WASHINGTON — Senators are launching hearings to help Republicans and Democrats decide if they can forge a modest agreement to shore up the nation’s individual insurance markets. The effort will show whether divided Republicans are ready to pivot from trying to obliterate the Obama health care law to helping it survive, and if both parties can overcome lingering raw feelings over that battle.
The Senate health committee was holding the first of four scheduled hearings Wednesday, with testimony planned from five states’ insurance commissioners. The session comes with analysts expecting 2018 premium increases to match or exceed the average 25 per cent boosts on midlevel plans sold this year on the government’s Healthcare.gov online marketplace. Insurers say additional upsurges are possible due to uncertainty over actions by the Trump administration.
In addition, nearly half the nation’s roughly 3,000 counties are expected to have only one insurer offering coverage on government insurance exchanges next year. Republicans say that lack of competition shows a failing of President Barack Obama’s 2010 health care law. Republicans also had asserted that a handful of mostly rural counties would have no insurers selling policies in 2018, but the latest federal figures project that will not happen.
The bipartisan push is being led by health committee chairman Lamar Alexander, R-Tenn., and the panel’s top Democrat, Patty Murray of Washington state. Alexander wants a bill approved by late September — when insurers must decide whether they will sell policies on the government marketplace — in hopes that the legislation would avert even steeper premium increases.
“We’ll see if there’s a limited bipartisan step we can take,” Alexander said in an interview Tuesday. “The timing is challenging. Getting Congress to do something in three weeks is hard to do.”
Alexander envisions a bill that would finance government subsidies to insurers for 2018. The payments, which cost around $7 billion this year, compensate companies for lowering out-of-pockets costs for customers’ deductibles and co-payments, which Obama’s law requires. Almost 7 million lower-earning people benefit from the reductions.
The subsidies are also legally required, but they’re the subject of a federal court case over whether Congress properly approved the payments. President Donald Trump has threatened to halt them, calling them bailouts for insurers. Insurance companies and nonpartisan budget analysts say blocking that money would prompt insurers to raise premiums even further, and lawmakers from both parties want the payments to be approved.
In return for the money, Alexander wants to make it easier for states to get waivers so insurers could provide less stringent coverage than Obama’s law requires. He’s been vague about details, but said he personally would not favour easing requirements, including coverage for people with pre-existing medical conditions and specified services, like maternity care, that insurers must provide.
Murray has said she wants the cost-reduction payments to be extended for multiple years, not just one, and favours creating another federal fund states could tap to help insurers contain premiums. She’s also warned she’ll oppose weakening Obama’s statute.
“This needs to be a conversation about moving our health care system forward, not backward,” she said in a written statement last week.
A coalition of insurance, doctors and hospital groups wrote the two senators Tuesday, saying that “uncertainty will persist” in the individual insurance market unless Congress extends the payments for at least two years, defying Trump. The organizations, which included America’s Health Insurance Plans, said an extension would help “bring much needed stability” to those markets. That group is a political advocacy and trade association with about 1,300 member companies selling health insurance coverage to more than 200 million Americans.
The states whose insurance commissioners testify Wednesday range from Oklahoma, where every county is projected to have just one insurer selling individual policies on the marketplace next year, to Washington, where most counties are expected to have two insurers or more. Officials from Tennessee, Pennsylvania and Alaska will also appear.
Hardened partisan positions might be hard to overcome after the two parties fought bitterly all year over the GOP repeal drive. And Republicans are split: While Trump and conservatives want the GOP to revive a full-fledged drive to erase the law, Senate Majority Leader Mitch McConnell, R-Ky., has resisted doing so without the votes to prevail.
The chemistry between Trump and Senate Republicans remains uncertain after Trump spent August repeatedly assailing McConnell and GOP senators for letting the health bill crash. McConnell opened the Senate’s return from summer recess Tuesday listing a busy September agenda that excluded mention of health care.