Democrats fear that GOP demands for concessions on a bill meant to stabilize insurance markets could lead to the end of key protections for consumers under ObamaCare.
Republicans say that in exchange for funding for insurers that would help prevent an ObamaCare premium spike, Democrats should agree to expanding waivers that could allow states to opt out of certain requirements under ObamaCare.
This could include allowing insurers to not cover services like mental health as part of an insurance plan or rolling back government subsidies that help people afford coverage.
{mosads}“We’re not going to change the waiver system to have a backdoor approach to undo protections of health-care reform,” Sen. Patty Murray (Wash.), the top Democrat on the Senate Health Committee, told reporters Tuesday.
Sen. Lamar Alexander (R-Tenn.), chairman of the Health Committee, says this is all part of the negotiations.
He says Democrats have to give up something in exchange for GOP concessions on funding to insurers, particularly given Republican control of the government.
“To get a Republican president and a Republican House and a Republican Senate just to vote for more money won’t happen in the next two or three weeks unless there’s some restructuring [of regulations],” Alexander said.
The stakes are high and the two sides have little time.
Lawmakers hope to reach a deal by the end of next week, so they can pass a bill by the end of the month.
The centerpiece of the bill would be funding for key ObamaCare subsidy payments known as cost-sharing reductions.
President Trump has threatened to cut off these payments, which have been made by both his administration and former President Barack Obama’s. Conservatives decry them as a bailout to insurers, and there’s no guarantee Republicans will back a bill making the fix no matter what else is in it.
Senate Finance Committee Chairman Orrin Hatch warned in a Washington Post op-ed on Friday against a “bailout” from the subsidy payments and said a bill would need to include “relief for American families and job creators from the onerous mandates and taxes.”
Alexander’s argument is that expanding existing waivers to ObamaCare provisions will provide an incentive for Republicans to back the bill.
“This is a compromise we ought to be able to accept,” Alexander said.
But Sen. Chris Murphy (D-Conn.) said he’s worried about how far the GOP might go in allowing states to make changes.
“The problem is you’re trading really short-term relief on the [cost-sharing reductions] for potentially long-term evisceration of the regulatory guardrails,” Murphy told The Hill. “I don’t know how much we should be willing to give for one year of certainty on [payments].”
This isn’t the only potential stumbling block either.
Democrats also want multiple years of payments to insurers, while Alexander and Republicans are so far only agreeing to one year.
Democrats want to protect what are known as the “guardrails,” which prevent any changes under the waivers from leading to reductions in the number of people with coverage, or less affordable or comprehensive coverage.
Republicans argue that those guardrails inhibit states from innovative solutions.
Another hurdle is that the early deal to fund the government and raise the debt ceiling takes away legislation moving through Congress that a health care deal could have been attached to.
Still, a Senate Democratic aide argued there would be more opportunities for the health-care bill to be attached to something, including possibly reauthorization of the Federal Aviation Administration or another hurricane relief bill.
Despite all these obstacles, there are lawmakers from both parties who still express hope that a deal could be reached.
“I think there’s a deal; I really do,” said Murphy.