Senate Republicans are willing to fund two years of insurer payments to help stabilize Obamacare, but they say they still haven’t received an adequate trade-off from Democrats to reach a deal.
Republicans are hoping they can pass a bill that would provide more flexibility for how states implement Obamacare. Under the law, states can seek waivers, but the process requires months of work and the involvement of top federal and state officials. States also must meet certain requirements under Obamacare, which Republicans say are too constraining.
The Senate Health, Labor, Education and Pensions Committee has been working since the beginning of September to reach a deal. Part of the bill would include funding two years of insurer payments, called cost-sharing reduction subsidies, which are mired in a legal battle that began under former President Barack Obama. President Trump is authorizing the payments each month, but has not said he would do so in the long term. Without them, more insurers say they would leave the Obamacare market or raise their rates by an average of 20 percent more than expected in 2018, according to a Congressional Budget Office report.
The willingness to fund the cost-sharing payments is a shift for HELP Committee Chairman Lamar Alexander, who said during hearings in early September that he believed the funds should be appropriated for one year. Alexander said Wednesday that he and Sen. Patty Murray, the committee’s top-ranking Democrat, are “still talking.”
“We talked earlier today, we talked yesterday,” he said. “We are talking in good faith. We still have differences in opinion on what amounts to giving states meaningful flexibility in exchange for two years of cost-reduction payments.”
It isn’t clear what offers for state flexibility Murray has made that Republicans have deemed inadequate.
Alexander pushed back on statements from Senate Minority Leader Chuck Schumer, D-N.Y., who called earlier in the day for the Obamacare stabilization bill to be attached to a bill that would fund coverage for low-income children.
“It’s a little premature because we don’t have a deal,” Alexander said. “When we have an agreement I’m going to hand it to Sen. McConnell and Sen. Schumer and I know that they will, in their wisdom, know what to do with it.”
Republicans have pushed for more flexibility with Obamacare, which may include allowing states to shift some of their Medicaid population onto the private market or allowing states to opt out of certain Obamacare mandates. Democrats have been concerned about how far a flexibility provision would go, warning that they will not allow states to deny coverage to people with pre-existing illnesses or charge them more, or allow states to remove mandatory coverage for a range of medical services, from maternity care to addiction treatment.
Republicans stressed Wednesday that they hadn’t received an offer from Democrats that they could support.
“The issue now is how much flexibility will the Democrats allow, as opposed to kind of sticking to the old Obamacare approach,” said Sen. John Barrasso, chairman of the Senate Republican Policy Committee.
One option being discussed was to allow other states to replicate waivers that one state had received, rather than “having to go through the full process,” he said.
Sen. Lindsey Graham, R-S.C., said he hoped the bipartisan conversations could “bear fruit.”
“The changes have to be real because Obamacare is failing, they can’t be cosmetic,” he said. “I hope that Sen. Alexander and Murray can find something we can all rally around. That would be good.”
