With Obamacare in limbo, senators look for fix to stabilize health insurance market
WASHINGTON — With a critical deadline fast approaching, senators began working this week to come up with a bipartisan plan to stabilize the individual health insurance market and guarantee that affordable coverage is available for those who want it.
A Senate committee held the first of four hearings on Wednesday, with the goal of passing a bipartisan bill by the end of the month to provide relief for Americans who buy insurance on the marketplaces created under the Affordable Care Act, or Obamacare.
The Senate Health, Education, Labor and Pensions panel decided to hold the hearings on stabilizing the individual market after the collapse of GOP efforts to repeal and replace Obamacare.
Unless Congress steps in, millions of Americans may find themselves stuck next year with policies they can’t afford — if they are able to buy insurance at all.
Congress has little time to act. Insurers must sign contracts by the end of September to participate in the Obamacare marketplaces, unless President Trump’s administration extends the deadline.
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“Timing is a real challenge here,” conceded Sen. Lamar Alexander, the Tennessee Republican who chairs the committee.
But Alexander said his hope is that by the end of next week, lawmakers can agree on “a limited, bipartisan, simple piece of legislation” that keeps prices down and makes it possible for everyone in the individual market to be able to afford insurance.
“My goal is to make sure that 350,000 Tennesseans and 18 million Americans who buy their insurance on the individual market can be able to do that in 2018 and do it at a price they can afford,” Alexander said.
Citing the experience in his home state, Alexander said that if you’re a Nashville songwriter making $55,000 a year and receiving no insurance subsidies from the federal government, “there’s a real chance that your insurance — and your copays and deductibles — will be so expensive next year that you won’t be able to afford it.”
“And there’s some chance that the insurance company won’t even be able to offer you insurance,” he said. “Last year at this time, Blue Cross Blue Shield pulled out of Nashville, Knoxville and Memphis, and I don’t want that to happen again.”
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In the first of the Senate panel's four hearings, top state insurance officials from five states — Tennessee, Washington, Pennsylvania, Alaska and Oklahoma – testified before the panel on Wednesday. The committee will hear Thursday from the governors of Massachusetts, Montana, Tennessee, Utah and Colorado.
At Wednesday’s three-hour hearing, the state insurance regulators called on lawmakers to continue the cost-sharing payments the federal government provides to insurers to help them offer lower co-payments and deductibles to nearly 6 million low- and moderate-income families.
Tennessee Insurance Commissioner Julie Mix McPeak, president-elect of the National Association of Insurance Commissioners, said cost sharing is the key to stabilizing insurance markets and potentially bringing down costs next year.
McPeak insisted the payments should not be seen as an “insurer bailout.”
To the contrary, she said, cost-sharing funding “ensures that some of our most vulnerable consumers receive assistance for copays and deductibles that are required to be paid under federal law.”
Trump has threatened to end the payments, worth about $7 billion this year. But the nonpartisan Congressional Budget Office projects that premiums would rise 20% to 25% and the federal deficit would increase if Trump cancels the payments.
Alexander said he would recommend continuing the cost-sharing payments for another year.
The state insurance regulators also asked for more flexibility in approving health insurance plans. In addition, they called for a broader conversation about what is driving up the cost of health insurance and specifically the costs of health-care services.
“We can continue to look for solutions to these problems at the state level, but these are national problems that I believe merit national solutions,” Pennsylvania Insurance Commissioner Teresa Miller said.
Meanwhile, in anticipation of this week’s hearings, nearly 100 consumer, patient and provider groups sent a letter to House and Senate leaders on Tuesday asking for “swift” bipartisan action to stabilize the health insurance markets and improve health care for consumers.
“Quick, bipartisan action is critical,” said Craig Obey, deputy executive director of Families USA. “It’s time for both parties to work together to stabilize the insurance markets so health coverage and care remain available and affordable for America’s families.”
The groups’ demands include guaranteed funding for the cost-sharing payments and continued funding for programs that promote health care enrollment under the Affordable Care Act.
The Trump administration announced last week that advertising spent to encourage sign-ups next year will be slashed to $10 million, down from $100 million in 2017. Funding for consumer helpers called “navigators” will also be cut about 40%, from $62.5 million for 2017, to $36.8 million for next year.