WASHINGTON – Despite broad support from consumer advocates, state officials and health care leaders across the country, a bipartisan effort in Congress to stabilize health insurance markets and control rising premiums is being threatened by resurgent political fighting over the Affordable Care Act.
With time running out before millions of Americans could be subject to major rate hikes, it is increasingly unclear if Congress will be able to come together to offer relief.
The bipartisan health care push in the Senate health committee – spearheaded by Chairman Lamar Alexander, R-Tenn., and Sen. Patty Murray of Washington, the senior Democrat – has spawned an unusual outbreak of harmony between Republicans and Democrats over the last several weeks.
And it has fueled hopes that after seven years of bitter partisan fighting over the 2010 health care law, often called Obamacare, the two parties might be able to work together to help Americans burdened with rising health care costs.
Republicans and Democrats on the health committee have voiced support for funding monthly payments to insurers that help them offer lower copays and deductibles to millions of low-income consumers.
The uncertainty over these so-called cost-sharing reduction payments – which the Trump administration has repeatedly threatened to withhold – has prompted numerous insurers around the country to warn that they must raise premiums by double digits next year to account for the possibility that they won’t get the federal assistance.
And governors and state insurance regulators from both parties, as well as insurance industry officials, have called on Congress to end the uncertainty.
Tennessee’s regulator, Republican Julie McPeak, last week told the Senate health committee that assuring consistent cost-sharing payments is “the single most important issue” to stabilizing markets.
Senators from both parties also have expressed interest in setting up new systems to protect insurers from big losses if they are hit with very costly patients.
Such reinsurance systems are used in other marketplaces such as the Medicare Part D prescription drug program and are seen as crucial to controlling premiums.
But several senior Republicans – including Senate Finance Committee Chairman Orrin Hatch of Utah – have derided additional cost-sharing payments as a “bailout” for the insurers.
And many GOP lawmakers are demanding that Congress agree to give states greater flexibility to waive requirements in the 2010 health care law dictating minimum standards for what health insurance should cover.
“There still are significant differences to deal with,” Alexander warned Tuesday, noting the importance to Republicans of granting states more power, which many conservatives believe could help lower costs.
“A true compromise requires Democrats to accept something that Republicans want – more flexibility for states – and Republicans to accept something that Democrats want – continued funding for cost-sharing payments in the Affordable Care Act,” Alexander said.
But Democrats and many consumers advocates worry that weakening insurance standards in the current law could make insurance more difficult to get for sicker Americans.
“Democrats will reject any effort to use this discussion as a way to erode the guardrails and protections that so many patients and families rely on,” Murray warned Tuesday.
While debate over the future of consumer protections in the current law intensifies, partisan health care efforts are again proliferating on Capitol Hill.
Democratic lawmakers are lining up behind legislation by Sen. Bernie Sanders, I-Vt., to move toward a “single-payer” model of medical care that would put more health care under the control of the federal government.
And a group of Senate Republicans is kicking off a last-ditch effort to resuscitate the campaign to roll back the Affordable Care Act.
The prospects for both efforts appear dim.
House Minority Leader Nancy Pelosi, D-Calif., a leading liberal, dismissed Sanders’ bill Tuesday, saying her immediate goal is to protect the Affordable Care Act from President Donald Trump’s efforts to dismantle it.
And Senate GOP leaders and the White House are not rushing to embrace the new repeal push by Sens. Bill Cassidy, R-La., and Lindsey Graham, R-S.C.
Sen. John Thune, R-S.D., compared the bill’s chances for passage to “a double bank shot.”
The GOP has less than three weeks before authorization expires to use a special procedure to advance repeal legislation with only 50 votes. “I think that’s just really, really hard,” Thune said.
Alexander said he hopes he and Murray will be able to develop some compromise by the end of next week.
Insurance rates for 2018 for many state marketplaces are supposed to be finalized by the end of this month.