” he said. “They both ask me what progress we are making and I have told them that Sen. Murray and I both think we are both making good progress, and that if we are successful we will bring them something they can deal with in the last week of the month. So they know that we may get a result and if we do, they will have to deal with it in the last week of September for it to have effect in 2018.”
Further complicating the efforts are proposals by several senators that would overhaul the healthcare system but go in different directions.
Four Republican senators have introduced a bill that would divert Obamacare’s revenue to states in the form of a block grant so they could create their own systems. It is sponsored by Sens. Lindsey Graham of South Carolina, Bill Cassidy of Louisiana, Dean Heller of Nevada and Ron Johnson of Wisconsin, following a failure by Republicans in July to repeal portions of Obamacare. Such repeal efforts, through the use of budget reconciliation that allow for passage with 50 votes and the vote of the vice president, face a Sept. 30 deadline for this year.
Alexander told reporters that he does not see those efforts as an obstruction to his, though he declined to say whether he believed the bill stood a chance at receiving a vote.
“It’s a serious effort,” he said. “I have always supported block grants. Sen. Cassidy said yesterday that he thinks what he is doing is a complement to what we are doing. We are focused on the short term … Sen. Cassidy and Graham are focused on the long term.”
The same day the GOP bill on Obamacare was introduced, an unprecedented number of Senate Democrats, 17, backed a single-payer bill by Sen. Bernie Sanders, I-Vt., even as Democratic House leaders say they are focused on fixing Obamacare.
While the single-payer proposal will not get a vote under the Republican-controlled Congress, it entered the conversation during the HELP hearings. Sanders blasted the U.S. for not having a single-payer system last week, and Sen. Elizabeth Warren, D-Mass., who also supports single-payer, blasted insurer Anthem on Thursday for profiting off government funding in programs such as Medicare and Medicaid, while pulling out of some exchanges.
“If you’re curious about why a majority of Americans support Medicare for All,” she said. “Here’s exhibit A.”
Polls show that single payer receives varying levels of support depending on the phrasing used and tends to lose support when it is presented as the government having more involvement in healthcare or as a system that would result in higher taxes.
Other lawmakers used the HELP hearings as a vehicle to express their preferences on changes they believed should be made to Obamacare, even though they wouldn’t be included in an Obamacare stabilization bill. Sen. Tim Kaine, D-Va., on Thursday said he supported a public option that customers could buy into, and Sen. Susan Collins, R-Maine, who for years has opposed Obamacare repeal, this week introduced a bill that would define full-time work as 40 hours a week, rather than 30. She noted Thursday that someone who gets a raise may then be blocked from receiving federal subsidies to buy insurance and ultimately end up paying more out of pocket for healthcare coverage than if he had a lower income.
“In the ACA there are many provisions that discourage work,” Collins said.
Lawmakers also have decried the prices associated with the cost of healthcare during the two weeks of HELP hearings, but for now leaders of the committee said see the task is focused on Obamacare for 2018, whether that means allowing states to craft their own plans or whether that means a year or several years of insurer funding for out-of-pocket costs, or increasing the cost of outreach to consumers.
“When Sen. Patty Murray and I say we want to get a result, we usually do,” Alexander said in concluding the last of four hearings. “We try to remember the institution is more important than our own opinion.”
