Kentucky Sen. Rand Paul urged fellow Republicans on Wednesday to abandon the “bailouts” that would go toward health insurance companies to help stabilize the Obamacare exchanges in the short term.
In a letter to Senate Majority Leader Mitch McConnell that detailed his reasons for opposing the draft healthcare bill, Paul said that the funding for insurers under Obamacare is designed to “backfill the losses the insurers take in the Obamacare exchanges, while they make huge profits in the group markets.” He lamented that insurer profits from 2008 to 2015 had grown from $8 billion per year to $15 billion per year.
The draft, the Better Care Reconciliation Act, calls for providing billions of dollars in funding for four years for states to stabilize the exchanges, and would also fund cost-sharing reduction subsidies, which help insurers offer lower out-of-pocket medical costs to consumers. The funding is meant to reduce disruption for customers in the exchanges, but a Congressional Budget Office report projects that if the bill is signed into law, then 15 million people would be uninsured by 2018 compared to under Obamacare.
Paul was one of at least nine Republicans to oppose the Republican healthcare plan, and on Tuesday, McConnell canceled a planed vote this week to move forward on debate and postponed a deadline to pass the healthcare bill ahead of the Fourth of July recess. Republicans cannot pass the bill if more than two senators in their party oppose it, leaving them to negotiate details of a compromise in the days and weeks ahead.
Paul also asked Republicans to rethink the tax credits that would help people purchase private coverage, saying they were too similar to those in Obamacare, and to do away with a requirement that people who let their coverage lapse face a waiting period of six months before their insurance kicks in, criticizing it as a Republican version of Obamacare’s individual mandate, which fines people if they do not purchase insurance.
“This continues the top-down approach that has led to increased premiums and has not changed behavior of the young and healthy who are priced out of the market, and those who game the system to purchase insurance after they become sick,” he said. “I urge you to remove the mandate and simply allow insurance companies to impose a waiting period.”
On association health plans, he urged Republican leaders to allow small business to pool together to offer coverage, including those who are self-employed, and to allow small businesses to self-insure. He also said the group market contained too many Obamacare regulations.
Paul has criticized much of the Republican plan to repeal and replace portions of Obamacare as “Obamacare lite.” He banded with other conservatives, including Sens. Ron Johnson of Wisconsin, Ted Cruz of Texas and Mike Lee of Utah to oppose the bill as not going far enough to reduce premiums. The group alone was enough to sink a planned debate on the healthcare bill. Paul had a lunch with President Trump on Tuesday, where he detailed his concernes about the bill.
After the meeting, he tweeted: “Just came from WH. @realDonaldTrump is open to making bill better. Is senate leadership?” Paul, however, has also signaled that he would vote in favor of the legislation if Republicans were at an impasse.
“If they cannot get to 50 votes, if they get to [an] impasse, I’ve been telling the leadership for months now that I will vote for a repeal. It doesn’t have to be 100 percent repeal. So, for example, I’m for 100 percent repeal. That’s what I want, but if you offer me 90 percent repeal, I’d probably vote for it. I might vote for 80 percent repeal,” Paul told ABC on Sunday.
