Despite partisan headwinds and a crowded September to-do list, a bipartisan crop of senators is pushing a GOP-led Congress to endorse what would have been unthinkable at the start of the year — a bill to shore up Obamacare.
The Senate Health Committee says Capitol Hill has no choice but to throw a lifeline to Americans facing higher prices and dwindling choices in the individual market, where roughly 20 million Americans buy insurance on their own, after GOP lawmakers failed to send President Trump a bill to repeal and replace the Affordable Care Act.
Republicans thought they’d be presiding over a “stable transition period” to a conservative health care model and fully pivoting to tax reform by now.
Instead, Health Committee chairman Lamar Alexander is urging his GOP colleagues to bless short-term fixes for consumers and insurers who’ve been left in a type of “no man’s land” ahead of this fall’s sign-up period, as Mr. Trump mulls longer-term options for pulling away from the 2010 health law.
“There are a number of issues with the American health care system, but if your house is on fire, you want to put out the fire, and the fire in this case is the individual health insurance market,” Mr. Alexander, Tennessee Republican, said in launching the effort with Sen. Patty Murray of Washington, the panel’s highest-ranking Democrat.
The panel will kick off its push right after Labor Day, vetting ideas from state insurance commissioners and governors who are close to the problem — including Colorado Gov. John Hickenlooper, a Democrat who reached across the aisle to work with Republican Gov. John Kasich of Ohio on a blueprint for reform.
The following week, the panel will hear from witnesses in the insurance and medical industry and experts who’ve studied ways to give states more control of their insurance markets.
Time is of the essence, since insurers must decide by the end of September whether to stay in Obamacare’s markets.
But the legislative push faces skeptics in the House, where conservatives want to revive a fast-track repeal bill, or don’t feel a stabilization bill is necessary. They say a central part of the burgeoning plan — contested “cost-sharing” payments for insurers — are still being paid anyway, and they don’t want to approve money they view as a bailout.
Mr. Alexander and powerful House GOP committee chairmen would prefer to appropriate the money through next year, though they want to pair the funding with efforts to let states duck the law’s tighter strictures on insurers, employers and consumers.
Obamacare’s champions in Congress will object to provisions that undermine the overhaul’s core provisions, though, meaning the health panel faces a thorny path.
“The problem here is that taking away any of the consumer protections is something that makes Democrats uneasy,” said Robert Laszewski, a healthy policy consultant in Alexandria, Virginia. “Just what levels of market flexibility can be agreed to is where Alexander and Murray will have to find the sweet spot.”
Mr. Alexander seemed to acknowledge those challenges during a press event in Tennessee last week, saying: “Many Republicans don’t want to extend the money, and many Democrats don’t want to give states more flexibility. We’re going to have to do some things we don’t want to do for the next year or we’re going to hurt people.”
Congress will also debate an extension of federal payments to the Children’s Health Insurance Program, or CHIP, which was created with bipartisan support in 1997 covers nearly 9 million young Americans. Key members of the Trump administration and the Senate Finance Committee have urged members to reauthorize the program.
Yet Darrell West, director of governance studies at the Brookings Institution said he doubts that Congress can deliver on the Obamacare side, saying there is “too much else going on.”
“It is a contentious subject and Congress has to pass a budget, raise the debt limit, and provide billions to Texas for hurricane relief,” he said. “Those issues will take considerable time and there won’t be much space for other issues. It may even be difficult for Republicans to find time to move on tax reform.”
Mr. Kasich and Mr. Hickenlooper tried to give Congress a bipartisan head start last week by releasing a blueprint that calls on Congress to fund the cost-sharing payments and set aside money for high-cost consumers, while giving states more room to innovate under the Obamacare waiver program known as “1332.”
“Lasting solutions will need support from both sides of the aisle, and we applaud the bipartisan efforts that have now commenced in both the House and Senate,” they wrote to congressional leaders.
Obamacare has divided Capitol Hill for years, however, so politics could still get in the way.
Republican Sens. Lindsey Graham of South Carolina, Bill Cassidy of Louisiana and Dean Heller of Nevada are pushing a bill that effectively would let states take the money they’d receive under Obamacare and spend it how they wish.
The White House has expressed interest in the bill as a way to keep repeal-and-replace alive, though lawmakers are waiting on an analysis from the Congressional Budget Office to see whether the plan can gain traction.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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