Republican senators are not dismissing the idea of giving states waivers to opt out of Obamacare requirements that prevent insurers from charging sicker people more money.
But they say much more money is needed to provide a safety net to ensure that those people can get affordable coverage.
An amendment to the American Health Care Act would let states opt out of Obamacare’s community rating mandate, which forces insurers to not take into account health history when creating rates. The Congressional Budget Office said the amendment could lead to higher prices for sicker people who live in states that get a waiver.
But some senators didn’t dismiss the waiver entirely, saying that states need some type of flexibility.
“We want states to have flexibility, but that is why you need some kind of federal support or backstop such as a risk pool or reinsurance,” said Sen. John Hoeven, R-N.D.
While the legislation, which narrowly passed the House this month, included $23 billion in funding for invisible high-risk pools, the CBO said the amount was far from enough.
Hoeven said the funding needs to be higher but didn’t say by how much or how it would be paid for.
“We are working to get information from insurance industry and actuarial people so that we can have a number that they say works,” he said as he went into a closed-door meeting.
Sen. Bill Cassidy, R-La., who also attended the meeting, added that more money is needed for such a backstop.
“You have to do something very robust,” he said.
Cassidy said that an invisible risk pool is a better method for covering sick people than a traditional pool.
A regular high-risk pool segregates people with pre-existing conditions from the individual market, which is used by people who don’t get insurance through their employer, and the government subsidizes their care. An invisible pool keeps them in the individual market but still pays for their care.
Republicans routinely point to Maine’s invisible risk pool as evidence the program works, as it helped to lower premiums.
However, experts have said that Maine’s individual market was in shambles and premiums were already high.
Sen. Susan Collins, R-Maine, also said $15 billion a year is needed to make her state’s program go national, far more than what the American Health Care Act would provide. The bill would provide $15 billion over eight years and another $8 billion over five years.
