Policy

Will Congress support bipartisan proposal to restore health insurance subsidies Trump ended?

The proposed legislation seeks to provide funding for subsidies to insurance companies to support lower-income Americans and more flexibility for states without doing away with core Obamacare provisions. It drew a mixed response from Republicans.

Following President Donald Trump’s move last week to cease payments to health insurance for subsidies to provide health insurance for lower-income Americans on the insurance marketplace set up through the Affordable Care Act, two senators have come up with a bipartisan proposal that would fund those payments for the next two years. The goal is to stabilize the health insurance markets ahead of Open Enrollment, which begins next month.

The compromise from Sens. Lamar Alexander (R-Tennessee) and Patty Murray (D-Washington) would provide states with greater flexibility under the Affordable Care Act in exchange for authorizing cost-sharing reduction payments known as CSRs for two years, according to The Washington Post. Those payments help offset deductibles and other out-of-pocket costs for low-income consumers who obtain insurance under the ACA.

Those out-of-pocket costs include deductibles, coinsurance and copays. People who qualify for the subsidies make up to four times the Federal Poverty Level —$47,000 for an individual and $97,000 for a family of four.

The bill would also expand eligibility for catastrophic plans for people aged 30 and over and would maintain a single risk pool to prevent people with serious medical needs from being priced out. It also requires the Department of Health and Human Services to boost funding for outreach and enrollment assistance activities for 2018 and 2019.

In a statement on the Senate floor, Alexander acknowledged that the seven-year partisan stalemate over ACA has largely been over the six percent of Americans who get their insurance through the individual market.

“It is only about 10,000 people in Tennessee, but every single one of them is terrified that skyrocketing premiums and the possibility that they may not [be] able to buy insurance at all if we don’t act. The best course is to take this limited bipartisan first step that would avoid the chaos that could occur in 2018 and 2019 if premiums continue to skyrocket and millions of Americans would find themselves without a way to purchase health insurance.”

Although the proposal would give states more flexibility, it would keep intact ACA requirements that plans cover essential benefits and people with pre-existing conditions.

Republicans response to the proposal was mixed. Although Freedom Caucus Chairman Mark Meadows said it was “a good start”, Republican Study Committee Chairman Mark Walker was less than enthusiastic, as per his quote cited by Axios.

“The GOP should focus on repealing & replacing Obamacare, not trying to save it. This bailout is unacceptable.”

Trump’s argument for ending the subsidy payments stemmed from a decision by a federal district court judge that the payments were unconstitutional because Congress never explicitly provided money for them. That move prompted legal challenges from at least 18 state attorneys general.

Photo: Justin Sullivan, Getty Images

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