Almost eight months after President Donald Trump took office and promised to immediately repeal Obamacare, Republican senators are instead developing a small package of changes to help the Affordable Care Act system rather than end it.
Sen. Lamar Alexander, the Tennessee Republican taking the lead on some of the efforts, said he wants an Affordable Care Act package to include money for insurers to defray low-income Americans' health costs, as well as flexibility for states to decide how they cover their citizens under the law.
"This hearing is about taking one small step, a small step on a big issue which has been locked in partisan stalemate for seven years," Alexander said Wednesday at a hearing by the Senate Health, Education, Labor and Pensions Committee, of which he is chairman.
The new, more modest plan is a sharp change of direction after Republicans' efforts to repeal the Affordable Care Act failed earlier this summer. In another shift, GOP and Democratic lawmakers have pledged to work together on the changes and appeared during the hearing to be prepared to iron out any differences. Alexander said that members of both parties will have to agree to proposals they might not be comfortable with.
"Democrats will have to agree to something — more flexibility for states — that some are reluctant to support. And Republicans will have to agree to something — additional funding through the Affordable Care Act — that some are reluctant to support," he said.
Timeline for Bill
Alexander said his hope is to pass a bill by the end of the month. The Senate just returned from its summer break and is convening a series of hearings on the Affordable Care Act.
Sen. Susan Collins, the Maine Republican who was one of three votes against de-funding the ACA in July, dooming the GOP effort, called the hearings — which Republicans declined to hold during their repeal effort — a promising first step.
"They will help us come up with a solution to help further stabilize the markets and correct a few, not all, but a few of the flaws in the ACA," Collins said Tuesday.
It's likely, said Collins, that some of those efforts could be combined into a single bill in order to get it through both chambers. Yet other items, such as debate over tax reform, immigration, and investigations into the Trump administration and the election, could become obstacles.
Insurance Commissioners
Five state insurance commissioners at the hearing from Tennessee, Pennsylvania, Alaska, Washington and Oklahoma strongly backed funding payments that go to health insurers to reduce low-income patients' out-of-pocket medical costs. Known as cost-sharing reduction subsidies, or CSRs, the Trump administration has threatened to stop making the payments.
"The CSR funding issue is the single most critical issue that you can address to help stabilize insurance markets for 2018 and potentially bring down costs," said Tennessee insurance regulator Julie Mix McPeak, who is also president-elect of the National Association of Insurance Commissioners.
