Health insurers and state officials are lining up in support of two senators’ bipartisan proposal to stabilize the Affordable Care Act—even as the measure’s fate appears to be getting dimmer.
“AHIP supports and is encouraged by this bipartisan legislation, and we thank Senators [Lamar] Alexander and [Patty] Murray for their continued commitment to developing solutions that will help ensure the American people have a pathway to more affordable coverage and health care.,” America’s Health Insurance Plans said in a statement on Wednesday.
In particular, the trade group supports the continuation of funding for cost-sharing reduction payments, “which makes it more affordable for low- and middle-income Americans to see their doctor or fill their prescriptions.”
The Alliance of Community Health Plans concurred.
“Cost-sharing reduction subsidies are critical to ensuring access to affordable health coverage for millions of working Americans,” said ACHP President and CEO Ceci Connolly. “We are pleased to see a bipartisan proposal moving forward in the Senate and look forward to additional details.”
President Donald Trump has long criticized CSR payments as “bailouts” for insurers, an argument he’s revived in recent days despite initially appearing to support the Alexander-Murray deal. He reiterated his position Wednesday, saying, “I won’t do anything to enrich the insurance companies, because right now the insurance companies are being enriched.”
But it's misleading to call CSR payments “bailouts,” as many witnesses said during a recent series of series of hearings before the Senate Help, Education, Labor and Pensions (HELP) Committee. The government reimbursements do go to insurers, but cover out-of-pocket healthcare costs for eligible low-income enrollees. They're not intended to prop up insurers.
In fact, to make certain that CSR payments aren’t used to enrich insurers, the Alexander-Murray bill would require insurers to offer the subsidies as one-time or monthly rebates to consumers—or they will be repaid to the federal government, according to NPR, which obtained a draft of the measure.
Adding further doubt about the future of the bill, though, a White House official said Wednesday night that it should include "relief" from the ACA’s individual mandate, according to The Hill. Democrats would most likely not agree to that, as the mandate is one of the law’s core components.
State officials step into the fray
While the political tussle over the Alexander-Murray bill continues on Capitol Hill, a coalition of state attorneys general is continuing its court battle to save the CSR payments.
The officials, representing 18 states and the District of Columbia, filed a motion (PDF) seeking a temporary injunction to compel the Trump administration to continue paying the subsidies until the lawsuit they filed earlier this week is resolved.
That suit argued argues that the federal government is required to make CSR payments under law, and failure to do so would be “arbitrary and capricious” in violation of the Administrative Procedure Act.
Other state officials are also piping up in defense of the Alexander-Murray deal.
A bipartisan group of governors sent a letter on Wednesday to House and Senate leaders, urging them to pass the ACA stabilization bill and continue funding for CSRs.
Once again, Republican and Democrat governors join together, united in support of the bipartisan efforts of Sens. Alexander and Murray to bring real, positive change to America’s health care system. pic.twitter.com/ZK0ndgHmVP— John Kasich (@JohnKasich) October 19, 2017
“We urge Congress to quickly pass legislation to stabilize our private health insurance markets and make quality health insurance more available and affordable,” said the letter, a copy of which was tweeted by Republican Gov. John Kasich of Ohio.
“With the elimination of the federal payments for the cost-sharing reduction program, insurers are faced with significant financial losses, which could force them to withdraw from the marketplace, or, in some states, request significant rate increases,” the letter added.